Failure to Obtain Consent for Palliative Care – Shocking Result

You can never say you’ve heard it all when it comes to medical malpractice cases. There are an infinite number of ways that medical errors occur. Miscommunication is one of the top three root causes of sentinel events reported to The Joint Commission. See a slide presentation on root causes of sentinel events. Root_Causes_by_Event_Type_2004-2Q2013

The following case has such disturbing implications in its description of aggressive medical care.

A sixty-two-year-old woman was admitted to a Maryland hospital because she had infected bilateral leg ulcers. The physician debrided the ulcers down to the bone. Five days later, a diverting colostomy was performed. Physicians told the family about nine days later that the woman’s prognosis was bleak and that palliative care should be considered. The day after that discussion the physicians administered excessive amounts of morphine, oxycodone, and other narcotics while withdrawing antibiotic treatment. The patient became comatose and died soon thereafter.

The plaintiff claimed that the family told the physicians that they would have to think about it when palliative care was suggested. The hospital, however, felt that consent for palliative care had been given, leading to the administration of the drugs. The defendant denied any negligence. The jury awarded a $958,238.05 verdict.

Comment: The implications of this misunderstanding and miscommunication are stunning. Before the family could really process what the physicians were suggesting, their loved one was gone. What was the rush?

Palliative care implies dealing with symptoms and making a person comfortable, not actively terminating their lives.

Where were the nurses as patient advocates for this patient and her family? Very likely they were carrying out physician orders and administering the medications, just following orders.

I find this case very disturbing. What do you think about it? Share your thoughts in the comments box.

Case: Frank Gargiulo Sr. et al v. Upper Chesapeake Health Center, Harford County (MD) Circuit Court, Case No. 12-C-12-001372 as reported in Laska, L. (Ed) Medical Malpractice Verdicts Settlements and Experts, October 2013, 14-15

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