Is this a malpractice/negligience case?

[cybernana]

What is the name of your state? MN
A patient who is depressed and is a known prescription narcotic abuser is admitted to the hospital for flu-type symptoms. Nurse on duty finds prescription narcotics in patients room but does not confiscate and patient dies the following day from an accidental overdose. Is the hospital, doctor, or nurse negligient in this case? Assume the facts are true and proof is in the medical records.

 

[Ozark_Sophist]

Was the prescription in the patient's name?

Depression is not always an indicator of suicidal behavior. Was it suicide or accidental overdose?

 

[lya]

What is the name of your state? MN
A patient who is depressed and is a known prescription narcotic abuser is admitted to the hospital for flu-type symptoms. Nurse on duty finds prescription narcotics in patients room but does not confiscate and patient dies the following day from an accidental overdose. Is the hospital, doctor, or nurse negligient in this case? Assume the facts are true and proof is in the medical records.

Personal medications should be sent home with family members or sent to the pharmacy for safekeeping, after being recorded and placed in a security envelope.

Hospital policy is also a factor.

By the way, accidental overdose and negligence resulting in death are not interchangeable terms.

 

[Zigner]

Why do all your questions sound like homework assignments?

 

[ecmst12]

Probably just because of the phrasing. But I would be willing to bet that the questions are all related to the same situation.

 

[lya]

Why do all your questions sound like homework assignments?

The stated scenario is 'right out of' Nursing 101's end of chapter questions r/t medical-legal liability. I chose to answer it with very basic information that will require further 'digging in' to the subject.

 

[dedlock]

Flu or depression

What is the name of your state? MN
A patient who is depressed and is a known prescription narcotic abuser is admitted to the hospital for flu-type symptoms. Nurse on duty finds prescription narcotics in patients room but does not confiscate and patient dies the following day from an accidental overdose. Is the hospital, doctor, or nurse negligient in this case? Assume the facts are true and proof is in the medical records.

It depends on the admitting diagnosis and the type of unit where patient was admitted.
Danger to self is the criteria for admitting someone for depression. So if it was depression, the nurse and the hospital (as the nurse is employed by the hospital) might be found negligent if the patient overdosed on the narcotics found in the patient's room.

 

[cybernana]

I suppose my question does sound like a homework assignment, lol. It was my attempt to keep my relationship to the incident unknown in order to receive an objective response.
To clarify some of your questions:
The medical examiner classified the death as "accidental "
Yes, the prescriptions were in the patients name.
He wasn't hospitalized for depression although he was being treated for it for about two months. He was ill with flu type symtoms.
While in the hospital he was confronted about his abuse of pain killers and arrangements were made for him to enter a treatment program within a couple of days.
The nurse seached the room on the third day and stated she found two bottles of pills but she didn't confiscate them. Her statement was made the following day (when he died) to the family. There is a notation in his chart stating a nurse "thought" she found Darvocet in his room but later it was empty.
Again, what is hospital protocal here? Are patients allowed to have any medications on them while hospitalized, let alone a patient who has become addicted to pain killers? Should the nurse have confiscated the pills and reported it to someone?
Also, how should this patient have been monitored?
Thanks for your opinions!

 

[dedlock]

When patients are admitted to a medical unit they aren't strip searched for contraband. Even if they are known to be depressed and have a hx of addiction, the staff is not authorized to invade their privacy and confiscate their personal belongings.

If a patient is admitted and they have their own meds and chose to take the meds in addition to meds administer by the nursing staff, it is not the hospital responsibility to put the patient on suicide watch and take away anything if there was nothing to indicate he was suicidal.

It sounds like an awful experience for everyone. Although you didn't say why it was considered accidental, it sounds like the person may have been dehydrated which would increase the toxicity of any medication taken.

 

[lya]

I suppose my question does sound like a homework assignment, lol. It was my attempt to keep my relationship to the incident unknown in order to receive an objective response.
To clarify some of your questions:
The medical examiner classified the death as "accidental "
Yes, the prescriptions were in the patients name.
He wasn't hospitalized for depression although he was being treated for it for about two months. He was ill with flu type symtoms.
While in the hospital he was confronted about his abuse of pain killers and arrangements were made for him to enter a treatment program within a couple of days.
The nurse seached the room on the third day and stated she found two bottles of pills but she didn't confiscate them. Her statement was made the following day (when he died) to the family. There is a notation in his chart stating a nurse "thought" she found Darvocet in his room but later it was empty.
Again, what is hospital protocal here? Are patients allowed to have any medications on them while hospitalized, let alone a patient who has become addicted to pain killers? Should the nurse have confiscated the pills and reported it to someone?
Also, how should this patient have been monitored?
Thanks for your opinions!

I refer you to my initial response in which I answered your questions.

Oops, I hit the submit "button" before I was ready!

Continuing on...the nurse should have followed hospital policy and standards of care, both which require removing personal medications from the patient's room. It is impossible when the patient and, or the family members hide the medication; but, this was not a factor in your stated scenario.

It takes a lot of Darvocet to equal death. There has to be more to this situation.

Negligence appears to be a factor. Proving that the negligence is the one and only cause of the patient's death may be harder to prove than proving that negligence did occur.

 

[dedlock]

Quote cybernanna:

Again, what is hospital protocal here? Are patients allowed to have any medications on them while hospitalized, let alone a patient who has become addicted to pain killers? Should the nurse have confiscated the pills and reported it to someone?
Also, how should this patient have been monitored?
Thanks for your opinions!

The protocol for each institution may vary. Yes. Patients are allowed to keep medications "on them" while hospitalized. The health care institutions have changed dramatically over the past 30 years, with the Patient Bill of Rights and the third party payors advocation of cost containment.

Days of the condescending nursing staff who dictate what patients do are gone.

If the patient's death was ruled an accident and not a suicide, there is no basis for negligence nor wrongful death

 

[LAWMED]

What???!!!

Quote cybernanna:


The protocol for each institution may vary. Yes. Patients are allowed to keep medications "on them" while hospitalized. The health care institutions have changed dramatically over the past 30 years, with the Patient Bill of Rights and the third party payors advocation of cost containment.

Days of the condescending nursing staff who dictate what patients do are gone.

If the patient's death was ruled an accident and not a suicide, there is no basis for negligence nor wrongful death

NO NO NO NO....For God's sake....

NO. A hospitalized patient is NEVER allowed to keep two bottles of narcotics discovered in his room. EVER... PERIOD....NO GRAY AREA HERE.... Drug addicts with depression are even less favored for stockpiling personal narcotic stashes. No institution allows this. The patient's bill of rights does not allow this. Third party cost containment has absolutely nothing to do with this so why it is mentioned we will never understand.....

Can you possibly be implying that patients are allowed to bring thier own meds and administer them as a cost containing measure??? ARE YOU OUT OF YOUR MIND????

Nurses are not to tell patients what to do? How can one even respond to that??

"If the patient's death was ruled an accident and not a suicide, there is no basis for negligence nor wrongful death" Incorrect. Initial rulings such as this are turned over daily. It is not the final say in an uninvestigated negligence or wrongful death cause of action. Further, if the patient was reveiving medications administered by the hosp. staff as prescribed, and these medications exacerbated the effects of the narcotics the patient wass allowed to keep, and the patient self medicated with those narcotics causing his unintentional death, HE may have accidently OD'ed....but the failure of the staff to protect the patient's saftey by removing narcotics they knew were prestn and a danger (as medical professionals), due to potential interactions, the patients HX of drug abuse and depression, is NOT an accident. It is negligent. ALWAYS...EVERYWHERE

Spare the OP any childish nonsense in responding. Attack the SUBSTANCE of my post....use facts, personal attacks (probably unavoidable) are immature.

 

[LAWMED]

Speechless...

Although you didn't say why it was considered accidental, it sounds like the person may have been dehydrated which would increase the toxicity of any medication taken.

Uh....I.....oh boy....

 

[dedlock]

Please respond to the question the person asked. This is a legal forum and not a contest to speculate on what if's.

This person stated the coroner ruled the death to be "accidental".

There is absolutely nothing posted that connects the botlles of meds to the "accidental overdose".

I suggest you research death due to Darvocet overdose- death in overdosage is due to liver damage from the acetaminophen which generally occurs 2-4 days after the overdose, Greg. And Greg, the liver must be hydrated to flush the toxic drugs out of the blood. So if the overdose was Darvocet it more than likely happened way before the bottles were found by the nurse.

But this is all speculation. Because that is not the question.

These are the questions:

Again, what is hospital protocal here? Are patients allowed to have any medications on them while hospitalized, let alone a patient who has become addicted to pain killers? Should the nurse have confiscated the pills and reported it to someone?
Also, how should this patient have been monitored?

If you can't add anything but sarcastic remarks, why do you bother to come here?

 

[lya]

Darvocet does not contain aspirin.

LAWMED
A few years ago, you provided a consulting review for and agreed to provide expert testimony in a case in which I was consulting. As happens, it wasn't necessary for you to come all the way down here to testify. Just thought I'd say "hi'.