Reference no: EM133445077
Legal Case Study Paper
Family NP Legal Case
Thirty-one year old male went to the office of his primary care physician in October 2001. He was seen by the nurse practitioner and complained of burning and cramping, abdominal pain and inability to eat, which had resolved as of the appointment.
The nurse practitioner prescribed Zantac and set up a complete physician exam for the next month. At the November visit the decedent gave a history of chewing tobacco and heavy coffee intake, occasional abdominal pain and increased stools, as well as a family history which included nurse practitioner his mother's diagnosis of colon cancer at 54. The nurse practitioner did not perform a rectal exam, order any diagnostic tests, or refer to a specialist at this time. The nurse practitioner changed medications from Zantac to Protonix and ordered an upper GI series with contrast to rule out gastritis or an ulcer. The negative test results were provided to the primary care physician, who never saw the patient or reviewed his chart.
The patient was seen by the nurse practitioner a month later, when he reported that his symptoms were improved on Protonix, but he continued to have problems with eating. The nurse practitioner continued with a diagnosis of gastritis and gave instructions to call with any concerns and follow-up in six months.
In April 2002 the patient returned and reported worsening stomach cramps and burning to the nurse practitioner. The nurse practitioner then changed the medication to Prevacid, continued with a diagnosis of gastritis and arranged for an appointment with a gastroenterologist for a possible esophagogastroduodenscopy in July.
The patient returned in May with increasing pain and loose stools. The appointment for a GI consult was moved up after a discussion with the physician, but the decedent went to an emergency room before the scheduled visit. A work-up at the hospital, which included an abdominal CT scan and colonoscopy, resulted in a diagnosis of near obstruction of the right side of the colon by a Stage IV tumor and metastasis to the peritoneum and lymph nodes.
Immediate surgery was performed, followed by chemotherapy, and more. He died about two years later, in December 2004.
- Identify the defendants AND areas of negligence in this case
- Given the patients symptoms listed above, provide a comprehensive differential diagnoses list (ONLY a list)
- Reflect on this case and what you would have done differently at an advanced practice registered nurse.
- What do you think the verdict was and why?