Reference no: EM133700871

On Movember 2, 2000, Lewis Blackman, a healthy 15-year-old, entered a teaching hospital for elective surgery for pectus excavatum, a deformity of the anterior wall of the chest. The surgery was successful. Lewis was prescribed a full adult course of ketorolac (Toradol) for pain by a young senior resident who was following the postoperative protocols for that procedure. On the morning of the third postoperative day, Lewis began to experience severe pain in his upper abdomen, and his abdomen grew hard and distended. A nurse told him it was gas. By afternoon, his temperature was dropping, his skin was pale, and he was diaphoretic; his pulse was increasing. Lewis's parents were becoming increasingly alarmed at his rapid decline and asked nurses to call the attending physician. The physician who arrived, however, was a resident; despite repeated requests, nurses had not summoned the attending physician. Lewis was developing peritonitis and was also bleeding internally. Over 30 hours of alarming clinical decline were going unnoticed. Prescribed |V fluids were inadequate. Lewis went more than 24 hours with virtually no urine output and 4 hours of completely undetectable blood pressure, which nurses attributed to malfunctioning equipment. On day 4, the staff spent 2.5 hours looking for a blood pressure cuff to detect his blood pressure. Twelve attempts were made to take his blood pressure using seven different cuffs. On Movember 6, 2000, Lewis died of an N5AID-induced duodenal ulcer. MNow that you have learned about legal and ethical issues surrounding health care, consider these questions: 1. What legal and ethical duties were breached? Why? 2. What do you think were the factors involved in the health care providers' failure to rescue? 3. Assume you were Lewis's primary care nurse over the weekend. How would you have explained your rationale for your failure to contact a supervisor or the attending physician as Lewis's condition deteriorated? 4. Who should be held accountable for this tragic outcome? 5. What would you have done differently, and why?