Gwen Moore

HMG-410 Healthcare Law and Ethics

Module 3 Assignment
September 22, 2014
3. Pertinent facts of the case: In the case of Candler Gen. Hosp., Inc. v. Persaud, Dr. Freeman received
a patient referral on February 15, 1990 and recommended that the patient undergo a laparoscopic laser
cholecystectomy procedure. Dr. Freeman requested and was granted temporary privileges to perform the
procedure on February 16, 1990. The privileges were granted based on a certificate Dr. Freeman
received after completing a laparoscopic laser cholecystectomy workshop on February 10, 1990. Dr.
Freeman was allowed to perform the procedure with assistance of Dr. Thomas on February 20, 1990.
Procedural history of the case: A complaint by the administrator of the patients estate, supported by an
experts affidavit, alleged that the cholecystectomy was negligently performed, and as a result, the
patient bled to death. The compliant charged the hospital with negligence in permitting Dr. Freeman to
perform the procedure on the decedent without having instituted any standards, training requirements, or
protocols, or otherwise instituted any method for judging the qualifications of a surgeon to perform
the procedure. The complaint also alleged that the hospital knew or reasonably should have known that
it did not have a credentialing process that could have assured the hospital of the physicians education,
training, and ability to perform the procedure. The trial court denied the hospitals motion for summary
judgment, finding that the plaintiffs evidence was sufficient to raise a question of fact regarding whether
surgical privileges should have been issued by the hospital to Dr. Freeman.
The legal issue(s) presented to the Georgia Court of Appeals: Was there a material issue of fact as to
whether the hospital was negligent in granting the specific privileges requested by Dr. Freeman?
The Georgia Court of Appeals ruling: They held that there was a material issue of fact as to whether the
hospital was negligent in granting the specific privileges requested, thus precluding summary judgment.
4. Discussion Questions on page 194:
1) Discuss how the outcome in this case might have been different if Massey had referred his patient
to, for example, a family practitioner. Hopefully, the outcome would have prolonged Mr. Powells life if
he had been referred to a family practitioner instead of the infectious disease specialist. I would also like
to think that the family practitioner would have ordered a consult for a skin specialist to exam Mr.
Powells neck and complete a fine needle-aspiration to properly diagnosis the cancer and start treatment
as soon as possible.
2) Discuss the role of expert testimony in this case. Dr. Holder testified that the defendants
misdiagnosis of cat scratch disease caused his patient delay in diagnosis and treatment of his cancer
from January to July and that if Mr. Powell had been informed of the possibility of cancer in January and
options were offered in terms of biopsy for fine-need aspirations, then Mr. Powell would have had a
diagnosis of cancer probably in the first week of February. He was also able to confirm that the delay in
diagnosis and treatment was a direct and proximate cause of the injuries to Mr. Powell. Dr. Ali testified
that Mr. Powell would have had a 75% chance of surviving 5 years compared with the 15% to 20%
chance he had in July 1992. Dr. Tercilla testified that in his opinion, if Mr. Powell had been treated in
January as opposed to July, he would have had a higher likelihood of being in control of this disease
than he had when he presented to the VA hospital. Dr. Kipreos stated that in her opinion, if Margileth
had requested a fine-needle aspiration in January 1992, rather than misdiagnosing Mr. Powell with cat
scratch disease, his cancer would have been diagnosed at that time.

5. Review Questions on page 213:

3) What, if any sanctions should be imposed on an on-call physician who fails to respond to such call
when requested? Failure to respond is grounds for negligence should a patient suffer injury as a result of
a physicians failure to respond to an emergency call. The physician should be reported to the state
licensing board and any related credentialing and fair hearing committee for review of the physicians
failure to respond to a requested call.
8) Is a poor outcome always an indication of a negligent act? Explain. No, a physicians efforts do not
constitute negligence simply because they were unsuccessful in a particular case. A physician cannot be
required to guarantee the results of his or her treatment. The mere fact that an adverse result may occur
following treatment is not in and of itself evidence of professional negligence.
9) When is a physician considered to have abandoned his or her patient? The following elements
should be established in order for a patient to recover damages for abandonment: 1) Medical care was
unreasonably discontinued. 2) The discontinuance of medical care was against the patients will.
Termination of the physician-patient relationship must have been brought about by a unilateral act of the
physician. 3) The physician failed to arrange for care by another physician. 4) Foresight indicated that
discontinuance might result in physical harm to the patient. 5) Actual harm was suffered by the patient.
6. Discussion Questions on page 236:

1) Was Dr. Hawkinss telephone assessment of the patient appropriate? No, it was obvious that after
reading the facts of the case that Dr. Hawkins telephone assessment was very inappropriate. The
judgment brought against the hospital was confirmed by testimony that they deviated from the standard
of care.
2) How would you apportion negligence among the attending physician, resident, obstetrical nurse,
nursing supervisor, and hospital? I believe that everyone had their own individual share of
responsibilities and should have followed hospital procedures required for their specific job functions.
The reasons of the case stated that, The hospitals negligence was based on acts of omission, by failing
to have Mrs. Anthony examined by a physician and by discharging her in pain. The hospital should have
foreseen the injury to Anthony because its own staff was questioning the judgment of Hawkins while, at
the same time, failing to follow through with the standard of care required of it. The nurses were not the
agents of Hawkins. All involved had their independent duty to Anthony.
3) What are the lessons that should be learned from this case? It is important to provide proper care to
all patients and follow established hospital procedures. Its important to adhere to rules such as making
sure that every patient who presents herself to the labor and delivery area, the emergency department,
or any area of the hospital should be seen by a physician before anything is undertaken and certainly
before she is allowed to leave the institution.
4) What educational issues are apparent? The educational issues are that hospital staff should be
prepared to follow are hospital procedures. I also believe the staff should know what to do when there
are questions about something the attending physician is doing in error. The staff already knew that to
provide the patient with medication in the form of a prescription without the physician ever seeing the
patient was below any standard of care. They really need to receive educational training on the
importance of following established hospital procedures and protocols and making the right decisions.