How to write a medical malpractice essay based on a case study (Solved): Nurse Marie

How to write a medical malpractice essay based on a case study (Solved): Nurse Marie

Marie an RN, a physician; her charge nurse and the nursing supervisor have been named in a malpractice lawsuit. The events pertaining to the action are as follows.
Marie was to administer digoxin to her patient. Per hospital protocol, Marie took the patient’s apical pulse for 1 minute before administering the medication. The patient’s pulse was 130 and irregular. Protocol also dictates that if there are unusual changes in the rate or rhythm of the patient’s pulse, the medication should be held and the physician contacted. The patient denied any chest pain but said she felt ‘funny” as though “my heart is jumping in my chest.” In the four days that Marie has provided nursing care to the patient, her pulse had never been above 100, nor was it irregular.

Marie held the mediation and telephoned the physician who became quite irate. “She’s getting digoxin because of her heart problems! Don’t you know anything?” Marie explained that the elevated pulse rate was unusual, but before she could tell him about the irregular rhythm and the patient’s statements, the physician hung up. Marie immediately called him back, but the physician’s answering service answered and informed her that the physician was now on rounds at another hospital and would not be available for several hours.

Marie returned to the patient who now complained of feeling dizzy. Marie consulted her charge nurse who told her to go ahead and give the medication. Still unsure about administering the medication, Marie consulted the nursing supervisor who, in turn, consulted with the charge nurse. The charge nurse became quite angry and told Marie that she was behaving in an insubordinate manner and that a written disciplinary letter would be placed in her file. The supervisor agreed with the charge nurse. The charge nurse then administered the digoxin.

Marie documented all of her findings, including her conversations with the physician, charge nurse, and nursing supervisor. Within an hour, the patient became quite anxious and complained, “It feels as if my heart is stopping!” The rapid response team was called and the patient was rushed to the cardiac care unit where she spent several days after receiving a pacemaker because of a heart block.

The physician was overheard to say to the charge nurse and nursing supervisor, “I guess you shouldn’t have given the digoxin, but don’t say anything. The patient will be OK, and there’s no need for her to think we did anything wrong.” The patient later filed a malpractice suit for pain and suffering. Marie filed a grievance regarding the disciplinary letter in her file.

1.Were the four elements of malpractice met?

2. Who breached duty?

3. Should the disciplinary letter be removed from Marie’s file?

4. Start by determining who had a legal duty to the patient.

5. Evaluate each health care professional’s behavior.

6. What type of ethical questions does this raise?

7. Did the patient suffer harm?

8. Can the actions (or failure to act) of the physician, charge nurse, and nursing supervisor be linked to breach of duty, harm, and causation

9. Speak to the ADVOCACY required in this situation… you must list a minimum of four citations appropriate to submission

10.Summary response (summarize). Each response is worth 3 point for a total of 30 points.

Please answer questions in order and numbered accordingly. As with other submissions, APA and references required. Contact an LCC librarian if you need help with this. Ten points will be deducted if Cover Page, in body citations and formatting as well as Reference page not APA

This is the final submission, you must be able to demonstrate APA submission correctly.

SOLUTION TO Nurse Marie Case study

Elements Of Malpractice Met

Medical malpractice is a common occurrence in the healthcare system. The four elements of malpractice include the existence of a legal duty, breach of that duty, injury caused by the breach, and resulting damages (Bookman & Zane, 2020). In the case study, all four elements of malpractice were met. Firstly the healthcare team has a professional duty to ensure the provision of safe care to the patient. One of the duties of healthcare providers is to ensure safe medication administration. The physician breached the duty by her failure to advise the registered nurse to stop administering the drug—the act results in the patient suffering from pain. The injuries made the patient claim damages due to the suffering and the pain.

Breach of Duty

Breach of duty occurs when a healthcare provider’s conduct and behavior are not in line with the standard of care. In the case study, the physician breached his duty. She becomes irate to the nurse without considering that digoxin should be held if the patient’s heart rate is below 60 or cannot be determined.

Should The Disciplinary Letter Removed From Marie’s File

The disciplinary letter should be removed from Marie’s file. She is trying to follow the existing protocols regarding the administration of digoxin medication. Indeed, the protocols state that the medication should be withheld if the patient’s heart rate cannot be determined. Marie is just unsure of administering the medication. Seeking second thoughts from the healthcare provider is the best she could do. The charge nurse should not put the letter in her file. Even the outcome of the scenario indicates she was right.

Who Had A Legal Duty To The Patient?

The physician had a legal duty to the patient. The physician had a legal duty to provide the standard of care and skill to the patient (Bakewell et al., 2020). Legal duty of care is created when the doctor agrees to provide care to a patient who requested their services.  In providing the care, the physician needs to determine if the care they provide is appropriate for the patient.  In the case scenario, she needed to exercise a higher degree of skills. She should have advised the registered nurse to withhold the drug until the patient’s heart rate was normal. Additionally, the physician should have been concerned about the irregular patient heart rate. The physician had a legal duty to the patient.

Healthcare Providers’ Behavior

Various healthcare providers’ behavior can be depicted from the case study. The registered nurse is concerned and strictly adheres to rules and regulations. She is concerned that administering the drug will pose a risk to the patient. The physician is arrogant and negligent. She even questions the registered nurse if she knows anything. She is not concerned about the irregular heart rate.  The nursing supervisor and the charge nurse are not concerned with details. They feel that the physician’s word is final. They should have had reservations and tried reaching the physicians.

Types Of Ethical Questions That Can Be Raised

Various ethical questions may arise from the scenario. Firstly one can ask if the physician, charge nurse, and the nursing supervisor acted in a manner to prevent harm to the patient. This is the principle of non-maleficence (McDermott-Levy et al., 2020). This principle requires healthcare providers to do no harm. This principle was not followed as the care resulted in patient pain and suffering. Secondly, one can ask if the charge the healthcare provider acted in a manner that would be beneficial to the patient. This is the principle of beneficence. Healthcare providers are required to act in the best interest of the patient. The physician failed to respond to the registered nurse’s concern.

Did The Patient Suffer Harm?

From the case study, it is clear that the patient suffered harm.  After administration of the medication, the patient complained of her heart-stopping. She also spent several days receiving a pacemaker because of a heart block. The patient complained of pain and suffering.

The actions (or failure to act) of the nursing supervisor, charge nurse, and the physician can be linked to the breach of duty, harm, and causation. The physician failing to act on the concerns of the registered is a breach of duty. She is obliged to provide care to the patient. Additionally, she failed to answer the call. This caused harm to the patient. Failure to answer the call resulted in the nurse communicating to the charge nurse and the supervisor, who then gave the drug that resulted in harm.

Patient Advocacy

Patient advocacy is key in reducing medical malpractice.  Advocacy enables patients’ access to quality and safe care. Advocacy facilitates human dignity preservation, equality of patient care, and freedom from suffering (Stein et al., 2018).  It also includes educating patients about their rights to make decisions regarding their health. In the case study, the registered nurse could advocate for the patient. She could ensure that she acts on behalf of the patient to ensure their health is not put at risk.


Healthcare providers have a professional duty to provide care to patients. In the case study, malpractice occurred because the physician breached her duty. The physician’s role was to provide care to the patient professionally and ethically. She did not adhere to the ethical principle of beneficence and maleficence. The registered nurse did no harm raising her concerns regarding administering the drug with an irregular heartbeat. Therefore the disciplinary letter was unfair.



Bakewell, F., Pauls, M. A., & Migneault, D. (2020). Ethical considerations of the duty to care and physician safety in the COVID-19 pandemic. Canadian Journal of Emergency Medicine22(4), 407-410.

Bookman, K., & Zane, R. D. (2020). Surviving a medical malpractice lawsuit. Emergency Medicine Clinics38(2), 539-548.

McDermott-Levy, R., Leffers, J., & Mayaka, J. (2018). Ethical principles and guidelines of global health nursing practice. Nursing Outlook66(5), 473-481.

Stein, S., Bogard, E., Boice, N., Fernandez, V., Field, T., Gilstrap, A., & Mathieson, T. (2018). Principles for interactions with biopharmaceutical companies: the development of guidelines for patient advocacy organizations in the field of rare diseases. Orphanet journal of rare diseases13(1), 1-10.

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