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Pedi NP Legal Case

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About the Patient

A teenager playing hockey outside on a ice rink

Name: Brian

Age: 13

Gender: male

Other information: Active in sports

Adapted from Medical Malpractice Verdicts, Settlements & Experts; Lewis Laska, Editor, 901 Church St., Nashville, TN 37203-3411

Visits

January 2003

Brian was taken to a Pediatric Practice in January 2003 with complaints of right shoulder pain which was attributed to a hockey injury. Chris was examined by a nurse practitioner. On exam, swelling of the right shoulder blade was noted, but the patient had full range of motion and equal strength bilaterally. Ibuprofen 600 mg q 8 hours prn was prescribed.

March 2003

Brian returned in March 2003 with continued swelling or the right scapula. At this time he was seen by the collaborating doctor. The doctor diagnosed a rhomboid muscle strain and prescribed Vicodin, ice, rest and continued use of the Ibuprofen.

April 2003

Brian returned the next week with the same complaints and was seen by the same physician seen previously. The MD prescribed physical therapy as the next treatment plan.

June 2003

Brian continued to have pain two months later and the doctor referred him to a sports medicine physician.

July 2003
Brian went to see the sports medicine physician who recommended an orthopedic surgeon.
August 2003

About the same time (sports medicine physician visit) Brian went to a rehabilitation specialist who ordered x-rays of the thoracic spine. These x-rays revealed a large mass in the right, upper lobe of his lung. Brian underwent a lung and bone marrow biopsy and was diagnosed with Ewing’s sarcoma. Further testing showed that the cancer had metastasized to other parts of his body.

Treatments

Brian underwent multiple rounds of radiation, chemotherapy and other treatments, but he died of the cancer in April 2006.

Review the Case

Please review the listed questions.

  • Identify the defendants in this case and the areas of negligence.
  • Define and identify signs and symptoms of Ewings sarcoma and then compare/contrast this diagnosis with the diagnosis given to the patient by the primary care provider.
  • Reflect on this case and what you would have done differently as an advanced practice registered nurse.
  • Review the risks that NPs face associated with practice identified in Buppert (2021) p. 299 and identify which of these apply to the case. What strategies might have reduced the risk of the outcome presented in this case? Refer to Buppert (2021) Chapter 8: Risk Management.
  • What do you think the verdict was and why?
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