Psych/Mental Health Nursing: Legal Case Study
Please review the listed questions.
- Identify the defendants and the areas of negligence in this case.
- Identify and describe appropriate screening measures and safety risk assessment procedures in adolescents with depression.
- Reflect on this case and identify what you would have done differently as a psychiatric mental health nurse practitioner.
- Review the risks that NPs face associated with practice identified in Buppert (2018) p. 289 (Bottom of first page of Buppert uploaded file) 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 (2018) Chapter 8: Risk Management. (Buppert Uploaded file)
- What do you think the verdict was and why?
PMHNP Legal case
About the Patient
Name: Lucia
Age: 15
Gender: Female
Guardian/parent: Mother
Other details: Hispanic
Adapted from Medical Malpractice Verdicts, Settlements & Experts; Lewis Laska, Editor, 901 Church St., Nashville, TN 37203-3411
Visits
January 2012
Lucia was seen in an emergency room two days earlier for nausea, abdominal pain and vomiting. She was then seen at the outpatient mental health clinic by the psychiatric nurse practitioner, who worked under the supervision of the off site psychiatrist. The clinic received federal funding.
The psychiatric nurse practitioner was informed of the recent emergency room visit during the review of the intake paperwork completed by Lucia’s mother. The psychiatric nurse practitioner prescribed Zofran 4 mg by mouth every 4 hours prn for nausea and Prozac 40 mg by mouth every morning on a prescription pad which had been pre-signed by the supervising psychiatrist. The psychiatric nurse practitioner’s notes indicated that the Prozac was prescribed for depression, but an in depth screening and safety risk assessment was not documented.
February 2012
The patient was instructed to return in one month. Three weeks later Lucia hung herself in her bedroom closet with a belt. She was found by her mother and brother and was transported to a nearby hospital. The patient suffered a catastrophic brain injury and died three years later. She required around-the-clock care during those three years.
Family’s Complaint
The family claimed that Prozac should not have been prescribed due to a lack of signs of clinical depression and claimed that the FDA had issued a warning regarding the use of Prozac in adolescents, specifically that Prozac use in adolescents increased the risk of suicidal thinking and behavior.
NP’s Claim
The psychiatric nurse practitioner claimed that the clinical evaluation for depression supported the diagnosis. The psychiatric nurse practitioner also claimed that the suicide attempt followed a breakup with her boyfriend and a fight with her father and that the medication played no part in the incident.
Grading Rubric
-Identify defendant. Use of legal standards when analyzing potential medical malpractice: duty, breach of duty, causation, damages and negligence. All components very well-demonstrated
-Scholarly discussion of standard of care of the practice issues relevant to the case. If applicable differential diagnosis. Thinks critically about relationship of legal issues and standard of care.
– *Uses Ch 7 & 8 Buppert (uploaded file doc) and 2 two peered reviewed articles* as resources.
-Demonstrates synthesis of legal issues as they apply to personal professional practice. Describes complexity of legal issues as they apply to personal future practice.
-Support prediction of case verdict with sound logic thread grounded by legal concepts. Consistently & accurately uses synthesis & evaluation.
-Professional Application, Major elements of the paper are supported by evidence based articles/guidelines.
-Technical aspects of paper: Grammar, spelling, Intelligible, Quality of writing/organization of paper; and use of APA. Consistently demonstrates appropriate format. Easy to follow clear quality and organization of paper.