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Attached is the assignment along with the reading material.Only focus on the highlighted partThe questions on number 4 will be based on the case reading. The pages given from the book will be another resource you can refer to help with the questions. No other resources should be used besides the case and the 2 chapters from the book that are provided.


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Assignment for Meeting #4 6500 Legal Aspects of Healthcare
NOTE: Unless indicated otherwise, all written assignment are to be in 12 point Times New
Roman font, 1 inch margins, double-spaced of a minimum of three (3) pages; and the cases,
questionnaire, articles, and links to videos are located in the weekly module for this
assignment on D2L (unless noted otherwise). The LearnScapes episodes are located in the
publisher site (Jones & Bartlett) using the access code that you purchased with your
1. Read
a. Chapter 6 (pages 191-200), Chapter 8 (pages 262 – 295) from our textbook, Legal and
Ethical Issues for Health Professionals by George D. Pozgar (4th Edition).
b. Read the case, Darling v. Charleston Community Memorial Hospital.
c. Scan the article “Pre-Injury Agreements to Arbitrate” by Sandra S. Benson.
2. Watch Dr. Benson’s original video and Prepare to Discuss in class: Watch “Illegal
Bargains: Is this Legally Shocking?” Be prepared to discuss in class:
3. Experience the Simulation and Complete Your Role by Answering the Questions in a
Word Document: Watch LearnScapes Episode 2 in Jones & Bartlett LearnScapes for
Health Care Ethics.
“LearnScape 2: Stockpiling
You are a purchase/procurement manager of a large hospital within the Bright Road Health
Care System. Part of your responsibility is to purchase pharmaceuticals for the hospital. You
recently stockpiled quantities of a specific cancer drug after hearing that the manufacturer
might stop its production. However, the Procurement Manager of a rival hospital has asked
you for help. Her hospital has a cancer patient who is on the drug that was taken off the
market, but they have none of the drug in stock. If the patient does not receive treatment
quickly, there could be severe repercussions. Your humanitarian side would like help, and it
would be good publicity for the hospital, but you also know that your hospital is in an area of
high cancer prevalence, and this drug is routinely prescribed. You will work with the
hospital’s counsel to discuss legal issues with sharing the drug, consult with the
administration regarding the community’s perception of providing the drug, and debate future
repercussions with other staff in order to make an informed decision.”
BLAW 6500 Spring 2019 A2 Revised 2/13/19
Page 1
4. Complete Written Assignment #4. Reflect on the following questions. Then write a memo
answering the following questions and upload your memo to the Dropbox on D2L by the due
Part I: Legal Issues with Negligence, Stockpiling and Arbitration
a. Who you think should have won and why? What are the implications of allowing
entities to be held legally responsible for the negligent actions or (inactions) of its
providers? Does this make healthcare safer?
b. Why are many healthcare entities asking/requiring patients to sign arbitration clauses?
Do you think healthcare providers should be allowed to require or request patients to
agree to arbitration, waiving their right to a jury trial, BEFORE care is delivered?
Why or Why not?
c. Answer the questions from the LearnScapes episode about stockpiling?
Part II: Research Your Cause:
Continue planning your advocacy project. Do additional research and answer the following
1. With whom did you meet to discuss your project? What did you find out?
2. Need: What are the critical issues that persuade you that action is needed? Cite to
sources which provide evidence of the issues (government-published statistics, news
articles, scholarly research, textbooks, published books, a respected organization’s
information posted on its website etc.). You do not have to use any specific citation
method – just give enough information so I can find the source and know the date. If
you need to collect data, describe how you will collect and what measures you will
take to ensure you have proper consents and security of your data.
3. Feasibility: How will you collect, store and use your data, if necessary? With whom
will you partner? Will you provide your own funds? How much are you seeking
from the Award Grantor in our competition? Is your project sustainable to
accomplish your goals?
4. Orderly development: What types of action/ results do you aim to achieve (Examples:
specific legislation to address the needs of the elderly who do not have access to
psychiatric services, education to patients about healthy choices to control diabetes,
reforms in the school cafeterias to stop the sale of snack foods/ soft drinks, grants to
agencies who provide aid to low-income pregnant women to improve prenatal care
and reduce the numbers of infant mortalities, etc.)? Who else is doing this?
5. Quality and Impact: How will you measure outcomes and ensure quality?
BLAW 6500 Spring 2019 A2 Revised 2/13/19
Page 2
Part III: Prepare and Practice your Draft 5 Minute Report (This can be PowerPoint Slides
instead of a written report):
Prepare and practice your draft 5 minute Report or PowerPoint slides: Be prepared to
present your cause to the class in Week 4. You need to practice and have it down to the
seconds and minute noted below. You will get feedback. You will give your final report in
Week 5. In Week 5, each of you will be seeking hypothetical funding in our Health Care
Grant Competition where up to a hypothetical amount $250,000 will be awarded. The award
grantor wants to fund several worthy projects based on the four criteria used to award CONs
in Tennessee (need/feasibility/orderly development/ quality). Your presentation is to be in
the following format:
✓ Total 5 minutes:
✓ Minute 1 (seconds 0-60): Start with your story. Jump right in. What
happened to get you interested in this topic? Colorful details, personal
stories, and genuine interest grab attention.
✓ Minutes 2 (seconds 61-120): Your recommendation. What do you
propose to do?
✓ Minutes 3 – 4 (seconds 121-240): Apply the four criteria:
o 1. Describe the problem and the need.
o 2. Feasibility. How will you collect, store and use data pertaining
to your project? How will you fund what you are seeking? How
much do you need from the Award Grantor? How much will you
raise from other sources and who are your sources?
o 3. Orderly Development. How does this fit in with what others
are already doing? Why can you do this best? Will you partner
with others, and if so, with whom?
o 4. Quality. What will you do to ensure high quality of this
project? How will impact and quality be measured?
✓ Minute 4 – 4 ½ (seconds 240-270): How much money do you want from
the Award Grantor? Provide a hand-out your budget (you do not have to
go every detail, but hand out and be prepared to answer questions at the
✓ Minute 41/2 – 5 (seconds 271-300): Explain the impact and benefit: How
will your target audience benefit? How will the grantor benefit? How will
all of us benefit as a society?
✓ Visual Aid. In addition to your budget, you must use at least 1 visual aid.
This can be a chart, graph, diagram, etc. It can be on paper, hand-outs, flip
chart, PowerPoint – your choice.
✓ Include at an appropriate point, the contact with whom you met and what
you learned.
BLAW 6500 Spring 2019 A2 Revised 2/13/19
Page 3
Darling v. Charleston Community Memorial Hospital
33 Ill.2d 326, 211 N.E.2d 253
Ill. 1965
September 29, 1965 (Approx. 9 pages)
Top of Form
33 Ill.2d 326, 211 N.E.2d 253, 14 A.L.R.3d 860
Supreme Court of Illinois.
Dorrence Kenneth DARLING, II, Appellee,
No. 38790.
Sept. 29, 1965.
Rehearing Denied Nov. 18, 1965.
Action brought on behalf of minor by father to recover damages for allegedly negligent medical and
hospital treatment which necessitated leg amputation. Prior to trial action was dismissed as to doctor.
The jury returned verdict against hospital, and judgment was entered accordingly by the Circuit Court of
Coles County, Robert F. Cotton, J. Judgment was affirmed by Appellate Court for Fourth District, 50
Ill.App.2d 253, 200 N.E.2d 149, and hospital appealed. The Supreme Court, Schaefer, J., held that
hospital could not limit its liability as a charitable corporation to amount of its liability insurance, that
evidence supported verdict, and that other contentions and objections of hospital gave no ground for
*328 SCHAEFER, Justice.
This action was brought on behalf of Dorrence Darling II, a minor (hereafter plaintiff), by his father and
next friend, to recover damages for allegedly negligent medical and hospital treatment which
necessitated the amputation of his right leg below the knee. The action was commenced against the
Charleston Community Memorial Hospital and Dr. John R. Alexander, but prior to trial the action was
dismissed as to Dr. Alexander, pursuant to a covenant not to sue. The jury returned a verdict against the
hospital in the sum of $150,000. This amount was reduced by $40,000, the amount of the settlement
with the doctor. The judgment in favor of the plaintiff in the sum of $110,000 was affirmed on appeal by
the Appellate Court for the Fourth District, which granted a certificate of importance. 50 Ill.App.2d 253,
200 N.E.2d 149.
On November 5, 1960, the plaintiff, who was 18 years old, broke his leg while playing in a college
football game. He was taken to the emergency room at the defendant hospital where Dr. Alexander,
who was on emergency call that day, treated him. Dr. Alexander, with the assistance of hospital
personnel, applied traction and placed the leg in a plaster cast. A heat cradle was applied to dry the cast.
Not long after the application of the cast plaintiff was in great pain and his toes, which protruded from
the cast, became swollen and dark in color. They eventually became cold and insensitive. On the evening
of November 6, Dr. Alexander ‘notched’ the cast around the toes, and on the afternoon of the next day
he cut the cast approximately three inches up from the foot. On November 8 he split the sides of the
cast with a Stryker saw; in the course of cutting the cast the plaintiff’s leg was cut on both sides. Blood
and other seepage were observed by the nurses and others, and there was a stench in the room, which
one witness said was the worst he had smelled since World War II. The plaintiff remained*329 in
Charleston Hospital until November 19, when he was **256 transferred to Barnes Hospital in St. Louis
and placed under the care of Dr. Fred Reynolds, head of orthopedic surgery at Washington University
School of Medicine and Barnes Hospital. Dr. Reynolds found that the fractured leg contained a
considerable amount of dead tissue which in his opinion resulted from interference with the circulation
of blood in the limb caused by swelling or hemorrhaging of the leg against the construction of the cast.
Dr. Reynolds performed several operations in a futile attempt to save the leg but ultimately it had to be
amputated eight inches below the knee.
The evidence before the jury is set forth at length in the opinion of the Appellate Court and need not be
stated in detail here. The plaintiff contends that it established that the defendant was negligent in
permitting Dr. Alexander to do orthopedic work of the kind required in this case, and not requiring him
to review his operative procedures to bring them up to date; in failing, through its medical staff, to
exercise adequate supervision over the case, especially since Dr. Alexander had been placed on
emergency duty by the hospital, and in not requiring consultation, particularly after complications had
developed. Plaintiff contends also that in a case which developed as this one did, it was the duty of the
nurses to watch the protruding toes constantly for changes of color, temperature and movement, and to
check circulation every ten to twenty minutes, whereas the proof showed that these things were done
only a few times a day. Plaintiff argues that it was the duty of the hospital staff to see that these
procedures were followed, and that either the nurses were derelict in failing to report developments in
the case to the hospital administrator, he was derelict in bringing them to the attention of the medical
staff, or the staff was negligent in failing to take action. Defendant is a licensed and accredited hospital,
and the plaintiff contends that the licensing regulations, accreditation standards,*330 and its own
bylaws define the hospital’s duty, and that an infraction of them imposes liability for the resulting injury.
The defendant’s position is stated in the following excerpts from its brief: ‘It is a fundamental rule of law
that only an individual properly educated and licensed, and not a corporation, may practice medicine. *
* * Accordingly, a hospital is powerless under the law to forbid or command any act by a physician or
surgeon in the practice of his profession. * * * A hospital is not an insurer of the patient’s recovery, but
only owes the patient the duty to exercise such reasonable care as his known condition requires and
that degree of care, skill and diligence used by hospitals generally in that community. * * * Where the
evidence shows that the hospital care was in accordance with standard practice obtaining in similar
hospitals, and Plaintiff produces no evidence to the contrary, the jury cannot conclude that the opposite
is true even if they disbelieve the hospital witnesses. * * * A hospital is not liable for the torts of its
nurse committed while the nurse was but executing the orders of the patient’s physician, unless such
order is so obviously negligent as to lead any reasonable person to anticipate that substantial injury
would result to the patient from the execution of such order. * * * The extent of the duty of a hospital
with respect to actual medical care of a professional nature such as is furnished by a physician is to use
reasonable care in selecting medical doctors. When such care in the selection of the staff is
accomplished, and nothing indicates that a physician so selected is incompetent or that such
incompetence should have been discovered, more cannot be expected from the hospital
The basis dispute, as posed by the parties, centers upon the duty that rested upon the defendant
hospital. That dispute involves the effect to be given to evidence concerning the community standard of
care and diligence, and also the *331 effect to be given to hospital regulations adopted by the State
Department of Public Health under the Hospital Licensing Act (**257 Ill.Rev.Stat.1963, chap. 111 1/2,
pars. 142-157.), to the Standards for Hospital Accreditation of the American Hospital Association, and to
the bylaws of the defendant.
As has been seen, the defendant argues in this court that its duty is to be determined by the care
customarily offered by hospitals generally in its community. Strictly speaking, the question is not one of
duty, for ‘* * * in negligence cases, the duty is always the same, to conform to the legal standard of
reasonable conduct in the light of the apparent risk. What the defendant must do, or must not do, is a
question of the standard of conduct required to satisfy the duty.’ (Prosser on Torst, 3rd ed. at 331.) ‘By
the great weight of modern American authority a custom either to take or to omit a precaution is
generally admissible as bearing on what is proper conduct under the circumstances, but is not
conclusive.’ (2 Harper and James, The Law of Torts, sec. 17.3, at 977-978.) Custom is relevant in
determining the standard of care because it illustrates what is feasible, it suggests a body of knowledge
of which the defendant should be aware, and it warns of the possibility of far-reaching consequences if a
higher standard is required. (Morris, Custom and Negligence, 42 Colum.L.Rev. 1147 (1942); 2 Wigmore,
Evidence, 3rd ed. secs. 459, 461.) But custom should naver be conclusive. As Judge Learned Hand said,
‘There are, no doubt, cases where courts seem to make the general practice of the calling the standard
of proper diligence; we have indeed given some currency to the notion ourselves. * * * Indeed in most
cases reasonable prudence is in fact common prudence; but strictly it is never its measure; a whole
calling may have unduly lagged in the adoption of new and available devices. It never may set its own
tests, however persuasive be its usages. Courts must in the end say what is required; there are
precautions so imperative*332 that even their universal disregard will not excuse their omission.’ The T.
J. Hooper (2d cir. 1932), 60 F.2d 737, 740.
In the present case the regulations, standards, and bylaws which the plaintiff introduced into
evidence, performed much the same function as did evidence of custom. This evidence aided the jury in
deciding what was feasible and what the defendant knew or should have known. It did not conclusively
determine the standard of care and the jury was not instructed that it did.
‘The conception that the hospital does not undertake to treat the patient, does not undertake to act
through its doctors and nurses, but undertakes instead simply to procure them to act upon their own
responsibility, no longer reflects the fact. Present-day hospitals, as their manner of operation plainly
demonstrates, do far more than furnish facilities for treatment. They regularly employ on a salary basis a
large staff of physicians, nurses and internes, as well as administrative and manual workers, and they
charge patients for medical care and treatment, collecting for such services, if necessary, by legal action.
Certainly, the person who avails himself of ‘hospital facilities’ expects that the hospital will attempt to
cure him, not that its nurses or other employes will act on their own responsibility.’ (Fuld, J., in Bing v.
Thunig (1957), 2 N.Y.2d 656, 163 N.Y.S.2d 3, 11, 143 N.E.2d 3, 8.) The Standards for Hospital
Accreditation, the state licensing regulations and the defendant’s bylaws demonstrate that the medical
profession and other responsible authorities regard it as both desirable and feasible that a hospital
assume certain responsibilities for the care of the patient.
We now turn to an application of these considerations to this case. The defendant did not object
to the instruction on the issues, which followed Illinois Pattern Jury Instruction 20.01. Nor did it move to
withdraw any issues from *333 the jury. Under section 68 of the Civil Practice Act, an entire verdict is
not to be set aside because one asserted ground of recovery was defective or inadequately proven, if
one or more of the grounds is sufficient, unless a motion to withdraw the issue in question **258 was
made. (Ill.Rev.Stat. 1963, chap. 110, par. 68(4).) Therefore we need not analyze all of the issues
submitted to the jury. Two of them were that the defendant had negligently: ‘5. Failed to have a
sufficient number of trained nurses for bedside care of all patients at all times capable of recognizing the
progressive gangrenous condition of the plaintiff’s right leg, and of bringing the same to the attention of
the hospital administration and to the medical staff so that adequate consultation could have been
secured and such conditions rectified; * * * 7. Failed to require consultation with or examination by
members of the hospital surgical staff skilled in such treatment; or to review the treatment rendered to
the plaintiff and to require consultants to be called in as needed.’
We believe that the jury verdict is supportable on either of these grounds. On the basis of the
evidence before it the jury could reasonably have concluded that the nurses did not test for circulation
in the leg as frequently as necessary, that skilled nurses would have promptly recognized the conditions
that signalled a dangerous impairment of circulation in the plaintiff’s leg, and would have known that
the condition would become irreversible in a matter of hours. At that point it becam …
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