The book Patient Safety for Health Professionals states: \"A.L. was in a rollove

Question

The book Patient Safety for Health Professionals states: "A.L. was in a rollover motor vehicle accident while traveling 3 hours from her home early one weekend morning. She was removed from the vehicle by paramedics and transported by ambulance to the nearest regional hospital. In the emergency room, she was examined, recieved staples to close a head wound, and had radiographs taken, Although she was sore all over, her main complaint was pain and numbness in the middle of her shoulder that continued down to her arm into her fingers. The radiographs were negative, and the patient was disharged from the hospital 2 days of observation. She was to see her family physican to get the staples removed. The patients symptoms did not improve, and when she saw her family physican, she requested a referral to physical thearpy, the physical thearpist discussed additional imaging studies with the patient's physician. Magnetic resonance imaging (MRI) revealed three fractures and a sublaxation fo the c6-c7 vertebrae, which would be consistent with the patient's symptoms. (The original plain films were blurry in this area.) Subsequently, A.L., underwent a cervical fusion. Although improvement was noted, she now has some restriction in her neck movements."

4 Questions of Closing Case

Describe the adverse event in this case.
Did an error occur? If so, what was it?
Was the patient harmed?
Who should be blamed?

Explanation / Answer

1. ADVERSE EVENT.

a. C6 and C7 spines are found in the lowest level of cervical spine just below the base of neck any injury or harm caused in this region of the spine may lead to quadriplegia, quadriplegia is the partial or total loss of sensation of all four limbs and torso, it is also known as tetraplegia. While some has reported patient with C6-C7 subluxation can also lead to death due to cardiopulmonary complications as injuries to spinal cords can affect anything under the rib cage.

b. Another adverse event that could occur in this case is due to cervical spinal fusion or arthrodesis as the procedure is highly risky which involves joining the affected boned. This procedure can lead to failure of fusion of the bone, blood clots, nerve or spinal cord injury, hemorrhage, infection.

2. Error did occur in this case as the patient arrived in the hospital the health care members should have taken the history or complaints very carefully as the patient was complaining of pain and numbness in the middle of her shoulder that continued down to her arm into her fingers, physian or nurses should be well aware that it is the sign of C6-C7 injury and in such cases treatment should be started as soon as possible to get a good result and fast recovery and to avoid any complications.

3. The patient was harmed as the patient did not receive the correct treatment without receiving the correct treatment it could lead to partial or complete paralysis.

4. The physician who examined A.L. in an emergency room was to be blamed as it did not completely listened to A.L.'s complaint properly which led to wrong treatment.

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