SUMMARY CAS cify of San Rfe All the elements necessary to establish negligence w
ID: 347152 • Letter: S
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SUMMARY CAS cify of San Rfe All the elements necessary to establish negligence were wel established in Niles v. City of San Rafael.34 O at approximately 3:30 PM, Kelly Niles, a young boy, got into an argument with another boy on a ball field, and he was hit on the right side of his head. He rode home on his bicycle and waited for his father, who was to pick him up for the weekend At approximately 5:00 PM, his father arrived to pick him up. By the time they arrived in San Francisco, Kelly appeared to be in a great deal of pain. His father then decided to take him to Mount Zion Hospital, which was a short distance away. He arrived at the hospital emergency department at approximately 5:45 PM On admission to the emergency department, Kelly was taken to a treatment room by a registered nurse. The nurse obtained a history of the injury and took Kelly's pulse and blood pres- sure. During his stay in the emergency department, he was irri- table, vomited several times, and complained that his head hurt An intern who had seen Kelly wrote, "pale, diaphoretic, and groggy," on the patient's chart. Skull X-rays were ordered and found to be negative except for soft tissue swelling that was not noted until later. The intern then decided to admit the patient. A second-year resident was called, and he agreed with the intern's decision. An admitting clerk called the intern and indicated that the patient had to be admitted by an attending physician. The resident went as far as to write "admit" on the chart and later June 26, 1973Explanation / Answer
Title and Citation: Nile v. City of San Rafael and citation refers it as a New York case.
Facts of the case: On June 1973, 3.30 pm, Kelly Niles got hit, after which he rode home. At 5pm his father arrived to pick him up for week end, and then took him to Mount Zion hospital. At 5.45pm he was taken to emergency department . Nurse took history of injury, pulse, bp. Skull xray done and came negative. An intern made report and asked to admit him and it was confirmed by a 2nd yr resident, but issue came as ,admit only can be done by physician. In the meantime pediatrician checked Kelly and then sent him home. At 7pm he returned to his father's apartment,and was already showing signs gor head injury. A phsiciatrist friend checked him and found one pupil larger and then Kelly taken back to emergency department where he was diagonised with epidural hermatoma. At present Kelly can move only his eyes and neck.
Issues : (1.) Organisational effectiveness (2) Faulty Operations management (3) Workforce collaboration issues (4) Service quality and negligence (5) Support liabilities (6.) Consumer distress
Decisions: The proximate cause of injury was placed with the hospital and $4 million was awarded against the defendants.
Reasoning: $2.5 million was compensatory damages and $1.5 million was for pain and suffering.
Analysis: (1) The hospital lacked Organisational effectiveness. It did not follow the procedures, protocols, policies relating patient care. (2.) The hospital did not follow the required operations management needed for patient care. It neglected the steps related to handling emergency situations (eg. The physician did not conduct thorough examinations and did not mention them to the patient's father. The pediatrician too did the same. There was clear issue regarding diagonising and admitting the patient) (3.) There was lack of workforce collaboration as the patient though initially suggested to be admitted, was not done due to process issue of requiring physician (4.) The service quality of the hospital was poor as there was erroneous diagonisis which led to early discharge. It was clearly testified by the neurosurgeons in Court, that if Kelly was admitted properly, he would have recovered. So definiitely negligence too was involved. (5.) The patient's guradian was not informed about the precautions pertaining to head injury signs referred in results, for which he needed to be admitted. So there was also support laibilties. (6.) Kelly now can move only his eyes and neck and so have suffered immnesely. So the judgement was righfully awarded.
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