Case Study – A mother expecting her first child miscarried at home

Case Study – A mother expecting her first child miscarried at home

Case study – A mother expecting her first child miscarried at home on June 22, 2010. The pregnancy was six months along. An ambulance was called at 4:57 a.m. The EMTs helped the mother to the stretcher and then went inside to retrieve the fetus from the bathroom floor. The baby was seen moving its head. The EMTs requested ALS to the scene. The baby was placed inside a small container. The ALS personnel visually assessed the fetus and stated the fetus was “non-viable”. There was never a fetal heart check in the field. Mother and fetus were transported to the hospital arriving at 5:16 a.m.

At the hospital, a nurse noticed that the fetus was warm and had a heartbeat. The baby was raced to the special care nursery and placed on a warmer. The staff then proceeded to resuscitate the baby. The baby was dusky and noted to have a heart rate of 30 with respirations of 6-8 at 5:40 a.m., and cardiopulmonary resuscitation was initiated. The oxygen saturation was 2-10%. The baby was intubated at 5:55 a.m. At 6:05 a.m., the blood pressure was 44/24. By 6:15 a.m., the baby was on a ventilator with oxygen saturation of 96%, a heart rate of 102, but remained dusky. By 6:30 a.m., the baby’s heart rate was 120 and blood pressure 52/24.

At 7:45 a.m., the baby was transported to a Boston hospital NICU for further care and treatment. Unfortunately, the baby died on August 10, 2010 at age 1 month and 16 days, not from prematurity but rather from brain damage due to lack of oxygen.

The plaintiffs’ claimed the accepted standard of care for basic and paramedic emergency medicine technicians in Massachusetts in 2010 required basic and paramedic EMTs to provide appropriate evaluation and treatment by following established protocols. It is beyond the scope of practice for EMTs at any level to make determinations in regard to viability of a patient. As a result of the negligence, the baby was improperly designated as “non-viable”, was placed in a Pizzeria Uno’s delivery plastic bag inside of a box with a lid on it further depriving the baby of oxygen, and as a result was not resuscitated for the first several minutes of life.

Lubin & Meyers. (2016). EMT negligence lawsuit settles for $1 million. 2011 medical Malpractice Trial Report. Retrieved from http://www.lubinandmeyer.com/cases/emt-malpractice.html

1. Title page (1 slide)
2. What are the facts of the case? This should include: what do we need to know, who is involved in the situation, where does the ethical situation take place, and when does it occur? (3-4 slides)
3. What is the precise ethical issue in regards to autonomy, nonmaleficence, beneficence, fidelity, and justice? (4-5 slides)
4. Identify the major principles, rules, and values of the case.  Values are sets of beliefs about good and bad, right and wrong, and about many other aspects of living and interacting in the society with others. A principle is a personal rule that governs personal behavior. A rule is generally imposed by a figure of authority, and used to guide and govern people. (3-4 slides)
5. Locate the scope of practice for EMTs in your state.  Is your scope of practice dictated by the state or facility the EMT works for? Does the scope of practice vary from state to state? Explain and support your answers (4-5 slides)
6. Locate your professional code of ethics for EMTs.  Does the code of ethics address autonomy, nonmaleficence, beneficence, fidelity, and justice? Explain and provide an example for each (5-6 slides)
7. Based on the scope of practice and code of ethics found, do you support the EMT’s decision in this case? Why or why not? Be specific with examples (3-4 slides)
8. If you were a member of the ethics committee at this facility, what actions or changes would you recommend changing? Why? (2-3 slides)