THE UNITED METHODIST CHURCH

ECUMENICAL CHRISTIAN COLLEGE

MATATALAIB, TARLAC CITY

Submitted By:
Gutierrez, Maricris A.
BSN IV-B
Submitted To:
Sir Julius Quijano

NEGLIGENT ADMINISTRATION OF "CLOT BUSTING" MEDICATION TPA TO

ONE-YEAR-OLD INFANT - MASSIVE STROKE - PERMANENT BRAIN INJURY
- 24-HOUR NURSING CARE REQUIRED - DAMAGE AWARD CAPPED BY
CONFIDENTIAL HIGH/LOW AGREEMENT.

This medical malpractice action was tried against the defendant

Children's Hospital of Philadelphia, the chief of the hospital's intensive care
unit, a paediatric haematologist, critical care paediatrician and neurosurgeon.
The plaintiff claimed that the defendants negligently administered a "clot
busting" medication, a tissue plasmogen activator also known as "TPA," to a
one-year- old boy, causing a massive stroke and permanent brain damage. A
number of other physicians involved in the child's care were dismissed from the
case prior to trial. The defendants argued that the TPA administration was
appropriate and did not cause the child's cognitive and developmental
difficulties. The minor plaintiff was born in November 2002 as one of twins and
presented in a breech position. He suffered a seizure disorder and was
hospitalized several times during the first year of his life. He also required a
feeding tube and continuous nursing care during the day. During a March
2002 hospitalization at the defendant hospital to treat the boy's seizure
disorder, he developed a blood clot in the thigh in the area of an I.V. tube. The
child was evaluated for the blood clot by the defendant paediatric
haematologist. The minor plaintiff's blood clot was treated with TPA. The
plaintiff claimed that he subsequently suffered a massive stroke as a result of
the TPA, causing permanent brain damage and significant cognitive deficits.
The plaintiff's medical experts testified that the dosage of TPA administered to
the child was excessive. The medication, which inhibits clotting of the blood,
led to a brain bleed, cranial pressure and ultimately the stroke, according to
the plaintiff's claims. The plaintiff also alleged that the defendant hospital
lacked an appropriate protocol for administration of TPA to children and failed
to timely diagnose and treat the minor plaintiff's stroke. The minor plaintiff,
age five at trial, has been left with severe mental retardation. The plaintiff's
experts testified that the boy will never be able to live independently and
requires 24-hour nursing care.

The defendants argue that the minor plaintiff suffered from an infantile
seizure disorder known as West Syndrome. The defendants' medical experts
opined that it was this condition, and not administration of the TPA, which
caused the child's retardation. The defendants argued that the TPA was
properly administered in an appropriate dosage and that the boy's medical care
met the required standard of care in all respects. The defendant's expert also
testified that the child's life expectancy is limited to approximately ten years.
The jury found the defendant hospital 50% negligent, the defendant chief of
ICU 25% negligent and the defendant paediatric haematologist 25% negligent.
The defendant critical care paediatrician and neurosurgeon were found not
negligent. The plaintiffs were awarded $30 million in damages. The award
included $5 million in past medical expenses, $10 million in future medical
expenses and $15 million in pain and suffering. The damage award was capped
by a confidential high/low agreement.
REACTION:
On my own opinion, based on what the article is all about, it is an
example of medical negligence wherein the medical team involved didnt think
the appropriate measure that is to be done on the child. And because of this
medical negligence, it resulted to the death of the baby. The medication given
which is the TPA caused a severe brain damage on the child that resulted to his
death. This wont happen if the medical team involved thought of better
measures considering the age of the child and considering the reactions to the
childs illness. For me, this was a negligent act because negligence is a type of
tort or delict (also known as a civil wrong). "Negligence" is not the same as
"carelessness", because someone might be exercising as much care as they are
capable of, yet still fall below the level of competence expected of them. In this
case, the medical team lacked the high level of competence that is expected
from them.

THE UNITED METHODIST CHURCH

ECUMENICAL CHRISTIAN COLLEGE
MANGGA II, MATATALAIB, TARLAC CITY

Submitted By:
SANTOS, REGINA G.
BSN IV-B

Submitted To:
Mr. JULIUS QUIJANO

Hospital negligence issue nothing new

By Ramon Tulfo
Inquirer
HEALTH Secretary Francisco Duque III recently came out with the
results of an investigation of the Rizal Medical Center, saying the
deaths of seven new-born infants at the facility were not caused by
the hospitals negligence and dirty equipment. The investigation
also showed the babies mothers had infection of the blood which
they had not acquired at the hospital, he added.
Although Duque said the investigation revealed some degree of
negligence on the part of the hospital, Duque said the probe team
did not find a link between contaminated equipment and the
outbreak of neonatal sepsis, the cause of the infants deaths.
Were the probers dined and wined so they would come up with a
decision favorable to the government hospital? If not, were they
motivated by camaraderiethe them and us syndromesince
those involved are government health people and the probers are
from the Department of Health?
A former student nurse, who did on-the-job training at the RMC
three years ago, said the hospital had dirty equipment and the staff
didnt care to sterilize these. The complainant, now a licensed
nurse, said the staff didnt have any regard for the patients wellbeing. Doctors and nurses were also allegedly arrogant toward
mothers about to have babies.

As I said in my column dated Oct. 17, the alleged shabby treatment

of patients at the RMC delivery room was brought to my attention
by the student nurse in the now defunct Isumbong mo kay Tulfo
program. This columnist, in turn, informed Dr. Winston Go, RMC
director, about the complaint.
You know what happened to the nurse? She was expelled by her
school for coming to me.
I fought for the student nurse and got the services of lawyer-friend,
Vicente Chuidian, who made representations with the university to
reinstate her.
Because my attention was now focused on having the student
reinstated, the complaint on how the RMC staff handled their
patients was shelved and eventually forgotten.

REACTION:
First and foremost, I wanted to react on the statement
witnessed by the student nurse that the Hospital was dirty and all
the equipments are not being cared of to be sterilized that resulted
to neonatal sepsis. In that mere statement, it only proves that there
is this concerned citizen or student nurse that bothers to report this
to the columnist. Secretary Duque went to the hospital for a visit, of
course in that case, the hospital already bothered to do necessary
sanitary actions in their place. They already had their witness that
she saw how dirty the hospital was. And why did the institute tend
to expel her out of the school if she was not really telling the truth?
This only means that they are guilty of what she had reported and
that what she reported was really true. In that sense, the hospital
has committed negligence even if some tests say that the mother of
the babies have infections in them. Thats it; those mothers have

infection in them then why the does the hospital didnt make any
form of actions to prevent or to eradicate the said infection? Its just
there way of having defense mechanisms to cover up there faults.
For me, the hospital must be summoned for negligence because
they do have a witness to stand there and tell the hospital is dirty
and that they are not taking into considerations those sanitary
measures.

THE UNITED METHODIST CHURCH

ECUMENICAL CHRISTIAN COLLEGE
MATATALAIB, TARLAC CITY

SUBMITTED BY:
MARICEL NICDAO
BSN IV-B

SUBMITTED TO:
MR. JUIUS QUIJANO

Dr. Malaria's License must be Revoked

I went to the medicare center in our town here in Palawan because
of high fever and intolerable headache. The doctor on duty asked me

questions:
Dr: Anong nararamdaman mo?
Me: Mataas po ang lagnat ko, tsaka masakit po ang ulo ko.
Dr.: Masakit ba ang sikmura mo?
Me: Hindi po.
Dr.: Mapula ba ang ihi mo?
Me: Opo.
Dr: Nahihilo ka ba?
Me: Opo.
Dr.: Ay, malarya yan!"
He then called the nurse who gave him a pen and a sheet of paper.
He proceeded to write a "shopping list" of meds, etc. Then he left,
leaving the paper to the nurse. I asked the nurse to show me the
paper. There was no name of the patient (me), no date, no signature
of the doctor. Only names of medicines. No other info like number or
pieces of each. The nurse then told my "bantay, neng sunod ka na
kay doc, baka magsara na ang botika nila!" I said, "paano ang
bayad?" Nurse: "saka na lang po." When my "bantay" returned, she
has a bag of what she got from the botika. It was pretty obvious that
the doctor's wife in the botika knew the pack to prepare. All for
malaria. So that first night, I was given anti-malarial drugs like
'fancedar' and 'chloroquine'. Same until the 2nd day. Later in the
afternoon, I complained because my condition did not improve a bit.
Take note, there was no blood smear or urine test at least. I asked
the nurse why so. The lab tech was on leave. I showed signs of
irritation to the nurse. That was only the time when someone took
my blood and urine samples.
No one told me the results until I asked the nurse again.
Me: "Anong result ng test? may malaria ba ako?"
Nurse: Negative "po".
Me: "O, e bakit pinapainum nyo ako ng para sa malaria?
Nurse: "Yon po kasi order ni doc."
I told her that I want to change my doctor... and I did after much
"kulitan".
The new doctor confirmed my suspicion. "Wala akong malaria. UTI
ang meron." He gave me antibiotics and in less than 4 hours, I was
relieved of fever. Imagine, for 2 days they administered 'chloroquine'
to me? All the while I have UTI "pala...

REACTION:
A really sad story about that girl who was
misdiagnosed of Malaria. For me, its really beneficial for you as a
patient to ask on some things rather than letting other people
govern you and you just let them do their thing without merely
asking on some information that you should know. The girl is right;
the doctors license must be revoked because of malpractice and
incompetence. Same with the nurse on duty, you as a nurse must not
always follow the doctors orders, you must also know and think
critically what is right before following doctors orders, because
doctors orders are not always right and those orders are sometimes
were just misdiagnosed or misprescribed that is very dangerous to
the patient. You as a nurse must know how to think critically at all
times and never be afraid of asking the doctor but always do it on a
professional and polite way.