Mr. Ard began feeling nauseated and had shortness of breath while in the hospital. His wife rang the call bell multiple times over 1.25 hours but nurses did not respond until it was too late. Mr. Ard did not survive the medical emergency. Experts testified that nurses failed to properly assess and monitor Mr. Ard's condition, which fell below the standard of care. This negligence contributed to his death. As a result, a wrongful death lawsuit was filed against the hospital.

1. [From 10$/Pg] 2006 “ Health
[From 10$/Pg] 2006 “ Health CHANCE OF SURVIVAL DIMINISHEDOn the afternoon of May
20, the patient, Mr. Ard, began feeling nauseated. He was in pain and had shortness of
breath. Although his wife rang the call bell several times, it was not until sometime later
that evening that someone responded and gave Ard medication for the nausea. The nausea
continued to worsen. Mrs. Ard then noticed that her husband was having difficulty
breathing. He was reeling from side to side in bed. Believing that her husband was dying,
she continued to call for help. She estimated that she rang the call bell for 1.25 hours before
anyone responded. A code was eventually called. Unfortunately, Mr. Ard did not survive the
code. There was no documentation in the medical records for May 20, between 5:30 PM and
6:45 PM, that would indicate that any nurse or physician checked on Ard’s condition. This
finding collaborated Mrs. Ard’s testimony regarding this time period.A wrongful death
action was brought against the hospital, and the district court granted judgment for Mrs.
Ard. The hospital appealed.Ms. Krebs, an expert in general nursing, stated that it should
have been obvious to the nurses from the physicians’ progress notes that the patient was a
high risk for aspiration. This problem was never addressed in the nurses’ care plan or in the
nurses’ notes.On May 20, Ard’s assigned nurse was Ms. Florscheim. Krebs stated that
Florscheim did not perform a full assessment of the patient’s respiratory and lung status.
There was nothing in the record indicating that she completed such an evaluation after he
vomited. Krebs also testified that a nurse did not conduct a swallowing assessment at any
time. Although Florscheim testified that she checked on the patient around 6:00 PM on May
20, there was no documentation in the medical record. Ms. Farris, an expert witness for the
defense, testified on cross-examination that if a patient was in the type of distress described
by Mrs. Ard and no nurse checked on him for 1.25 hours, that would fall below the expected
standard of care.1 What happened?Why did things go wrong?What were the relevant legal
issues?How could the event have been prevented?What is your verdict? he similarities and
differences between the American legal system and the legal structure of health care
organizations.Regarding the American legal system and health care organizational legal
structures, there are a multitude of similarities and differences. Both systems implement a
degree of liability in the sense of governing bodies designed to facilitate the “agreed upon
actions,” laws given a specified situation. As Miller cites (2006), “government is divided into
three branches, legislative, executive, and judicial. On the federal level, statutes are enacted
by Congress and only become law when approved by the president” (p.4). However, a
particular bill can be over-ruled and disallowed by the Supreme Court of the United States.

2. Miller adds (2006), “a method of overriding a Supreme Court decision, while complex and
often time consuming, is to amend the Constitution” (p.4). Similarly, health care
organizations implement governing boards, a group of individuals designed to regulate,
instill, and facilitate specified laws and by-laws regarding the organization in question.
Miller explains (2006), “almost all health care is delivered within an organized system.
Clinical and regulatory complexity requires an infrastructure that can be provided only by a
well-ordered structure. The organization of most health care entities, regardless of their
type, includes a governing body and a chief executive officer” (p.29). Another interesting
similarity exists between the American legal system and the legal structure of health care
organizations. Both systems must comply with the specified laws imposed by the U.S.
President, Congress, and the Supreme Court. A prime example would be the enactment of
the laws governing workman’s compensation allocation and the unemployment benefits act
for all workers.A subsequent and primary difference between the American legal system
and the health care organizational legal structures centers on bylaws. For-profit
organizations incorporate bylaws into policies and procedures and any changes are
generally related to the workforce via addendums within the organizational personnel
employee handbook. Interestingly, regarding the Long-Term care industry, specific laws
governing the care of residents become enacted through federal and state mandates, such
laws are enforced by federal and state agencies and must be followed by the individual
Long-Term care facilities; however, the Long-Term care organizations cannot change such
laws, policies, and procedures. Yet, the federal and state agencies can and do change these
laws according to statistical incidence such as falls rates, medication errors, and reluctance
to comply pertaining to yearly facility inspections. Another poignant and specific difference
relates to appointment vs. election. Miller cites (2006), “health care entities ultimate
responsibility centers on establishing goals and polices, select the chief executive, and
appoint medical staff members” (p.30). Within the American legal system, the chief
executive leaders are elected and maintain their position through the process of re-
election.Lastly, the monetary acquisition of funds regarding the for-profit organizations
centers on investors, multiple corporations, and stakeholders/ stocks. However, federal
organizations are funded through taxation of its citizenry. Interestingly, there are in place a
great deal of federal and state regulations regarding the offering, sale, and re-sale of
company stock and partnership interests. Wolper (2004) suggests that, “historically, the
legal structure of the health care delivery system in the United States consists almost
exclusively of personal interactions between patients and physicians. Today, the health care
delivery system is almost completely composed of corporate entities, many of which are
investor owned” (p.93). Through similarities and differences of the American legal system
and the health care organizational legal structures, it is interesting to view the justification
of the intermingling and adaptation of principles that appear to be borrowed from the
American legal system and incorporated into the health care organizational legal system.
Yet, with this said, the federal government provides more than just structure for health care
organizations, they implement a great deal of the mandated policies and procedures that
must be followed with strict adherence, regardless of the health care organizations self-
enacted laws, by-laws, polices, and procedures.ReferencesMiller, R. D. (2006). Problems in

3. health care law. Sudbury, MA: Jones and Bartlett Publishers.Wolper, L.F. (2004). Health Care
Administration: planning, implementing, and managing organized delivery systems.
Sudbury, MA: Jones and Bartlett Publishers.Dr. Robert C. Smiles, Ph.D. Assistant Professor,
University of Arizona Global Campus