Regis College PMHNP Legal and Safety Risk Assessment Case Study Analysis

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Purpose: The purpose of this paper is to foster your synthesis of course content relevant to medical liability concepts. You should complete the learning materials before completing the case as important background information will be included in these resources.

Process: A rubric is provided to assist in communicating the expectations for this assignment. The questions within each case study are designed to direct the focus of your paper. Reference the paper where appropriate, especially in the discussion about the standard of care.

Case Navigation: Please answer the following questions listed as they relate to the case and the learning material related to malpractice and standard of care. (attached)

Remember to use APA format, including cover sheet and a reference list.

The paper should be about 3–5 pages in length.

Please refer to the Grading Rubric (attached) for details on how this activity will be graded.


****I think the PMHNP was found guilty because she did not conduct an in depth screening for depression and a safety risk assessment was not documented. The PMHNP should of also thoroughly documented that she reviewed the risks associated with taking Prozac and she should have gotten informed consent from the patient's mother regarding this before prescribing.

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11/1/2019 Legal Case Rubric Legal Case Rubric Legal Case Rubric – 100 Points Criteria Identify defendant. Use of legal standards when analyzing potential medical malpractice: duty, breach of duty, causation, damages and negligence Exemplary Exceeds Expectations All components very welldemonstrated 30 points Advanced Meets Expectations All components generally well demonstrated or some very well exhibited but not all elements included Intermediate Needs Improvement Components addressed to a more limited extent or some generally well described but others missing or minimally described Novice Inadequate Total Points Minimal discussion of each or many missing elements 30 20 points 26 points 23 points Scholarly discussion of standard of care of the practice issues relevant to the case. If applicable differential diagnosis. Thinks critically about relationship of legal issues and standard of care. Generally discusses relationship of legal issues and standard of care. Limited discussion and critical thinking about relationship of legal issues and standard of care. 30 points 26 points 23 points No or minimal critical thinking apparent. Incomplete discussion about legal issues and standard of care. 30 20 points Demonstrates synthesis of legal issues as they apply to personal professional practice. Describes complexity of legal issues as they apply to personal future practice Basically describes legal issues as they apply to personal future practice Does not clearly discuss legal issues as they apply to personal future practice 22 points 19 points Does not identify or discuss legal issues as they apply to personal future practice 25 17 points 25 points Support prediction of case verdict with sound logic thread grounded by legal concepts Consistently & accurately uses synthesis & evaluation Generally uses synthesis and evaluation Sometimes uses synthesis and evaluation 4 points 3 points 5 points Professional Application Major elements of the paper are supported by evidence based articles/guidelines Inaccurately or minimally uses synthesis & evaluation 5 2 points Elements only partially supported by evidence based articles/guidelines Poor quality or applicability of evidence based articles/guidelines 4 points 3 points Generally demonstrates appropriate format Mostly easy to follow quality and organization of paper Occasionally follows appropriate format lacks organization and clarity Does not include evidence based reference 5 2 points 5 points Technical aspects of paper: Grammar, spelling, Intelligible, Quality of writing/organization of paper; and use of APA Consistently demonstrates appropriate format Easy to follow clear quality and organization of paper Rarely uses appropriate format Ineffective organization and clarity 5 3 points 2 points 4 points 5 points Total Points https://lmscontent.embanet.com/RC/MSN/NU668/Rubrics/NU668_Legal_Case_Rubric_FA119.html 100 1/1 PMHNP Legal Case Study Name: Lucia Age: 15 Gender: Female Guardian/parent: Mother Other details: Hispanic 1January 2012 Lucia was seen in an emergency room two days earlier for nausea, abdominal pain and vomiting. She was then seen at the outpatient mental health clinic by the psychiatric nurse practitioner, who worked under the supervision of the off site psychiatrist. The clinic received federal funding. The psychiatric nurse practitioner was informed of the recent emergency room visit during the review of the intake paperwork completed by Lucia’s mother. The psychiatric nurse practitioner prescribed Zofran 4 mg by mouth every 4 hours prn for nausea and Prozac 40 mg by mouth every morning on a prescription pad which had been pre-signed by the supervising psychiatrist. The psychiatric nurse practitioner’s notes indicated that the Prozac was prescribed for depression, but an in depth screening and safety risk assessment was not documented. 2February 2012 The patient was instructed to return in one month. Three weeks later Lucia hung herself in her bedroom closet with a belt. She was found by her mother and brother and was transported to a nearby hospital. The patient suffered a catastrophic brain injury and died three years later. She required around-theclock care during those three years. Family’s Complaint The family claimed that Prozac should not have been prescribed due to a lack of signs of clinical depression and claimed that the FDA had issued a warning regarding the use of Prozac in adolescents, specifically that Prozac use in adolescents increased the risk of suicidal thinking and behavior. NP’s Claim The psychiatric nurse practitioner claimed that the clinical evaluation for depression supported the diagnosis. The psychiatric nurse practitioner also claimed that the suicide attempt followed a breakup with her boyfriend and a fight with her father and that the medication played no part in the incident. Review the Case Please review the listed questions. 1. Identify the defendants AND areas of negligence in this case. 2. Identify and describe appropriate screening measures and safety risk assessment procedures in adolescents with depression. 3. Reflect on this case and identify what you would have done differently as a psychiatric mental health nurse practitioner. 4. Review the risk reduction strategies identified in Buppert (2017) pages 306-309, and identify which of the strategies may have reduced the risk of the outcome presented in this case. 5. What do you think the verdict was and why?
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Explanation & Answer

Attached.

PMHNP Legal Case Study
I.
II.

Defendants and areas of negligence in this case
Appropriate screening measures and safety risk assessment procedures in adolescents
with depression
a. Safety risk assessment procedures

III.

Reflect on this case and identify what you would have done differently as a psychiatric
mental health nurse practitioner.

IV.

Review the risk reduction strategies identified in Buppert (2017) pages 306-309, and
identify which of the strategies may have reduced the risk of the outcome presented in
this case.

V.

What do you think the verdict was and why?


Running head: PMHNP LEGAL CASE STUDY

PMHNP Legal Case Study
Student’s Name
Institutional Affiliation

1

PMHNP LEGAL CASE STUDY

2
PMHNP Legal Case Study

Medical malpractice claims can be propounded against any health care giver, including a
PHMNP. This legal case study involves a psychiatric nurse practitioner (PNP) involved in an
adolescent depression treatment. The patient, Lucia, was a 15-year-old Hispanic female took to
the emergency room by her mother two days earlier for nausea, abdominal pain and vomiting
and later seen at the outpatient mental health clinic by the PNP, working under the supervision of
the off-site psychiatrist.
“Defendants and Areas of Negligence in This Case”
Even though PNPs diagnose psychiatric disorders, psychiatrist should carry out extensive
patient evaluations and prescribe medication. Therefore, both the PNP and the supervising
psychiatrist (SP) had a share of negligence in this case scenario. The PNP prescribed
antidepressants without undertaking and documenting an in depth screening and safety risk
assessment. Wise (2016) presume that care providers should avoid recommending
antidepressants to pediatrics wherever possible because they can double the risk of suicide and
aggression. The SP pre-signed ...


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