FNP 591 Week 1 Discussion – United States University

Nurse practitioners are crucial players in healthcare today since they are normally entrusted with the work of diagnosis, treatment, and management of individual patients. In others, making a wrong diagnosis may spell doom for a patient, and this is the reason why diagnosis and communication are paramount in this area.

The example of the case of Esteban and Mr. Shien illustrates the potential outcomes of misdiagnosis and a lack of collaboration between physicians and patients as well. In this case study, this paper will analyze the medical and legal implications of this case, in which we discuss the differential diagnosis, the legal liability of the provider, and the various opportunities that Esteban overlooked, which would have saved the life of Mr. Shien.

Appropriate Differential Diagnoses for Mr. Shien

Esteban had to think of the following differentials based on the symptoms of Mr. Shien that include swelling in the calf area and pain.

Deep Vein Thrombosis (DVT)

The most significant differential diagnosis should not be overlooked since the emergence of life-threatening pulmonary embolism is a possibility (Amato et al., 2021). The expression of unilateral swelling of the calf and pain exhibited by Mr. Shien was quite characteristic.

Baker’s Cyst

It may result in similar symptoms, and the chances of having a potentially dangerous disorder, like a pulmonary embolism, are lower.

Cellulitis

This may cause inflammation and stiffness, but the other typical external signs of inflammation, such as redness and heat, may exist, too.

Muscle Strain or Tear

This may bring about pains that are localized in an area, although they are usually associated with a history of trauma or overuse of a body part, of which none exists.

Gout Flare

Mr. Shien already had a history of gout, but the symptoms mentioned in this case do not feature a gout exacerbation, which typically includes the first metatarsal joint.

Legal Liability to Explain Diagnostics

Yes, a provider can be legally informed to inform the patient about the diagnostics that they need to order. This comes under informed consent and, in this case, the patients have the right and capacity to consent to the tests being administered and the rationale (Amato et al., 2021). In the case of Esteban, it may be considered as the absence of informed consent in case Scott failed to explain to him the potential development of DVT, and the purpose of the ultrasound; this would heighten the level of anxiety in the patient and make him less receptive to the treatment process.

Missed Opportunities by Esteban

Esteban has lost some important chances.

• First Visit: He did not initially consider the possibility of DVT as the diagnosis, but rather assumed that the patient had less acute problems.
• Communication: He did not communicate effectively through language when describing the risky condition the patient was in or the necessity to have an ultrasound, which could have assisted in detecting the issue and addressing it earlier.
• Follow-up and Urgency: His response to being informed that there was a DVT after they conducted an ultrasound was also a bit lethargic. The patient should have attended the hospital shortly after the diagnosis because it would have helped save the life of this patient.

Should Esteban Be Sued?

Esteban risks being sued in a medical malpractice lawsuit. The explanation of this would be the inability to properly diagnose and treat Mr. Shien as an inpatient. It takes place in cases where the physician engages in a negligent act, omission, or decision that causes injury to the patient.

In part, the negligence of DVT, inadequate explanation of the severity of the case, and delayed response to the diagnosis of DVT that was subsequently confirmed by swabbing by Esteban were likely to miss an opportunity to save the life of Mr. Shien through a pulmonary embolism (Gossard et al., 2021). The legal case would focus on whether the actions of Esteban in the special situation were reasonably unlike what can be expected of a nurse practitioner.

Conclusion

The tragic conclusion of the case Mr. Shien had is a clear testimony to the role that nurse practitioners are endowed with. The inadequacy in the management of the symptoms of Mr. Shien, as well as the inability to diagnose Esteban, led to a fatal pulmonary embolism. The case in question is a bright example of the necessity to provide adequate assessment, monitor the patient all the time, and clarify what traps and stages of the diagnostic process may occur.

On top of this, it demonstrates some of the legal implications that can arise in the event that the standard of care is not adhered to. Any indication of a client exhibiting in a health care environment should be taken into serious consideration and dealt with diligently to ensure that the patient is not exposed longer to health-related complications.