Final Project Submission

Case summary

The primer reviews a court ruling on an instance of Rosalinda Iturralde, who spoke to the offended party, Arturo Iturralde versus Hilo Medical Center – HMC. In synopsis, due to multiple falls as a result of leg weaknesses, Artuto Iturralde was admitted to HMC. Dr. Ricketson, an orthopedic surgeon, diagnosed the client with degenerative spondylolisthesis lumbar 4-lumbar 5 with stenosis, and the conclusion arrived on January 24, 2001, was that he would undergo spinal fusion surgery. Lack of proper Medtronic surgical hardware kit, the hospital decided to order them from Tulane and Memphis. The HMC staff in charge ignored the procedural inventory policy on each tray, and the instruments within. Final Project Submission

Despite Dr. Ricketson being informed that the full inventory was not completed as supposed, he decided to proceed with the surgery. Medtronic representative was contacted to deliver new rods, which they said it would be delivered after 90 minutes. Dr. Ricketson understanding the risks it will be on the patient due to prolonged surgery procedure decided to use a screwdriver in place of the rods instead of waiting for the 90 minutes stipulated. After he finished, the doctor did not inform the hospital, the patient, and the family, but instead advised the patient to continue with the therapy. While going home, the client’s screwdriver broke, and he was forced to have another post-surgery from the same hospital. Dr. Ricketson removed the shattered pieces and replaced with proper rods. The nurse circulator present for both surgical procedures reported the matter to her supervisors. She was told that it is the doctor’s responsibility to inform the client. Unable to speak in Spanish, Mrs. Feldmeyer did not notify the patient right from the first surgery. The nurse circulator collected the removed pieces of the shattered screwdriver, taken it to the attorney’s office then later informed the client’s sister Rosalinda, who takes care of him. Mr. Arturo’s condition kept on falling apart after release bringing about further medical procedures and hospitalizations and at last bringing about his passing two years later. Final Project Submission

The caretaker of the victim accused both the doctor and the hospital for negligence. The court awarded the family $5.6 million (Idemoto, 2007).


Medical Malpractice Component:

Legal Components

According to Bono & Hipskind (2019), Hippocratic oaths, which depend on the ethical guidelines such as equality, non-wrathfulness, respect for patient’s decision, and beneficence, are believed to guide doctors. It is considered a legal component the moment both the doctor and the hospital failed to check all the necessary instruments amid the medical procedure (Ricketson, 2009). Professionally, Dr. Ricketson acted against the standards of care when he decided to implant screwdriver to the patients without his consent and later harmed him, leading to death. This was a breach of healthcare legal standards of care, which demonstrates a high level of carelessness and disregard (Bono & Hipskind, 2019).

Malpractice Policies

Doctors suspected to be the cause of patient’s mischief and putting patients at risk of any harm are directed by malpractice policy to cater for the damages registered. State laws govern these policies by stipulating that any injured patient should receive full compensation after following due process of civil process in case of his/her health is endangered by a hospital or the doctor in charge (Idemoto, 2007). The patient can recuperate harms when the doctor claimed an obligation to the offended party, when the specialist neglected standards of care and when the damage is compensable. Final Project Submission

Standard of care

By implanting wrong rods when the correct ones were inaccessible shows a definite infringement of duty under the standard of care. Through Dr. Ricketson’s careless, it directly predisposed the entire hospital and staff being described as incompetent when providing health care services as well as attending to patient’s need. It as well shows the patient’s respect and privacy are breached because the doctor failed to seek permission from the patient before embedding the screwdriver rods. This event rhymes with the idea that government-sponsored healthcare facilities are incapable with respect to techniques, plus they are inappropriately supervised (Idemoto, 2007). Amid this medical procedure, the hospital was entirely responsible for the damages; notwithstanding, Dr. Ricketson was the key participant of this unfortunate malpractice.

Cultural back ground

Healthcare consumers from different cultural settings would be impacted explicitly by any malpractice exercised in this hospital. The community would have lost confidence and conviction for any healthcare facility run by the state; as they perceive these facilities as their source of tribulations rather than being useful for patients. Additionally, patients with terminal maladies could conceivably choose to get health care services from private sectors or conventional systems. There is a likelihood that patients would rely more on these traditional methods and medications then state-run facilities since they consider them unmistakably reliable and secure to the practices of a contemporary healthcare organization. Final Project Submission


Looking at the aftermath of this case and the malpractice affairs associated with it, Dr. Ricketson should carry the cross by being held accountable for the demise of the patient. He is supposed to pay for the damages he has caused to the family of the deceased, as well as his licensure to be withdrawn from practicing medicine since he abused patient trust. The caretakers present in the surgical procedure room ought to be reprimanded by the board of trustees of healthcare services to find out if they were aware of the malpractice and decided not to disclose the situation before it was taken to the point of a malpractice lawsuit.

With that being said, both Dr. Ricketson and HMC were both found negligent by the jury with them feeling both parties negligence was a substantial factor in causing Mr. Arturo’s harm leading up to death. According to the case, the jury allocated 65% of the fault to Dr. Ricketson and 35% to HMC determining that Arturo suffered general and unadjusted damages and awarding his estate and Rosalinda in the total sum of $2,000,000. The jury found that Medtronic was not liable or responsible for any of the damages leading to Mr. Arturo’s death as a claim was also filed against them.


Bono, M. J., & Hipskind, J. E. (2019). Medical malpractice. In StatPearls [Internet]. StatPearls Publishing.

Idemoto, S. K. (2007). Medical Malpractice in Hawai’i: Tort Crisis or Crisis of Medical Errors. U. Haw. L. Rev., 30, 167.

Ricketson, R (2009). Robert Ricketson and the Surgical Screwdriver Medical Malpractice Case: The medical records revisited. Retrieved from: Final Project Submission

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