Moral ambiguity and medical legal advice

[Ophannus]

Back story: My grandmother is 92 years old and has a severe level of dementia which impairs her mobility and balance. Several years ago she had a thyroidectomy and has been on synthroid since. A few days ago she was admitted to a hospital for a severe UT infection and during her stay she fell while unsupervised and fractured her hip and 3 vertabrae of her spine and is bedridden and in excrutiating pain. Since she was a fall-risk with dementia and was unsupervised during her fall this is a huge lawsuit here.
The problem is that the doctor was negligent in his treatment and when she was moved from the nursing home to the hospital.
My grandmother hadn't been eating and her legs were ridiculously swollen. Her sodium was abnormally low despite being on a very high dose of saline and the doctors couldn't figure out why. They were looking at cortisol levels and hormone levels and all that nonsense and my mom believed it might be due to her not getting her synthroid. My mom works in the same hospital system that my grandmother is a patient in and is an c.NP. She used her privliges to check my grandmother's medical records and low and behold there was no synthroid on the list. Had my mother not checked, my grandmother would have died from severe dehydration.
My mother wants to sue the hospital for the negligence and the fall but she's worried the hospital could trace her access of my grandmother's medical records and she may lose her job/license for breach of medical confidentiality. This is a moral gray area because my mother has been a nurse for over 25 years and always did the right thing but the doctors were being negligent with my grandmother and they almost killed her had my mother not intervened. Could the hospital really fire her for this violation and have her license revoked even though she saved someone's life or is that considered retaliation?

[Souj]

Is your grandmother hot?

[hey]

Is your grandmother hot?

OP obviously isn't able to fairly judge this, so he's just going to have to post nudes.

[Tyche]

Just because she had dementia does not mean she has to be supervised. Every hospital has protocols for fall risks. bed lowered, side rails up x4, bed alarm, etc, your mom should be familiar with the protocols. Unless their protocol was 24/hr supervision, I don't see where you have a case in regards to the fall. Medical administration could go a lot of ways. A medical history should have been done upon admitting stating she was on the synthroid. The doctor could have held the med for a number of reasons. Maybe the history didn't make it to admissions, which may not be the fault of the hospital. Quite honestly, it sounds like your mother is letting her emotions get the better of her clinical judgement.

[Ophannus]

Yeah she was supposed to be on 24/hour supervision because she has fallen before. NOW she's on 24 hour supervision that she actually broke something and the hospital knows a lawsuit is imminent. She is on synthroid but the hospital didn't have synthroid on their list of medications to order, something must have been lost during her transfer from the nursing home to the hospital. When my mom checked the records she saw that she hadn't received any synthroid in more than 6 days since she'd been in the hospital and the medical staff was completely unaware that was on it at all. She obviously wasn't going to tell the staff that she breached HIPAA by looking up her mother's chart, but she called the hospital and asked "Hi umm is my mother getting her synthroid because maybe that's why her sodium levels are in the single digits despite being on saline" and the staff basically said "synthroid? what synthroid? there's no order for synthroid on her chart".

[Tyche]

Also, all your mother had to do was ask to see her chart. Or have your grandmother ask to see it. Patients have a right to know what meds they are and aren't on. Your mom had no reason to go seal team 6 on her chart.

[Yugl]

Well, I understand if you need another month of five before you get the money to change servers now.

[hey]

Could the hospital really fire her for this violation and have her license revoked even though she saved someone's life or is that considered retaliation?

As an expert on medical dramas, and thus real life medicine, i can assure you, following protocol is the only thing that ever matters, regardless of how many lives it might cost.

[Tyche]

Yeah she was supposed to be on 24/hour supervision because she has fallen before. NOW she's on 24 hour supervision that she actually broke something and the hospital knows a lawsuit is imminent. She is on synthroid but the hospital didn't have synthroid on their list of medications to order, something must have been lost during her transfer from the nursing home to the hospital. When my mom checked the records she saw that she hadn't received any synthroid in more than 6 days since she'd been in the hospital and the medical staff was completely unaware that was on it at all.

Well, if this is true and the hospital breached a fall protocol and a fall occurred with injury, then you have a very very good case. It has to be proven that the fall occurred because protocol was not followed, which if she was on 24 hour supervision, this would be the case. Now whether the doctor or the nurse is held liable is a different story. If the protocol was ordered and in place and the nurse simply didn't follow it, the hospital could hang the nurse out to dry, the doctor or hospital wouldn't be liable, and you'd be dealing with whoever insures that nurse.

Before you even begin to deal with improper medication administration, you have to find out who is at fault and find damages. It sounds like the better case is the fall.

[mallister]

get a lawyer. do not screw with HIPAA.

[Apelila]

I don't directly see how the route to finding the medicine wasn't being administered is an issue. If your mom is a Nurse there and a family member and is authorized to access medical records of her family (Some places have rules against this) then nothing has been violated. If she has power of attorney I believe that covers HIPAA.
Though she could have just as easily asked to see her grandmothers chart and the list of medications she's been given, the fact that she didn't ask but went looking is going to be where the hospitals lawyers hammer down if there was a breach in protocol.

TL;DR - your mom should know more clearly than we will if she ran afoul of HIPAA regulations. If she didn't, and only broke hospital protocol then they still have a (weak) place of defence. If she did, then she risk's a lot more than free money.

[Ophannus]

Well the case IS the fall but what makes it sticky is that they can trace her access of the medical records and fire her for breach of HIPAA despite the fact that if she hadn't, my grandmother would have died. So what's keeping my mother from filing the lawsuit is her losing her job/license for in essence saving her mother's life because the doctors weren't on the ball.

[mallister]

^ this.

[Ophannus]

No power of attorney. My grandmother was a headstrong, obstinate fool and never gave it to my mother, and now that she has dementia she isn't of sound mind. So I think my mother has to now pay like $6000 to get guardianship so she can sue on her behalf -_-

[Byrthnoth]

Fault is clearly on the hospital. I don't think the fact she looked at medical records without permission would have any legal effect on the case, but with 25 years experience she sure as hell knows better than us what it'd do to her license. If she wins the case though (after several years of fuckery), she'd hardly need her license. <_<

[Ophannus]

You misunderstand. She isn't worried about it affecting the case at all. She's worried that the moment she sues, they'll trace the access records and see her name and fire her. So during the few months of the lawsuit being settled she'd be out of a job and we'd lose our car/house. And even then we wouldn't really get any money until my grandmother dies because she never gave power of attorney over.

She wasn't under 24 hour supervision during her fall but she should'vbe been because she's a fall risk. She fell 2 weeks ago because they tranquilized her and she was unsupervised so they should have put her under 24 hour supervision. My mother told the doctor recently that my mother is a fall risk, she fell before when she was sedated. The doctor said "well i dont like to sedate my elderly patients". My mother asked 'well how will you protect her from falling' and the doctor said "1 on 1 24hour supervision" which was never implemented, leading up to the subsequent fall and fractured spine.

[Apelila]

No power of attorney. My grandmother was a headstrong, obstinate fool and never gave it to my mother, and now that she has dementia she isn't of sound mind. So I think my mother has to now pay like $6000 to get guardianship so she can sue on her behalf -_-

Yeah as much as it sucks, your mom loses out much more than she gains when(not if) the hospital discovers the HIPAA breach.
At this point I'm talking out of my ass and good will having no experience in any of this.
Having said that, your mom should go to someone higher up she trusts for help and see about getting an internal review of those fuckers. Yeah I know it's not the blood bath I would want, and I'm assuming your mom does; in this case even with good intentions if she broke HIPAA reg's knowingly she's put in a very bad place. Why didn't she just ask to see your moms charts/records? Where they refusing to show her?

[Tyche]

The issues are exclusive. If your mom breached policy to view her mothers records, she would probably be fired, but then again, I doubt she'd hold her job too long anyway while suing her employer. I don't think she's at risk at all of losing her license.

[Byrthnoth]

... I doubt she'd hold her job too long anyway while suing her employer...

This is the real issue I'm seeing here. Even if she doesn't lose her license, she's probably never going to work at a hospital again.

[Ophannus]

Suing your employer looks bad but killing your empolyee's parents is equally so. >_>