HCA 640- HEALTH CARE LAW & ETHICS

TERM PAPER

Nish and Abbi Prenglass vs Renown Medical Center

Priyanka Nemalikanti

2712928
 INTRODUCTION

The following paper describes all the legal elements and statutes involved in the Nish and Abbi

prenglass vs Renown medical center case. Firstly, the eviction case of Nish and Abby prenglass

has led them to meet a representative who would later look up to their daughter Wendy’s death

details. Mr. Sammy Smart, a Legal Aid Lawyer helped them in the case regarding their house

concerning the government shutdown, after they have received an eviction notice. Secondly, Mr.

Smart has observed that this is a case of Medical malpractice and negligence by physician Dr.

Gapp, the nursing staff of the emergency department and Renown medical center, when they

were treating Wendy Prenglass (Daughter of Nish and Abbi Prenglass) in the emergency

services. Wendy was treated for presumed opioid overdose based on the Ohio state conditions

when she complained of headache and entered the emergency department and was continued the

same treatment even when there was no change after her initial treatment with Narcan. No

autopsy was performed by the hospital to check for the claims of drug overdose. Later when an

autopsy was done, it was revealed that she had died of brain hemorrhage or ruptured aneurysm.

The case has been analyzed and a liability of Medical malpractice and negligence has been

observed by the Hospital and its nursing staff and the Physician involved. In this analysis, I have

covered the elements concerning the case, incorporating the facts by taking Ohio state laws and

statues into account along with damages that be claimed by the parents due to their daughter’s

death. I have also analyzed the possibility of other liabilities upon the Renown Medical center

and Dr. Gapp whose license lapse is a great evidence.

 BACKGROUND OF THE CASE

Nish and Abbi Prenglass visited the local Legal Aid Security office to discuss about the eviction

notice they have received about their home as they have failed to pay rent due to government

shutdown. They have been assigned to Mr. Sammy Smart to get help about the eviction notice.

On a simple question asked about their daughter, the parents have told the story of their

daughter’s death. Wendy prenglass was 28 and had no health insurance covered. She developed a

headache on Halloween of 2017 (October 31, 2017), when she has gone out with her friends. The

issue was so severe that she asked her friends to take her to the emergency department, specially

to Renown Medical center surpassing St. Elsewhere hospital because she has read the brochures

about the hospital advertising about handling all medical emergencies and brain related issues.

Wendy had come in by 8.20 p.m. complaining of headache and the emergency department

nursing staff suspecting her of taking drugs. She was disoriented while walking to the bed by

8.40 p.m. and the nurses had administered Narcan immediately. By 9.15 p.m. a check was made

and there was no change and she was administered another dose of Narcan. Dr. Gapp was the

emergency department physician and he has checked her at 9.50 p.m. and when there was no

change, he ordered a CT scan. Wendy Prenglass was taken to the radiology department an hour

later and she suffered a cardiac arrest and died while being taken to the radiology department.

The parents have asserted Mr. Smart that their daughter did not do any drugs and that an autopsy

was never offered by the hospital. The parents then asked for an autopsy by the advice of Mr.

Smart and have found out that she died from a brain hemorrhage not by drug overdose. Wendy’s

medical records have confirmed that she does not have any history of using drugs. Mr. smart has
also observed that all the emergency physicians are independent contractors and were not

mentioned as such in any promotional material but in the website as a small space under the

emergency services. It was also revealed that Dr Gapp’s license has been lapsed by his office

oversight in later half of October 2017, and it was identified by the office and reinstated by the

board by November 1, 2017 where Renown administration was unaware of this license issue.

The hospital did not offer any autopsy and when an autopsy was requested it revealed that the

actual cause of the death is Brain hemorrhage but not drug overdose.

FACTS OF THE CASE

● Nish and Abbi Prenglass have been assigned Mr. Sammy Smart for their help with Legal

Aid, where Mr. Smart had got to know about the death of Wendy.

● Wendy Prenglass was treated for drug overdose by the nurses and staff of the emergency

department without any diagnosis.

● No action was taken when two doses were given and there was no change in her health

by the nursing staff.

● She was visit by the physician much later after being admitted and he then ordered a scan

as a part of diagnosis.

● Wendy prenglass has been taken to the radiology department an hour after the doctor

ordered the scan and she passed away before the test was done.

● Wendy did not have any insurance coverage including the government funded coverages

like Medicaid.
 ● She did not sign any consent forms like physician contract or enrollment as a low-income

member to receive government funding.

● Dr. Gapp’s license has been over lapsed during the later half of October 2017 till

November 1, 2017, which included the date of Wendy’s treatment.

● Dr. Gapp is an independent contractor to Renown medical center and he was not

identified as a separate legal entity by the research conducted by Mr. Smart.

● The medical expenses of Wendy were billed to Medicaid by the hospital.

● Hospital did not offer any autopsy of Wendy to her parents.

● Autopsy after the parents have requested for it, has revealed that Wendy Prenglass had

died of Brain Hemorrhage but not drug overdose as assumed by the nursing staff and as

written as the cause of death.

CASE ANALYSIS

After having a thorough lookout at the case, it has been observed that there was a medical

malpractice or Medical negligence and wrongful death by the Renowned hospital and its staff

including the physician. This determination was done by analyzing all the facts, considering the

elements and the details provided in the case by taking the Ohio statutes into consideration. To

understand the case completely, it has been subdivided into elements of the case and arguments

of plaintiff and defendant and then analyzed. According to the Ohio law, a medical malpractice

is defined as “when a medical professional such as doctor, medical nurse or medical institution,

injures a patient during the course of treatment”1

1
The Basics of Ohio Medical Malpractice | Attorneys.com,
To qualify a case for a negligence or a Medical malpractice, four basic elements of a malpractice

should be met2. Nish and Abbi Prenglass must gather evidence that there is a breach of standard

care, injury caused by the Physician, staff or the hospital; the connection between the breach and

damages related to the claim in order to succeed in the court. Each element of medical

malpractice must be satisfied to have a strong claim in the court. The more the depth of the claim

and its evidence, the more is the chance of success.

ELEMENTS OF MALPRACTICE

The first element of Medical malpractice is Existence of legal duty3. There must be a valid

patient-doctor relationship for the claim to be taken further4. As per the Ohio law, in state of

emergency, a hospital or its staff should treat the patient without any forms and as such a valid

contract is formed between the patient, the hospital and its staff56. It was the duty of Renown

medical center and its staff to give proper treatment to Wendy Prenglass in the emergency room.

Hospital cannot claim that there was no contract. The treatment given was not correct which

resulted in the patient’s death.

The second element of Medical negligence is Breach of the legal duty7. This part describes us to

show the proof of negligence on the part of the doctor, staff and the Hospital8. In this case, when

Wendy prenglass was admitted to the hospital, she was not properly diagnosed, and the staff has

assumed that she has taken street drugs due to the external conditions of the state. The nursing
2
The Four Elements of Malpractice| lawyersthatfightforyou.com
3
The Four Elements of Malpractice| lawyersthatfightforyou.com
4
Find your state laws
5
Lawriter - ORC - 1753.28 Emergency services coverage
6
Ohio Negligence Laws - FindLaw
7
The Four Elements of Malpractice| lawyersthatfightforyou.com
8
Breach of Duty & Medical Malpractice Law | MedicalMalpracticeHelp.com
record mention of suspicion but not confirmation of taking street drugs. Wendy was not tested to

see if she has taken drugs and was given wrong treatment. This shows the negligent behavior of

the nursing staff9. Being an emergency department physician, Dr. Gapp did not diagnose and

treat Wendy. Wendy drove to Renown medical center surpassing the St. Elsewhere Hospital.

St. Elsewhere hospital was an all-purpose hospital but Wendy has remembered an advertisement

of the hospital where it was clearly mentioned that the hospital has new department to handle all

major medical emergencies and the hospital has excellent medical care for trauma and brain

related injuries.

But when Wendy has been brought to the emergency department, she was given wrong drug

Narcan to treat her headache due to an assumption which makes a breach of duty from hospital

too. There was false advertisement on the part of hospital too.

The third element of medical malpractice is establishing a connection between the breach and the

injury caused10. After looking at the facts of the case, the ultimate injury caused by the breach is

death of the patient. Wendy prenglass passed away due to the negligence of the nursing staff for

wrong treatment and no diagnosis by the physician. She was not visit by the doctor in the

emergency department and even when she was visited, he was not licensed during that time. Dr.

Gapp’s license has overlapped from later half of October (October 15) to November 1,2017 and

Renown Medical center was unaware of this.

The final element of negligence in a healthcare setting is damages caused by that injury11.

Wrongful death of Wendy prenglass is the injury caused. Generally, damages are covered in the

form of monetary compensation or by paying money in the civil court. All expenditures

concerning the admission of Wendy prenglass into the hospital and subsequently thereafter
9
Breach of Duty & Medical Malpractice Law | MedicalMalpracticeHelp.com
10
The Four Elements of Malpractice| lawyersthatfightforyou.com
11
The Four Elements of Malpractice| lawyersthatfightforyou.com
should be paid to the parents. The attorney should address all the issues in the court so that the

case would be favorable to the parents. Damages would not cover costs like autopsy or

prescription drugs used. There are three types of damages that can be recovered12. General

damages like pain and suffering to the patient. Specific damages like care and cost of financial

aid obtained from the university. Non-economic damages have a limit up to $250,00013or three

times the amount of compensatory damages or whichever is higher14.

ARGUMENTS OF BOTH THE PARTIES

Nish and Abbi prenglass can claim for medical negligence and wrongful death of their daughter

Wendy prenglass based on all the evidences. They can appoint Mr. Sammy smart as their

representative in the jury. Hospital nursing staff has given wrong treatment, Emergency

department physician did not visit Wendy in the emergency department until an hour after she

has been admitted for diagnosis. Dr. Gapp being not licensed during Wendy’s treatment and the

hospital not offering an autopsy with grandiose advertisements are the elements that Nish and

Abbi prenglass can present as strong sources. They can also present that Wendy was taken only

after one hour after the Physician has ordered the scan to the radiology department while the

hospital advertisements claim that all medical equipment to handle major emergencies are within

the department. Nish and Abbi can also argue that although there was no initial improvement in

her case, the staff did not make a proper diagnosis or call the emergency department physician to

look at the case but have assumed yet another time that the treatment did not work and have

given her another dose. They can also claim liability for wrong administration of prescription
12
Damages in Medical Malpractice Cases LegalMatch Law Library
13
Damages in Medical Malpractice Cases LegalMatch Law Library
14
The Basics of Ohio Medical Malpractice | Attorneys.com
drugs. Dr. Gapp was also identified as an independent contractor working for the hospital and he

did not have a separate legal entity of his own after extensive research. The defense however can

have certain arguments too. The hospital was unaware of Dr. Gapp’s license and can claim that
15
he is an independent contractor and it was the duty of the physician to inform the issue of his

license to the hospital and can also claim that it is a direct breach of contract and thus would not

take the physician’s liability. But as it is the duty of the hospital to regulate the license issues and

the proper treatment by its staff, Renown medical center will be held liable for medical

malpractice along with the nursing staff and the Physician.

Dr. Gapp is also held liable as he was practicing without active license16. As per the official

website of the state medical board, his license was lapsed, and his office later had redeemed it. It

was the duty of Dr. Gapp to notify this to the hospital. He did not disclose the information and it

was his duty to reinstate his license timely. Renown medical center did not do enough

background checks on the independent contractors it had employed for services under the

emergency department. The nursing staff would be separately held liable for wrongful death by

giving wrong treatment. Any treatment requires a medical diagnosis by the doctor, but the

nursing records clearly indicate the word suspicion but not confirmation. Wendy has entered the

emergency department by 8.20 and she was not treated until 8.50. There was no diagnosis or

attendance to the patient for 30 minutes. She has also denied taking street drugs and her denial

was not taking into consideration. Nursing staff is liable for not taking an action when there was

no significant improvement in the health of the patient17. It is the duty of the nursing staff to

inform the department head or the concerning physician of the emergency department where

there is no change or when a significant action is required. Nish and Abbi prenglass can have
15
Lawriter - ORC - 3963.01 [Effective 3/20/2019] [Effective Until 4/5/2019]
16
Lawriter - ORC - 2305.113 [Effective Until 3/20/2019]
17
Nursing Malpractice www.nolo.com
Medical claim towards the hospital, nursing staff, physician involved and derivative claims for

relief for the damages to Wendy prenglass18. Nish and Abby prenglass must also provide the

details of Wendy’s health history to show that she was not a drug addict, or a user and the staff

has assumed that she was one. Authorized Patient health information of her entire life can be

provided to support the evidence. The defense cannot counteract the fact that no proper diagnosis

was made, and the nursing records have stated only the suspicion. Mr. Sammy Smart can also

place a liability on the hospital as a whistleblower, for billing the services to Medicaid as Wendy

was not enrolled into any insurance plan; Not even Medicaid. There was no information or proof

given by her parents that she has submitted her Medicaid application and no information was

provided about the hospital getting a consent form signed from Wendy as a low income member

so that they can put her billing services under government funding, so hospital billing to the

Medicaid is the violation of False claim act and imposes serious actions on the hospital. The

hospital also did not order autopsy but as per Ohio state law, a coroner can order the autopsy to

be performed if the condition looks suspicious and if the death occurs when there is a time gap in

physician visiting the patient19. Damages for the admission, tests and other health services

provided should be given to the parents of the patient. As per Ohio state law, Nish and Abbi can

make medical claim successfully as the incident time did not cross the four-year period20. They

can claim damages to the education and care as per the law21.

18
Lawriter - ORC - 2305.113 [Effective Until 3/20/2019]
19
Lawriter - ORC, http://codes.ohio.gov/orc/313
20
Lawriter - ORC - 2305.113 [Effective Until 3/20/2019]
21
Lawriter - ORC, http://codes.ohio.gov/orc/2125
 CONCLUSION

After analyzing all the facts, the court should hold the Renown medical center and its staff along

with Physician Dr. Gapp for the medical malpractice and subsequent death of Wendy prenglass.

Wendy prenglass died due to the medical negligence on the hands of nursing staff who are the

employees of the hospital. Renown medical center made false advertisements and is held liable

along with its staff. Dr. Gapp was not licensed during the treatment of Wendy prenglass and is

held liable for medical malpractice and negligence separately. Renown medical center will also

be liable for violation of false claim act as they have billed Wendy’s costs to Medicaid. There

was no mention of hospital getting the consent form to enroll into Medicaid signed by Wendy, so

the hospital is still liable. Damages in the form of monetary compensation for her education aid,

care and other services must be given to Nish and Abbi prenglass once the representative

receives it. Non-economic damages for their suffering and death must be provided.

Jury must also analyze the fact that Renown medical center has taken its employees without

proper background information and are not aware of its physician license regulations. Finally,

the autopsy which was initially not offered by the hospital gave away that Wendy prenglass had

died of Brain hemorrhage or ruptured aneurysm and the given cause of death was drug overdose.
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