Ethical Breach in Aged Care

This assignment presents a case study of Mr. Biffin, an elderly patient who died due to negligence within an aged care facility. The analysis examines the ethical code violation committed by medical staff, emphasizing the crucial role nurses play in ensuring patient safety and well-being during recovery. It delves into the legal ramifications of such breaches and the importance of adhering to ethical guidelines in healthcare.

Running head: CASE STUDY OF ALBERT ERIC BRUCE BIFFIN
CASE STUDY OF ALBERT ERIC BRUCE BIFFIN
Name of the Student
Name of the university
Author’s note

1Case study of Albert Eric Bruce Biffin
Table of Contents
Assignment 1...................................................................................................................................2
Assignment brief..........................................................................................................................2
The Tort of Negligence................................................................................................................4
Ethical issues...............................................................................................................................6
References........................................................................................................................................8

2Case study of Albert Eric Bruce Biffin
Assignment 1
Assignment brief
The following case study is about Albert Eric Biffin, who lived in Camden New South
Wales. It was reported, that he had died unexpectedly at a health care setting that has a low
nursing care facility. A residential health care setting is a system of care given by skilled doctors
to patients in a home like surroundings. It was mentioned that the Mr. Biffin was under the care
of his general practitioner, Dr John Lambie, for about 25 years. It was reported that the cause of
death of Mr. Biffin was unclear and therefore it was reported to the coroner. A full internal
autopsy had been done by the forensic pathologist Dr Terry, and it was reported that he had an
incarcerated umbilical hernia containing an ischemic small bowel. It was also reported that he
had bronchopneumonia and cardiomegaly; which is hypertrophy in the left ventricle and dilated
ventricular chambers. He had moderate to severe coronary artery disease that required a
pacemaker. It was also found that he had benign nodular hyperplasia of the thyroid gland and
benign cortical adenoma; he was also suffering from early cirrhosis of liver. Mr. Biffins death
raised questions on the efficiency of the health care professionals as well as the nursing home
care provided. It was found that he was staying at a low nursing care facility residence. A home
health care setting differs from the hospitals, in a residential health care setting the nurses work
alone with resources got from a central office (McKenna, Hasson & Keeney, 2014). It was also
provided in the case that the registered nurse that was appointed for him did not have any prior
information about Mr. Biffins hernia. The registered nurse did not touch or examine the hernia,
she did not know how long the hernia have been present and therefore prescribed him with just
movicol. Another mistake from the staff’s side is that they did not understand the importance of

3Case study of Albert Eric Bruce Biffin
the situation; therefore did not call for the doctors or the family members. The family should
have been notified of his health status before calling a doctor. It can be understood from the case
study that, the registered nurse would only attend Jacaranda, if called specially for urgent or
specific reasons, since she had a patient load somewhere else. It was not before the next
morning when the staff reported the pain in Mr. Biffins hernia. Dr. Lambia was busy with other
patients and did not find it of that much important; therefore it is clear from the given scenario
that there has been negligence from the staffs of the health care setting, both the health
practitioner and the registered nurse. The registered nurse in charge of Mr. Biffin did not find it
necessary to call his family as she found that his vital signs were all within the limits, for a
certain time. The registered nurse found it essential to inform the doctor, until an offensive
discharge was coming out through the wound in his lower leg. It was until then that Dr. Lambie
was unaware of Mr. Bruce’s hernia. It was also reported that doctor did not go through any
medical history, and did not instruct the nurses about the treatment regimen for Mr. Biffin. He
did not clearly document what the nurses would do after he had performed the procedure. It is
the duty of the nurses to measure the quality of care systematically. Many residential care centers
do not have public funding, managerial support to introduce new technologies to monitor
improvement in their services (McKenna, Hasson & Keeney, 2014). The conversation between
the doctor and the patient was very brief, therefore could not assess the problems faced by the
patient, properly. After the surgery, Dr. Lambia did not instruct the nurses to identify the
patient’s vital signs. The registered nurse reported that since she had patient load else where it
was not possible for her to keep an eye on anything and everything. The clinical nurse reported
that Mr. Biffin was suffering from short term memory loss, as per the cognitive test performed
on Mr. Biffin. The nurse had a very brief entry records and she also admitted that Mr. Biffin was

4Case study of Albert Eric Bruce Biffin
given unnecessary high doses of movicol without any improvement. The nurse was so careless
that she was unaware of the pain and the signs of vomiting, which is a gross negligence on her
part. Prolonged pain and vomiting are the clear signs of patient deterioration; therefore she
should have been much careful in treating these. She even admitted that she did not suggest the
enrolled nurse to call Dr. Lambia if emergency situation arises. She even did not hand over to the
other registered nurses on the closure of her shift, but just told the enrolled nurses. She would
have been alert to the signs and symptoms but she did not. It was a total failure in the
organization that led to Mr. Biffin’s death. Normally a registered nurse holds a high esteemed
position than the normal enrolled nurses, therefore it is her responsibility to involve directly with
the care regimen, which she did not. It is the duty of a registered nurse to provide a holistic care
to the patient (McKenna, Hasson & Keeney, 2014). It is the duty of a lead nurse to teach the
junior nurse, how to monitor and assess a patient’s condition and start practicing the evidence
based practice. A verbal guidance can never impart proper holistic care to the patient. Both
verbal handover and written notes are required to ensure patient safety. Direct involvement with
the patient, discussion with other clinical nurses regarding the care plan is required, which was
lacking in this case (Haakestad, 2014). It was reported that the enrolled nurses who came to
examine Mr. Biffin, was meeting him for the first time, therefore it is difficult for her to assess
the whole condition at a go. It was found from the report that the enrolled nurse had mentioned
in her records that the patient’s vital signs were normal, which was actually not. She seems to
have been influenced by the report provided in the handover of the previous nurse and
overlooked the low blood pressure. The enrolled nurse has admitted that the patient deteriorated
during her shift and she regrets that she would have shifted Mr. Biffin to the hospital on time.
The clinical staff load of the Jacaranda Place was also not very impressive to provide appropriate

5Case study of Albert Eric Bruce Biffin
care to the elderly patients. The registered nurse was informed that Mr.Biffin was continuously
having dry retching, but the she did not record about how long the retching had been going on.
Furthermore Dr. Lambie claimed Mr.Biffin did not inform him about the continuous pain
although Mr. Biffin reported that he was having prolonged pain around the umbilicus for the past
few days.
It can be seen from the case study that there had been negligence on the caregiver’s part
regarding administration of medicines. The nurses could have used broad spectrum antibiotics
such as Cefoxitin, Gentamycin, Ampicillin , but the registered nurse continued to give him
Movicol (McKenna, Hasson & Keeney, 2014).
The Tort of Negligence
The tort of negligence involves a person’s action that is less than the normal standard
behavior and the duty of a person and the actions have caused serious damage. A tort is a civil
wrong and tort of negligence can be applied in this study, as it can be clearly identified that the
negligence of the involved doctors and the nurses lead to the deterioration of Mr. Biffin.
Elements of negligence can be clearly seen in part of the doctor, the registered nurse and the
clinical staffs. In a civil law it is the torts that can allow the advocates to claim compensations
against the damage (Kitson, Marshall, Bassett & Zeitz, 2013).
There are normally four elements to prove a negligence case.
 Negligence- The surviving members or the legal helpers of the deceased person should be
able to provide appropriate proof of death of their loved ones due to the negligence of the

6Case study of Albert Eric Bruce Biffin
defending party (Brenner, Brenner, Awerbuch & Horwitz, 2012). This does not only
involve deaths and is applicable to other bodily harm to the patients.
 Breach of duty- It has to be proved that the defendant in the case owes a duty of care to
the plaintiff. The health care professionals of a hospital have the duty to impart
appropriate care to the patient according to their needs. It is up to the plaintiff to establish
that the duty was being breached through negligent actions (Heaton, 2014).
 Causation- After proving how the defendant’s duty was breached, the plaintiff should
also prove how the recklessness of the defendant actually took away the life of their
loved ones (McDonald & Then, 2014).
 Damages- The death of the person should have brought quantifiable damages like
admission to the hospital, medication costs, funeral, burial costs, loss of the potential
earning members, pain and suffering brought to life due to the death of the loved ones
(McDonald & Then, 2014). Mr. Biffin was an elderly person and his family might have
been at a loss due to his death.
In order to prove these elements, the lawsuit requires relevant evidences and witnesses,
and the whole procedure has to be done under the supervision of a specialized judge
(Heaton, 2014). The patient’s family or the patient himself should be able to prove that
the damages that had been done were foreseeable or avoidable.
A wrongful death is a civil wrong but not a criminal case. Therefore the burden of the proof is
normally set a bit lower.
Pursuing of the civil action in case of wrongful deaths can involve a number of steps like
development of new strategies, communicating with the experts, investigating the claim, meeting
the witnesses and researching about the tort law. The legal process related to wrongful deaths

7Case study of Albert Eric Bruce Biffin
involves demands and possible settlement of the claim. A skilled attorney is required that can
build a solid case in order to ensure that the proof burden has been properly addressed. Selection
of an efficient lawyer is also required as the claim for the wrongful deaths which are
complicated. A successful lawyer can communicate with the clients and work together to achieve
a common goal off getting a good compensation (Heaton, 2014). In this report it can be seen that
it is due to the organizational malpractice and the negligence of the nursing staff, that Mr. Biffin
could no longer survive. In such a case legal actions can be taken against the health care settings.
The inquest of Mr. Biffin’s death clearly provides with the idea that the total health care setting
was responsible for providing a standard care to the patient, which they failed to provide
(Brenner, Brenner, Awerbuch & Horwitz, 2012).
Ethical issues
Ethical issues are one of the major challenges that are encountered by all professional
nurses. In several cases, the nurses have to take critical decisions based on circumstances.
Nevertheless, the lack of capability of the nurse and the Health Care workers, can we one of the
major challenges that cause ethical concerns.
In the given case, of Mr. Biffin the major ethical issues are raised due to the fact that the
patient family has not been informed about the cause of the death, which is believed to be one of
the major ethical issues. According to the Coroners Act 2003, there are a set of rules that helps to
identify the cause of death of an individual within the healthcare settings. It is also the ethical
responsibility of the Healthcare organization to provide proper justification to the patient family
for the cause of the death if it occurs immediately after receiving any health care treatment
(Korhonen et al., 2015).

8Case study of Albert Eric Bruce Biffin
It is one of the major challenges of the Healthcare investigation team to evaluate the
proper reason for the day of the patient in the given case.
According to McCarthy and Gastmans(2015), there are several ethical issues related to
end of Life Care treatment. Due to multiple physical disorders that are encountered by an aged
patient, there are several medical complications that are encountered by the General physician
and nurses. Nevertheless, in the given case of Mr. Biffin, the nurse had not carefully attempted to
fulfill the multiple needs of the patients. The nurses have also failed to deliver the exact care, as
they were not properly able to diagnose the exact clinical condition Mr. Biffin. Hence, they have
not been able to provide the correct forms of medical care that is needed in the case. It is also
important to ensure that equal health care services are provided to every individual patient. It is
essential from the nursing context to provide extra care to the aged patient that can help them in
the process of recovery. In the given case of Mr Biffin, there has been clear breach of the ethical
code of conduct for medical practice that has caused the death.

9Case study of Albert Eric Bruce Biffin
References
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