Langley and Warren v. Glandore: Case Study

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Table of Contents

The Case-Study in the Context of Perioperative Nursing Practice
Evidence-based Literature and Standards
Relevant Standards and Recommendations
Reference List

The Case-Study in the Context of Perioperative Nursing Practice

The key incident that gave rise to Langley and Warren v. Glandore was carelessness during a comprehensive abdominal hysterectomy surgery. The trial judge’s decision in summing up the results was not objected to in the appeal’s rationale. Arguments also indicated that misdistribution of responsibilities. The proper medical documentation could possibly clear the stance but the lack of it led to the further confusion. The critics attributed to this case can be viewed through the lenses of unclear nursing responsibility division together with the judicial ambiguine, as well as the lack of proper medical documentation, undermining the nursing ethics and principles. The initial critical stance on this issue study became the fact that the court came up with the outcome that the surgeon was negligent, while the nurses were proved to be not negligent. The surgeon general was found guilty of negligence by the jury at trial, while the nurses were found not to be at fault (Cockburn et al., 2019). On appeal, however, the jury’s decision was reversed. The Court of Appeal decided that the nurses, who were largely responsible for keeping track of all the sponges used throughout the surgery, were not negligent (Cockburn et al., 2019). The ambivalent stand of the court, resulting in the reshuffling of the decisions, thus became a sign of judicial difficulties in attributing the proper responsibility and accountability. Although the plaintiff’s case was founded on events that occurred outside of the operating room in 1990, that incident was the source of the majority of the plaintiff’s damages, as the jury’s decision revealed, and so is at the heart of the issues to be reviewed. A claim is that the jurors had no available basis on which they could determine that the nurses were not reckless after having instituted negligent actions is doubtful and can be critically assessed. The objection usually leveled in this practice is that there was little opportunity to prove that the nursing aides were not negligent (Blomberg et al., 2018). It is crucial in terms of perioperative nursing to admit the potential of this relatively simple kind of responsibility exemption without the necessity for a new trial, assuming that procedural issues can be solved. The plaintiff, in this case, did not try to overturn the jury’s decision that the defendant was not negligent in treating and caring for the plaintiff throughout the surgery (Johnstone, 2016). The applicants, however, must do so if they are to prevail. The consequence of these developments is the growing need for open disclosure and multilevel communication between different instances in legislative and healthcare facilities. The perioperative and general nursing ethics considers a communication as a crucial aspect which was not followed in the case.

Evidence-based Literature and Standards

In modern health care, the issue of surgical items unintentionally left in the patient is serious and long-lasting. The preserved surgical instrument, dubbed a “sentinel event,” is one of the recorded adverse occurrences that the public believes has the potential to gravely damage the healthcare system (Haddad and Geiger, 2018). Despite the frequency of such cases, in reality, the judicial system has limited room for maneuver in evaluating culpability and potential negligence. The Australian Commission on Health Care considers the retention of tools or other materials after an operation that necessitates a second operation or further surgical treatment to be an incident that might substantially damage public trust in the healthcare system (Australian Commission on Safety and Quality in Health Care, 2018). Retained surgical items issue became one of the most prevalent in reporting, which signals the gaps in the hospital system and processes. The unclear debate over nurses’ duty assignment and distribution is another critical point that prevents such issues from being resolved and leads to the case being brought to the courts for resolution. Sophisticated technology and the distribution of responsibilities among operating room staff dictate the function of nurses in modern operating rooms, as defined by codes of conduct (Nursing and Midwifery Board of Australia – Code of conduct for nurses, 2018). The nursing accountability in this regard is one of the important aspects to be considered. Perioperative nursing involves accountability for preserved surgical instruments, making it a crucial aspect in nursing ethics and its connection to judicial responsibilities (Haddad and Geiger, 2018). It is also worth noting that modern hospitals have evolved into large interdisciplinary organizations in this regard. This should be considered while defending against patent claims for damages if they are determined to be indirectly liable for the workers’ negligence.

Relevant Standards and Recommendations

The standard procedures regarding perioperative nursing care adopted in Australia confirm the ambivalence of the court hearings. It is critical to remove any foreign items temporarily introduced during the procedure before the surgical wound of the patient is closed at the end of the operation (Cheluvappa and Selvendran, 2020). This must include tools and sponges, and other assisting material. To assure the total removal of all temporarily imported commodities, an accounting system is performed (Nursing and Midwifery Board of Australia – Code of conduct for nurses, 2018). A tally of the removed and unused materials is done at the end of the procedure and before the wound closure begins (Cheluvappa and Selvendran, 2020). The nurses are responsible for ensuring that all the items are removed. The accurate documentation, in this case, is vital in terms of the proper division of responsibilities and, when the subject is brought to court, requires a certain degree of professional honesty and transparency. Overall, while early settlement of such lawsuits might save parties money on legal fees and put less burden on the courts, they frequently involve confidentiality agreements. They essentially prohibit the publication and may indicate a situation that has not been validated by the courts. The development and availability of concepts that courts may depend on to attain a reasonable and balanced settlement appear to be constrained due to the small number of cases taken to trial. The numerous incidents of the retained surgical item and general medical negligence show the importance of maintaining correct medical records. The presented case can lead to an adequate reassessment of operating procedures, as well as room to work for determining culpability and potential negligence. Despite the lack of case studies in this field, the arguments presented might serve as a starting point for emphasizing key components of perioperative nursing care practice. This might be due to the current nature of the operating practice, which requires tight collaboration between surgeons and clinic personnel. The implication and recommendation stemming from this case can be viewed in the light of the need for a clear definition of roles and responsibilities in the facilities. This, alongside with the thorough track of medical records, can drastically improve the nursing practice. The perioperative nursing ethics considers accountability and honesty as key principles; however, misunderstanding and miscommunication, as it was presented in the case, leaves a space for a further debate and the improvement of practices.

Reference List

Australian Commission on Safety and Quality in Health Care (2018) Web.

Blomberg, A.C., Bisholt, B. and Lindwall, L. (2018) ‘Responsibility for patient care in perioperative practice.’ Nursing Open, 5(3), pp. 414-421.

Cheluvappa, R. and Selvendran, S. (2020) ‘Medical negligence-key cases and application of legislation’. Annals of Medicine and Surgery, 57, pp. 205-211.

Cockburn, T., Davis, J., & Osborne, S. (2019) ‘Retained surgical items: lessons from the Australian case law of items unintentionally left behind in patients after surgery.’ Journal of Law and Medicine, 26(4), pp. 841-848.

Haddad, L.M. and Geiger, R.A. (2018) Nursing Ethical Considerations. East Tennessee State University

Johnstone, M.J. (2016) ‘Key milestones in the operationalization of professional nursing ethics in Australia: a brief historical overview.’ Australian Journal of Advanced Nursing, 33(4), pp. 35-45.

Nursing and Midwifery Board of Australia – Code of conduct for nurses (2018) Web.

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Langley and Warren v. Glandore: Case Study

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