Iturralde v. Hilo Medical Center, USA

Medical malpractices have been rampant since time memorial, and the accountability enigma occurs during trials. Iturralde v. Hilo Medical Center, USA, involves Rosalinda Iturralde was the plaintiff in a case where her brother’s spine was fixed with a screwdriver instead of a standard titanium rod. Arturo Iturralde had degenerative spondylolisthesis, which affected the nervous system, thus requiring spine surgery. Dr. Robert Ricketson was in charge of the surgery, an employee in the Hilo Medical Center, and licensed by Hawaii Orthopedics Inc. On the surgery day, Dr. Ricketson went on with the surgery without an inventory of the instrument; and lacked titanium rods for the spine. The doctor improvised unilateral bars from the steel of screwdrivers and implanted them on the client. Within a day of the surgery, Arturo developed complications and underwent three other surgeries, which did not help, leading to his demise three years later.

Medical Malpractice Components

The client was subjected to medical malpractice elements: negligence of duty, deviating from providing standard care, damages, and being the leading cause of someone’s medical issue. Based on the charges, the surgeon and the medical center were required to cater to their duties as medical professionals and diligently to Arturo’s needs. Dr. Ricketson had a duty to check the kit inventory before performing the surgery to ensure the presence of the titanium rods. Nonetheless, Nurse Janelle Feldmeyer admitted to reporting the incident to the superiors during the case, but they wrote her claims off as the report would only count if Dr. Ricketson would report it (“Iturralde,” 2012). The medical center failed at this point. These two entities were tasked with ensuring the client’s well-being and failed at that.

Moreover, deviating from providing standard care, being the direct cause of Arturo’s death, and causing damage make up the other elements of medical malpractice. Medical practitioners are tasked with providing standard care to patients; thus, the use of improvised rods on Arturo’s spine did not meet the standard care. In addition to that, the medical team neither informed Arturo nor his family of the use of the screwdriver nor of the intention behind using it. This incident proved to be a direct cause of his complications even though the surgeon protested that Arturo had underlying issues. Nonetheless, the procedure cost Arturo his life, hefty medical bills, and impaired mental health among those around him. HRS § 663–10.5 exempts government institutions from liabilities, in which people may prejudice such indices. People from various cultures would choose private hospitals if they can afford them, as the increased malpractices and lack of accountability make them lose faith in their works.

Ethical Component

The major ethical issue addressed in the Iturralde v. Hilo Medical Center, USA case is negligence which may be solved by the deontology theory and having a physician-patient shared decision model. The deontology theory notes that surgeons cannot perform surgery unless all necessary instruments are available. In Arturo’s case, his surgery would have had a better chance of succeeding if he had a titanium rod in him and not an improvised rod. Additionally, the physician-patient shared decision model ensures transparency of what the procedure entails. In Arturo’s case, he had bits of a screwdriver installed in him without his knowledge which was a breach of professionalism. These ideologies would help in reducing negligence cases.


Arturo’s incident sheds the need to have clear ethical guidelines. These guidelines can be accomplished by allowing patients unrestricted access to all information. They should also implement physician-patient shared decision-making, which improves standard care delivery significantly. Nonetheless, surgeons should follow deontological ethics and learn about necessary tools for every medical procedure. Arturo’s case is a classic example of medical malpractice, in which medical professionals should be held accountable in case of an incident while others follow the ethical rules diligently.


Iturralde v. Hilo medical center, USA. (2012). Casement. Web.

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