A 28-yr-old man hurt his right knee. He was referred to an orthopedic surgeon who diagnosed a tear of the ligaments and related parts of the knee. When scheduling his outpatient surgery he was told he would have to have someone to drive him home after the procedure.

The patient appeared at the outpatient surgery center without the person who would drive him home. He said something had come up with his friend. He had no one available to drive him home. At that time the nursing staff again made him aware of the policy. The patient was very determined. Despite the protocol the surgeon and anesthesiologist both agreed to perform the procedure under local anesthesia. The anesthesia was administered before the surgery and the patient had a reaction to the anesthesia. To calm the patient the anesthesiologist gave him another, different type of anesthetic before they could take him in for the procedure. The patient stayed awake the entire surgery. He was awake and alert during the whole procedure. After surgery, he was taken to the recovery unit and was able to eat and communicate. After the normal wait time he was allowed to leave.

He drove himself home and had a terrible car accident which left him with a broken spine, paralyzed, and with no use of his legs. No other persons or vehicles were involved in the accident. No evidence of alcohol or drug use was noted by the police arriving at the scene.

Assume that you are the Risk Manager at this outpatient surgery center in the city where you reside.

Prepare a memorandum addressing the risks that need to be mitigated, and concerns about the staff not following the established procedures.

1. Who had the responsibility to make sure the patient had someone to drive him home?
2. How were the staff supposed to proceed when they learned that the patient came to the surgery center by himself and didn’t make arrangements for anybody to drive him home? Note the location (city and state) of your hypothetical surgery center at the top portion of your memo. Research and use state specific applicable regulations.