The Ethical Obligation for Disclosure of Medical Error in the Intensive Care Unit

The very facts that humans are fallible and that they are integrally involved in the delivery of healthcare and medical treatment guarantee that medical errors will occur despite the best of training, skills and vigilance, precautions, or preventive procedures. While medical errors occur across the spectrum of care and treatment, the propensity for their occurrence and the severity of the damage they are likely to inflict are undeniably greatest in the hospital intensive care unit (ICU). The fundamentals of biomedical ethics require nothing less than a thorough systematic analysis of the sources of error in the ICU, along with a comprehensive, coordinated approach to preventing error to the extent humanly possible and to handling and mitigating the effects of error whenever they do occur. Through the chapters of this dissertation, the research and analysis has provided the following: 1) a detailed account, to the extent that it has been documented, of the high frequency of errors occurring in the U.S. in general and specifically in hospital intensive care units, as well as the range and extent of the harm done to patients and family members, both physically and financially; 2) a classification and analysis of the proximate, intermediate and ultimate causes of and contributing factors to medical errors, which in addition to identifying causation has formed the basis for this dissertation’s recommendations aimed at developing procedures and protocols to effectively reduce errors to the greatest degree possible while minimizing their harmful impact; 3) an in-depth analysis of expectations, grounded in biomedical ethics, for dealing with the consequences of medical errors including disclosure and communication, the expectations of patients and family members, the attitudes and concerns of medical professionals, the disconnect between these two groups, and recommendations for procedures and protocols to ensure prompt, complete, and just handling of all consequences of the error; 4) an in-depth framework, based on Western religious and cultural foundations, for both those responsible for and those injured by medical errors to interact in handling the consequences of the error, as well as all of the communication which it engenders; and 5) proposals for numerous procedures and protocols, both for lessening the vulnerability of hospital ICU patients to suffering the effects of an error and for addressing and counteracting the variety of systemic problems which create or heighten the propensity for the occurrence of medical errors

Modal response of hybrid raster orientation on material extrusion printed acrylonitrile butadiene styrene and polyethylene terephthalate glycol under thermo-mechanical loads

In this paper we look at Acrylonitrile Butadiene Styrene (ABS) and Polyethylene Terephthalate Glycol (PETG), chosen for their low cost, high strength and temperature resistance. This study evaluates the bending fatigue performance of Material extrusion (MEX) ABS and PETG cantilever beams and compares their properties while varying a printing parameter under thermal loads. The study, using custom building orientation angles of 90o, 45o and 60o between the layers, tested the beams at different temperatures from 30o to 50 °C. The results show the effects of the building orientations and the effects of temperature on the sample. The printing orientation, which is the same as loading, also slows the crack growth

Strain release behaviour during crack growth of a polymeric beam under elastic loads for self-healing

The response of polymeric beams made of Acrylonitrile butadiene styrene (ABS) and thermoplastic polyurethane (TPU) in the form of 3D printed beams is investigated to test their elastic and plastic responses under different bending loads. Two types of 3D printed beams were designed to test their elastic and plastic responses under different bending loads. These responses were used to develop an origami capsule-based novel self-healing mechanism that can be triggered by crack propagation due to strain release in a structure. Origami capsules of TPU in the form of a cross with four small beams, either folded or elastically deformed, were embedded in a simple ABS beam. Crack propagation in the ABS beam released the strain, and the TPU capsule unfolded with the arms of the cross in the direction of the crack path, and this increased the crack resistance of the ABS beam. This increase in the crack resistance was validated in a delamination test of a double cantilever specimen under quasi-static load conditions. Repeated test results demonstrated the effect of self-healing on structural crack growth. The results show the potential of the proposed self-healing mechanism as a novel contribution to existing practices which are primarily based on external healing agents