A 33-Year-Old Woman Is Transferred to the University Medical Center

A 33-year-old woman is transferred to the university medical center from a small community hospital due to acute pyelonephritis with sepsis.  She has a history of recurrent urinary tract infections due to urinary retention related to a spinal cord injury in childhood.  On arrival, the patient is febrile and lethargic.  She provides no additional history, and the only information available is from poorly legible handwritten notes from the originating hospital.  The patient is admitted to the intensive care unit with orders to give imipenem and vancomycin.  Overnight, the patient develops a rash and severe respiratory distress requiring brief mechanical ventilation.  The following morning, a transcribed physician note from the originating hospital arrives by fax and indicates that the patient has an allergy to multiple antibiotics, including imipenem.  When discussing events with the patient and her family, which of the following statements is associated with reduced malpractice liability for the treating clinician?

A) "As your attending physician, this mistake is my fault.  I take full responsibility."
B) "I am so sorry an error led to your allergic reaction.  I will do my best to help you through it."
C) "There are things you can do to prevent problems like this.  I recommend you get an allergy alert bracelet."
D) "Unfortunately, modern antibiotics can have serious side effects.  But I am glad to see you are doing better."
E) "Unfortunately, we did not get information about your medication allergy yesterday.  That is why you received the wrong antibiotic."

Correct Answer:

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