The nurse’s inaction led to a wrongful death lawsuit against the hospital

In his article Inappropriate conduct Risk of failure in healthcare communicationJock Hoffman states that one third of medical malpractice cases will be directly linked to breakdowns in communication.

In the next unpublished case, a break in communication is presented by which the nurse’s failure to report a big change in her patient’s condition to the doctor is claimed to be the reason for his death. A wrongful death trial soon follows.

Case details

A 62-year-old patient underwent abdominal surgery, including gastric bypass surgery. The surgeries resulted in “excessive” scarring.

She presented to the emergency department complaining of abdominal pain and vomiting that had began the day prior to this. The patient’s lungs were clear, but as a consequence of her symptoms, she was admitted for intravenous hydration. Treatment for pain and nausea was also provided.

The patient stayed within the hospital for several days, and the doctor diagnosed her with constipation. She was advised to undergo “intestinal rest” by limiting the quantity of food she could eat. According to the doctor, there have been no indications for surgery.

Two days after admission to the hospital, the nurse’s notes showed that the patient was “spitting into the vomit bag” and had “dry vomiting”. She was re-examined by one other doctor who found that she was still constipated but was respiratory “normally.” However, the second doctor had concerns about whether the patient ought to be transferred and examined by the surgeon who performed the gastric bypass surgery. She was to be transferred the following morning.

That night, the patient vomited repeatedly throughout the night shift. The RN caring for her noted within the patient’s medical records that the patient expressed a sense of being “tied up.” [her] Belly[e]n” but her pain had decreased in comparison with earlier within the day.

The patient also had nausea, minor vomiting and bowel movements.

The nurse observed no signs of aspiration, documenting that the patient’s lungs were clear. Later that night, the RN documented that the patient had one other vomit, “small, brown… with a slight bowel odor throughout the night.” The RN didn’t contact the physician regarding these events.

When the patient was transferred within the morning, the RN’s documentation indicated that she was stable and that her condition “did not appear to worsen” since she began care the previous evening.

The patient was transferred and arrived on the second hospital, in keeping with the doctor’s note, “she appeared rested and not in distress.” However, the patient’s condition soon modified.

The white blood cell count was low, and a CT scan showed intestinal obstruction and signs of pneumonia in parts of the lungs, although there have been no signs of pneumonia. Antibiotics were immediately administered to treat the pneumonia, however the patient’s condition continued to deteriorate. She died the following day. An autopsy described the patient’s death as “aspiration pneumonia.”

The son files a wrongful death lawsuit

The patient’s son filed a lawsuit against the hospital and the doctors caring for his mother. Before the hearing, several doctors were released from the case by consent of the parties. The case against the hospital and the surgeon who admitted her to the second hospital went to court.

A jury returned a verdict within the son’s case, finding that the hospital nurses’ skilled negligence caused the deceased patient’s death, and awarded him $500,000.

However, the trial court later entered a summary judgment (JMOL) for the hospital and granted its motion for a brand new trial.

The son filed an appeal, difficult each decisions of the trial court.

Ruling of the court of appeal

The appellate court found that the trial court erred in awarding the hospital JMOL. The court found that the expert report prepared throughout the trial was sufficient to support the jury’s verdict; that’s, the RN’s failure to notify the physician concerning the tan-colored vomit and its odor “materially contributed” to the patient’s death.

It characterised vomiting as “a significant change… that causes the nurse to have a legal obligation to contact a physician.”

The trial court also erred in granting the hospital’s motion for a brand new trial, finding that the hospital’s contention that it had didn’t present evidence regarding the general skilled negligence of its nursing staff was false.

The appellate court discussed intimately the evidence presented regarding not only the RN’s care, but additionally the overall nursing care provided to the patient within the hospital. Since the hospital didn’t object at the moment, this might not be done on the appellate level.

The court reversed the hospital’s JMOL grant and granted a brand new trial. He remanded the case with an order to reinstate the jury verdict in his son’s case.

What does this wrongful death case mean to you?

It is obscure why the RN caring for this patient didn’t consider that the change within the patient’s condition – the colour and smell of the vomit – wouldn’t be a reason to contact the physician.

However, the RN’s omission is probably a living example of not being mindful when essential. It is essential that you simply are all the time attentive during patient care.

As a nurse, you mostly carry the burden of potential legal liability for yourself and your employer. RN was not a defendant within the lawsuit. However, her failure to comply with the standards of look after this patient resulted within the hospital being vicariously (not directly) liable.

Although she was not named as a defendant on this wrongful death lawsuit, the RN likely faced skilled disciplinary motion from the state board of nursing if she was reported to the board. This report could also be initiated by the deceased patient’s son, the hospital or, if required by state law, the court itself.

Please do not forget that disciplinary motion is all the time possible for those who violate the Nurse Practice Act and its rules. Constant review of each elements is essential.

Take related courses:

Swallowing is a fancy process that requires the coordinated motion of the muscles of the tongue, throat and esophagus. Many medical conditions and interventions can disrupt this process and increase the danger of aspiration. Due to the preponderance of a vulnerable population liable to aspiration, it can be crucial that every one healthcare professionals are knowledgeable about aspiration and recognize risk aspects to guard their patients.

From taking an order over the phone to transferring a patient to a different department, every healthcare skilled encounters situations day-after-day which will end in misunderstandings. This course discusses the importance of accurate and timely communication. Unacceptable medical abbreviations and a standardized patient transfer communication process were discussed.

Nurses have a responsibility to remain current on current issues related to the regulation of nursing practice not only of their states but additionally across the country. Nurses even have an obligation to patients to perform their work in a protected, competent and responsible manner. This requires nurse licensees to practice in accordance with the statutes and regulations of their states. This course provides information regarding nursing practices and their impact on nursing practice.