Malpractice suit questions whether RN followed standards of practice

Always follow your standards of practice to the letter — this case demonstrates why.

Over the years, I’ve written several blogs about standards of practice and the standard of care of a nurse named as a defendant in a professional negligence case, including “Case Underscores Importance of Adhering to Standards of Practice in Labor and Delivery.”

Standards of practice are the “how to” of your nursing practice. They are based on many sources, including your nurse practice act, your professional association’s adopted statements on its area of nursing practice and state and federal case law.

Standards of practice set a national basis for all nursing practice. Even so, based on each state’s laws and statutes they can interpreted and applied differently.

In a professional negligence case against you as a named defendant, a nurse expert witness establishes the applicable standard of care upon which the jury makes its determination as to your compliance or non-compliance with that standard.

Standards of practice serve as the basis for what your overall legal standard of care is in a particular situation in a lawsuit. That legal standard is what other ordinary, reasonable and prudent nurses would do in the same or similar circumstances in the same or similar community.

When researching this blog topic, I came across the New Jersey case of Colleton v. Biebel, which illustrates the importance of both your standards of practice and overall standard of care.

Facts of the case

The patient, a state trooper and a martial arts competitor, was injured during a match when he kicked his opponent. He immediately heard a “pop” in this right leg. An MRI and ultrasound showed a ruptured Achilles tendon.

His podiatrist suggested corrective surgery, which he described as a “simple procedure.” The patient underwent surgery with the podiatrist and his partner performing the procedure.

The patient was discharged with a “pain pump” attached to the back of his right leg. The catheter was removed after several days. However, shortly thereafter, the patient experienced severe pain in his leg, which strong anti-pain medications did not relieve.

Unable to determine why the patient was experiencing pain, the podiatrist sent the patient to a pain management specialist and a physiatrist. The physiatrist’s nerve conduction tests indicated there was no nerve function from his “right knee downward.”

The patient began experiencing painful “electric shocks” in the right leg. He saw a peripheral nerve surgeon, who did two separate surgical procedures that resulted in some feeling in the patient’s leg and foot, but the electric shocks continued.

Two years later, the patient underwent surgery to remove the tendons in his toes and insert metal screws to straighten the toes, which helped him walk.

However, his right foot increased two sizes, and he needed special shoes.

Patient files malpractice case

The patient’s lawsuit alleged that he suffered permanent nerve injuries because of the compression from the mid-thigh pneumatic tourniquet that was overpressurized during surgery. He also alleged others present during the surgery — the podiatrist’s partner, an anesthesiologist and a nurse — failed …read more

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