Many of my blogs have focused on nursing documentation and nurse expert testimony when malpractice is alleged against a nurse defendant. In the following malpractice case, an RN juror’s conduct during jury deliberations became the focus of an appellate court determination for a new trial.
Details Leading up to Malpractice Case
A physician removed a fatty tumor from the upper right arm of a male plaintiff by making an incision in the rear of the patient’s upper arm. The lipoma was removed, the incision was sutured, and the arm was bandaged.
The patient was told to return to the doctor’s office in 17 days. The patient kept the incision covered with the original bandage because, as he stated during the trial, he received no verbal or written wound care instructions.
Nine days after the surgery, the patient was taken to a medical center’s emergency department by ambulance. The ED physician initially diagnosed the patient as suffering from:
- Sepsis
- Pneumonia
- An acute kidney issue or damage to his heart
The patient was admitted to the ICU for treatment for pneumonia, and several hours later, a surgical consult occurred to evaluate the lesion on his right arm. The surgeon found a necrotizing soft tissue infection in the patient’s right arm. The patient was taken to surgery to remove the dead tissue.
The surgeons first treated a “ruptured bullae” on the bicep before discovering that the tissue deep in the arm under the bicep had been demolished by the infection. They then removed the sutures from the original incision. The “wound fell open” and pus oozed out from the wound. The patient’s condition continued to deteriorate, and the surgeons were forced to amputate the patient’s arms and legs to halt the spread of the infection.
The patient and his wife filed a lawsuit against the surgeon who initially treated him, alleging that he was negligent for not providing him with proper wound care instructions. This failure was a “substantial factor” in causing the infection that resulted in the loss of his arms and legs.
What Happened at the Trial Level?
The patient’s expert in the malpractice case testified that had the patient been given proper instructions and followed them, no infection would have occurred. The surgeon’s position was that the patient was provided with such instructions and that the infection was the result of the growth of bacteria in his respiratory system and not the wound, and that bacteria spread through the bloodstream.
A key issue at trial related to the wound care instructions was whether the patient was wearing a bandage when taken to the ED. Both sides relied on the ED’s and the ICU’s nursing documentation to support their respective positions as to liability.
The ED nurse’s documentation described the condition of the wound and noted that there was no dressing. The ICU nurse’s documentation noted that the dressing that was applied at home was removed. Neither of these two nurses were called to testify by the parties at trial.
During jury deliberations, a juror, who was an RN, stated her opinions during the …read more
Read full article here: nurse.com
