Nurse Practitioner’s Prescription Results in Negligence Lawsuit

According to the American Association of Nurse Practitioners (AANP), there are more than 355,000 licensed nurse practitioners (NPs) in the United States and 96.2% of them prescribe medications. The demand for NPs’ services continues to increase — but so, too, can their liability risks. In the following case, an NP’s actions raised many questions and led to a negligence lawsuit.

Facts of the negligence case

One Christmas Eve, a patient had a bad cough, which she believed was caused by bronchitis. Her primary care provider’s office was closed, and she did not want to go to the emergency room. When she told a friend about her symptoms, the friend suggested contacting a nurse practitioner she knows. The NP worked for an express, walk-in clinic but was not working on Christmas Eve.

The NP was called, but it is unclear whether the friend shared the patient’s symptoms with the NP or if the NP spoke directly with the patient. The NP prescribed an antibiotic, oral steroids, and an asthma inhaler for the patient without personally seeing her or having previously treated her. The patient’s friend took the prescriptions to a local drug store and picked them up later that day.

Neither the NP nor the pharmacist informed the patient that taking the antibiotic and steroids might cause tendonitis. She read the insert for the antibiotic but thought the risk of tendonitis only applied to elderly patients. So, she took the medicine as prescribed.

Several days later, the patient experienced arm and shoulder pain and was seen by her primary care provider who told her the “most likely cause of her condition” was the medication prescribed by the NP.

Challenges in this negligence lawsuit

When the patient filed the lawsuit, she had difficulty determining who should be named as defendants. One reason for this problem was that the NP had outdated information filed with the state board of nursing as to who her supervising physician was. The other reason was lack of clarity on where the NP actually worked. Naming the incorrect supervising physician and the clinic was not legally acceptable. She did ultimately name the pharmacy as a defendant.

In an amended complaint, the patient dropped the clinic as a defendant and named the NP as a defendant. The NP denied liability and raised several affirmative defenses, including the fault of the patient and “other person(s) and/or entities for whom” the NP was not responsible.

The NP was sent an “expedited set of requests for admission” to determine who her supervising physician was. She denied she was working for her employer and using its prescription pads that Christmas Eve, and that the named physician was her supervising physician that day.

The NP was temporarily dropped from the complaint for unknown reasons, but she was deposed. In the deposition, the NP identified the clinic as her employer and named her supervising physician. The NP also admitted that the physician named earlier was, in fact, her supervisor on the day in question — so …read more

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