RNs err in using 'unwashed' sperm for insemination.

KELLY AND CAROLINE CHAMBLISS, FEMALE 'LIFE PARTNERS,' OPTED TO HAVE A CHILD BY ARTIFICIAL INSEMINATION. After undergoing eleven unsuccessful attempted artificial insemination, they engaged Health Sciences Foundation, Inc., d/b/a Coastal Area Health Education center, d/b/a Women's Health Specialties, North, and Julie Ramsey, RNC, NP, to facilitate the artificial insemination of Kelly. Dr. Mark Pasquarette, a leader of a reproductive endocrinology and fertility practice, was engaged to direct the procedure. Kelly was to undergo monthly intrauterine insemination procedures. "Pre-washed" donor sperm was obtained from an accredited sperm bank. Non-"pre-washed" donor sperm had to be placed into a Sperm Select kit for cleansing while "pre-washed" sperm remained in the Sperm Select syringe for eventual insemination. A Sperm Select syringe, which has the non-"pre-washed" sperm, looks "completely different" than the type of syringe used for "pre-washed" sperm. The first attempt to inseminate Kelly was scheduled for August 26, 2002. On August 24, 2002, Karen Hale, a registered nurse who worked at the facility, prepared a sperm specimen for another patient. Hale and Debbie Cushing, a nurse at the facility, along with Nurse Ramsey, were the only nurses authorized to prepare specimens for artificial insemination. Hale drew a portion of the sperm into a Sperm Select syringe and cleaned it (the sperm used was not pre-washed). She drew up a smaller sample of the now cleaned sperm into a second Sperm Select syringe for insemination. She transferred a smaller portion of the cleaned sperm from this second syringe for insemination and transferred a smaller portion of the cleaned sperm from this second syringe into a catheter for actual use. She drew up the surplus unwashed sperm into the second syringe and placed it in an incubator. This unwashed sperm specimen remained in the syringe in the incubator in over the weekend. However, on August 26, 2002, Nurse Ramsey used the remainder of the unwashed sperm in Kelly's insemination procedure, and not Kelly's "pre-washed" donor sperm. The unwashed sperm used by Ramsey was in the same unlabeled Sperm Select syringe. Kelly became violently ill. On August 28, 2002, Nurses Hale and Ramsey recognized that the wrong sperm specimen was used. They immediately notified the Chamblisses. The Chamblisses sued all involved. After a jury trial, the jury awarded the plaintiffs both compensatory and punitive damages. The defendants appealed.

THE NORTH CAROLINA COURT OF APPEALS AFFIRMED THE JUDGMENT OF THE LOWER COURT FOR COMPENSATORY AND PUNITIVE DAMAGES. The court held, inter alia, that a thorough review of the record and trial transcripts and testimony illustrated that there was sufficient evidence to support submitting the question of punitive damages to the jury and consequently, to deny the defendants' renewed motion for a directed verdict which had been made in the lower court at several stages. The court noted that the facility had detailed protocols in place to ensure that what happened in this case would not happen. However, Nurse Ramsey admitted that though she was aware of the safety protocols in place, she violated the protocols in several ways including failing to examine the sperm specimen under a microscope prior to insemination. The court concluded that this evidence alone qualified as more than a scintilla of evidence regarding whether to submit the question of punitive damages to the jury.

THE COURT FOUND THAT THERE WAS SUFFICIENT EVIDENCE THAT NURSE RAMSEY ACTED WILFULLY AND/ OR WANTONLY. The court found that in addition to the fact that Nurse Ramsey acted wilfully and or wantonly, it was clear that she acted with reckless indifference for the safety of her patient, when she knowingly, consciously and deliberately used an unlabeled syringe containing an unknown substance in Kelly Chambliss' insemination procedure, knowing that to do so would expose her patient to a risk of harm. Editor's Note: While we must recognize Nurse Ramsey's candor and forthrightness in owning up to her mistake, it is almost inconceivable that an experienced nurse who held such a position of trust would not have realized that she was acting contrary to protocol. Needless to say that the very type of syringe that was used to inseminate Kelly Chambliss should have alerted Nurse Ramsey to the fact that she was injecting other than what she was supposed to inject. Nurses, take heed that even the very best can have lapses in concentration. Who knows what precipitated the error made by Nurse Ramsey? Was she preoccupied? Was she not concentrating on the very serious procedure with which she was so critically involved? No nurse should allow any outside influence to distract her! Chambliss v. Health Sciences Foundation, Inc., No. COA04-1687 (N.C. App. 03/ 07/2006) S.E.2d--NC

Meet the Editor & Publisher: A. David Tammelleo, JD, is a nationally recognized authority on health care law. Practicing law for over 40 years, he concentrates in health care law with the Rhode Island firm of A. David Tammelleo & Associates. He has presented seminars on medical, nursing and hospital law throughout the Unied States. In addition to his writings as Editor of Medical Law's, Nursing Law's & Hospital Law's Regan Reports, his legal articles have been published in the most prestigious health law journals. A prolific writer, his thousands of articles, as well as his achievements as an attorney and lecturer, have won him recognition in Martindale-Hubbell's Bar Register of Preeminent Lawyers, Marquins Who's Who in American Law, Who's Who in America and Who's Who in the World.