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Legal case briefs for nurses.

NY: Suicidal Pt. Lept to Death During Transport: Court Affirmed Nurse & Doctor Not Liable

CASE FACTS: On February 4.2005, Kirsten Dumas was admitted to Adirondack Medical Center after she had attempted to commit suicide. While at the hospital, she made two further attempts to take her life. Dr. Edward Frost, her attending physician, determined that her condition required that she be immediately transferred to the mental health unit at Glens Falls Hospital. Dr. Frost signed orders authorizing the transfer, but did not direct in those orders that Kirsten be placed in restraints while being transported. A nurse at the hospital, Richard Land, met the ambulance that was to transport Kirsten and advised the ambulance attendants of Kirsten's attempts at suicide and her suicidal ideation. After Kirsten was placed in the ambulance, she was secured with standard safety belts across her waist and ankles, and covered with a blanket. An attendant was assigned to ride in the back of the ambulance and watch over her during the transport. Several minutes into the transport, Kirsten who unlocked her safety belts, jumped up and threw herself out the rear door of the ambulance sustaining fatal injuries. Kirsten's husband, as Administrator of her estate, filed suit against Dr. Frost and Nurse Land, the Hospital, the ambulance service and its attendants. The estate settled its claim against the ambulance service and attendants. The case went to trial against Dr. Frost, Nurse Land and the hospital. After the close of the Estate's case, the defendants moved for a directed verdict. The trial court granted the defendants' motion and dismissed the case against them. The Estate appealed.


COURT'S OPINION: The Supreme Court of New York, Third Department, affirmed the order of the lower court, which had granted the defendants' motion for a directed verdict for Dr. Frost, Nurse Land and the hospital. The court held, inter alia, that a doctor is not liable in negligence merely because a treatment, which the doctor, as a matter of professional judgment elected to pursue, proved ineffective. The court noted that the evidence revealed that before giving the order to transport Kirsten, Dr. Frost consulted with the hospital's psychiatric staff: Since Kirsten had been medicated and had not exhibited any suicidal tendency during the two to three hours before being transported, Dr. Frost decided not to order restraints. As to Nurse Land, the court concluded that his failure to question Dr. Frost as to why no restraints had been ordered was predicated on all of the same facts and information, which Dr. Frost had. Moreover, the Estate's own expert acknowledged that Nurse Land, as a nurse, had no authority to direct that restraints be used. In addition, there was no record evidence indicating that Dr. Frost would have ordered restraints had Nurse Land raised the issue. Accordingly, the court found that the Estate also failed to make a prima facie case against Nurse Land. Dumas v. Adirondack Medical Center. 2011-07769 (11/3/2011)-NY

NY: Failure to Identify Stages of Decubitus Ulcer: Court Denied Hospital's Motion to Dismiss Suit

CASE FACTS: Mauricio Batista had been hospitalized at St. Luke's-Roosevelt Hospital Center on several occasions. On June 4, 2006, he was transferred from Kateri Residence to the Hospital's Emergency Department. His co-guardians filed suit against Kateri Residence and the hospital regarding the patient's admission and negligent treatment for decubitus ulcers in the area of the buttocks and sacrum. The plaintiffs noted that the patient had suffered a severe stroke the previous September (2005), which had left him hemiplegic intubated with a PEG feeding tube, and incontinent. They alleged, inter alia, that his injuries resulted from the hospital failing to properly treat the decubitus ulcer. The hospital's expert medical witness, Dr. Bruce Hirsch, who is board certified in Internal Medicine, with subspecialties in Geriatric Medicine and Infectious disease, opined that the hospital had at all times acted properly in treating the patient's condition. Conversely, the plaintiffs' medical expert witness, Dr. Ira Mehlman, who is board certified in Internal Medicine and Emergency Medicine, presented a completely different view, while also relying on the hospital's own records. He detailed multiple deviations from the standards of proper treatment for decubitus ulcers, such as the one in question.

COURT'S OPINION: The Supreme Court, New York County, denied the defendants' motion for summary judgment. The court held, inter alia, that the hospital, as the moving defendant, had the burden to show that no deviations of proper care occurred causative of injury. The court noted that Dr. Mehlman opined clearly that there were such deviations that caused the ulcer to worsen. Although Dr. Hirsch dismissed this as "nonsense," and in one conclusory statement after another, opined that" all went well," clearly it did not! The court noted that the hospital's own records showed clearly and convincingly that it did not all go well. Dr. Willman addressed the lack of proper assessments and staging of the ulcer. He noted that all agreed that a Braden scale is universally used to stage the seriousness of decubitus ulcers or pressure sores. The range ran from Stages I through IV, with IV being the most serious. However, the "failure of the hospital's own records to reflect any stages" spoke volumes as to the lack of appropriate treatment of the decubitus ulcer by the hospital. Further, he noted that upon admission the patient's ulcer was staged as both a Stage II and a Stage III. However, he noted that at no point in the records is the word "healing" ever used. He emphasized that from June 13,2006, through June 19, 2006, and from June 22, 2006, through June 24, 2006, the ulcer was "unstaged," meaning no grade was given. This was significant, since the ulcer was not covered by a bandage and could easily have been identified in terms of its stage. The fact that it was not identified by stage spoke volumes! Batista v. Residence, 211-32891 NYMISC (10/28/2011)-NY

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 United States. In addition to his writings as Editor of Medical Law's, Nursing Law's Hospital Line Regan Report his legal articles have been published in the most prestigious health law journals. A prolific writer, his thousands or articles, as well as his achievements as an attorney and lecturer, have won him recognition in Martindale-Hubbell's Bar Register a Preeminent Lawyers. Marquis {Mk Why in American Low, Who N Who in America and Who's Who in the World
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Author:Tammelleo, A. David
Publication:Nursing Law's Regan Report
Article Type:Case overview
Date:Nov 1, 2011
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