Nurse gives nitro w/o orders: undiagnosed cardiac pt. dies.
ISSUE: A patient with a forehead laceration is admitted for overnight observation. During the night, he complains of chest pain. Without consulting with or obtaining a doctor's order, a nurse administers five doses of nitroglycerin. The next day the patient is diagnosed with a myocardial infarction and dies. Should the nurse have called a doctor and obtained an order? Absolutely! However, this nurse, for whatever reason, failed to do so.
CASE FACTS: On February 5, 2002, Claude Michael went to Jackson South Community Hospital to receive treatment for a laceration on his forehead. He was admitted to the hospital overnight for observation. During his stay, he complained of chest pains. A nurse gave him five doses of nitroglycerin during the night without obtaining a doctor's order or consulting with a doctor. The next morning, the patient's doctor became aware of the chest pains and diagnosed a myocardial infarction. The patient was transferred to the hospital's Intensive Care Unit (ICU) and then to South Miami Hospital. The patient died later that day at South Miami Hospital. Pursuant to Florida law, the patient's wife, who was the personal representative of his estate, served Jackson South Hospital and two physicians who treated the patient with notice of intent to initiate suit. The notice named the prospective defendants as "The Public Health Trust d/b/a Jackson South Community Hospital, and its employees and actual and apparent agents." The notice indicated the prospective defendants' obligation to participate in informal discovery and specifically requested information on any other person or entity the prospective defendants contended might be responsible for the alleged negligence. The hospital delayed in responding to the patient's widow's request for the name and identity of the nurse the hospital contended administered the nitroglycerin doses to the patient for almost an entire year. The plaintiff filed suit against the hospital and the two physicians who treated the patient at the hospital, whose names were known, and immediately propounded interrogatories seeking to discover the name of the nurse responsible for administering the nitroglycerin. Ultimately, the hospital disclosed that the nurse involved was Milton McCall. The hospital further disclosed that the nurse was employed by Medical Staffing Network (MSN) with which the hospital had contracted. Immediately upon receiving this information, the plaintiff moved to amend the complaint alleging that the plaintiff failed to comply with the pre-suit notice requirement. The trial court allowed the plaintiff to file an amended complaint against MSN and Nurse McCall.
COURTS OPINION: The District Court of Appeals of Florida reversed the judgment of the trial court, which dismissed the claims against MSN and Nurse McCall. The court remanded the case back to the court for further proceedings not inconsistent with its decision. The court held, inter alia, that since the plaintiff was unable to identify or name either Nurse McCall or MSN, the agency that employed her, due to the hospital's failure to comply with Florida law', it made it impossible for the plaintiff to identify either the nurse or MSN as parties to the suit. Immediately upon learning the identity of the nurse and his employer, the plaintiff moved to join them both as defendants. The court concluded that on remand, the trial court's determination as to the legal relationship between the hospital, the agency, and the nurse, will be dispositive of the issue.
LEGAL COMMENTARY: The very purpose of discovery was subverted by the hospital in this case. Public policy has dictated that full and complete disclosure of all facts, with certain delineated exceptions, must be disclosed to opposing parties to promote the best interests of the punic in ensuring lair trials. In accordance with public policy and the discovery rule, all parties should put all their cards on the table. Again, subject to certain privileged information, which in the best interest of the public is, in fact, subject to being privileged and not subject to disclosure. The court concluded that in certain cases, like the one at bar, it is not necessary to identify by name, job title, or job description each prospective defendant in order to do a reasonable investigation into their involvement, especially when that information is unavailable to a plaintiff. The failure to individually name a particular defendant is not fatally defective, so long as the plaintiff has other, vise made it clear that the defendant's actions were properly reviewed and determined to be negligent prior to filing suit.
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 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, Marquis Who's Who in American Law, Who's Who in America and Who's Who in the World.
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|Title Annotation:||Nursing Law Case of the Month|
|Author:||Tammelleo, A. David|
|Publication:||Nursing Law's Regan Report|
|Date:||Sep 1, 2007|
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