Nurse refuses to `doctor' forceps records: Dr.'s license revocation results. (Nursing Law Case of the Month).
ISSUE: There was a time when nurses were considered handmaidens of physicians. During those dark days, few, if any nurses, would dare to challenge a physician's diagnosis. Nurses were often called upon to "correct" records to coincide with the physician's "recollection" of what transpired. Those days have long since passed. However, occasionally, a physician will ask a nurse to compromise herself by making false entries in records. In this New York case an OB/GYN, confronted with a difficult delivery, asked the nurse assisting in the delivery to change the time at which he initially used forceps in the delivery. This, along with several other incidents, led to the temporary, then permanent suspension and, finally, revocation of the physician's license.
CASE FACTS: Neils Lauersen, a physician board certified in obstetrics and gynecology, received a notice that a hearing would be held before the Commissioner of Health for the State of New York on charges brought by the Bureau of Professional Medical Conduct (BPMC) alleging voluminous counts of gross negligence, gross incompetence, negligence and incompetence, as well as allegations of excessive treatment, fraudulent practice, moral unfitness and a failure to properly maintain records. These charges stemmed from the obstetrical, prenatal, preoperative and operative care and treatment that Dr. Lauersen rendered to seven patients between 1984 and 1999. Following 12 days of hearings, the Hearing Committee of the State Board for Professional Medical Conduct recommended to the Commissioner of Health that the physician's license be temporarily suspended on the grounds that the physician posed an "imminent danger" to the public. The Commissioner, following this recommendation, suspended Dr. Lauersen's license pending a further hearing. Dr. Lauersen challenged the suspension by seeking a court order to show cause. Thereafter, the first of several court orders was issued directing the Department of Health to have a new Hearing Committee and Administrative Law Judge (ALJ) preside over an "imminent danger" hearing. Ultimately, the Hearing Committee issued its final determination which was to revoke Dr. Lauersen's license to practice medicine in New York. Dr. Lauersen appealed.
COURT'S OPINION: The New York Supreme Court, Appellate Division, affirmed the action taken regarding Dr. Lauersen's license. The court held, inter alia, that Dr. Lauersen's claim of bias had no merit. The court was convinced that those physicians who were on the Hearing Committee would be impartial despite the fact that they may have had prior knowledge of various incidents regarding Dr. Lauersen. The court found that the decision rendered was supported by substantial evidence. The court cited a particular incident regarding the testimony of a delivery room nurse who confirmed that Dr. Lauersen's improper use of forceps caused a newborn's skull fractures, subcutaneous hemorrhages, and hemorrhagic contusions. Moreover, and more significantly, the delivery room nurse testified that Dr. Lauersen, with intent to "deceive," requested her to change the time indicated on the printout which noted his initial application of forceps.
LEGAL COMMENTARY: The court went on to cite other outrageous incidents. One patient recounted that Dr. Lauersen had performed 13 laparascopic procedures upon her when he admitted to recalling no more than three. The Hearing Committee found that her testimony was fully supported. Another incident involved the determination that the care rendered to a patient was negligent, and that Dr. Lauersen failed to perform a pregnancy test prior to putting a patient on the drug Danocrine, failed to properly screen the patient for her gestational diabetes, and upon delivery of her baby, inappropriately used fundal pressure in the presence of shoulder dystocia which resulted in Erb's palsy. The audacity of Dr. Lauersen in asking the delivery room nurse to falsify her records concerning the application of forceps is only exceeded by the physician's incompetence. The delivery room nurse was instrumental in ensuring that Dr. Lauersen's privileges to practice medicine be curtailed. No nurse should ever acquiesce in any physician's. suggestion that she "doctor" records. Any physician who would do so is looking out only for himself and has no concern about putting the nurse or her license at risk, not to mention the well-being of his patients. Nurses should be adamant in their refusal to acquiesce in such a request and should be quick to come forward-just as the nurse in this case did.
Meet the Editor & Publisher: A. David Tammelleo, JD, is a nationally recognized authority on health law. Practicing law for nearly 40 years, he concentrates in health care law with the Rhode Island law 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 Reagan 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-Hubblle's Bar Register of Preeminent Lawyers and Marquis Who's Who in America Law.
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|Author:||Tammelleo, A. David|
|Publication:||Nursing Law's Regan Report|
|Article Type:||Brief Article|
|Date:||Apr 1, 2002|
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