Nursing & Healthcare Directories on: The Nursefriendly
Nursing Malpractice Case Studies By Date

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Editors Note: The urls to these cases are Permanent and Will Not Change. Feel free to link to any case you feel is helpful. To host any of our cases on your website or reproduce them in your publications, please contact Andrew Lopez, RN

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CPR Against, Facility Policy. Nurse Let Patient Die? Behind Closed Doors Case #9: Special Edition, #AmandaTrujillo, MSN, RN @NURSEINTERUPTED:"You've spent the better part of a year trying to find a job as a new nurse. Compounding your efforts is the fact you are early into your first pregnancy. Exasperated, you decide to start applying out of state in hopes of broadening your prospects and are thrilled when a beautifully updated independent living facility offers you a job. Your husband, an electrical engineer who graduated from the local state university with you a year ago has been having a tough time finding a job as well— so he is more than happy to help pack up the apartment and hit the road. It seems that brighter days are ahead for both of you. Surely he will find a job in California. For now, you will be the breadwinner and will be able set aside some money in anticipation of the baby that is due in another six months."
http://www.nursefriendly.com/nursing/clinical.cases/behind.closed.doors.9.no.cpr.htm

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Hospital Falls Are Not Always the Healthcare Provider's Fault, Or Are They? by Amanda Trujillo, MSN, RN:"In April of 2005 Mr. William Delk was a patient at Reid Hospital in Indiana when he fell while seated on a rolling commode in the bathroom. Mr. Delk had recently been a victim of a stroke that left him with complete left sided hemiparesis. He had been readmitted with complications associated with the stroke that were described as "a headache and numbness on the left side of his body." (Tammelleo, 2011) According to the case notes William was a rather large man and coupled with the injury from the stroke he was difficult to move. There were usually two to three people recruited to help move him."
http://www.nursefriendly.com/nursing/clinical.cases/2012.08.18.hospital.falls.htm

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Nurses Followed Dr.'s DNR Order On Patient, Confusion about Advanced Directives:"Summary: A nurse advised the CNA to stop CPR on a patient who had a DNR order in place, the family objected and filed a malpractice suit against the hospital, physician, and nurse involved in the case."
http://www.nursefriendly.com/nursing/clinical.cases/2012.08.07.nurse.followed.DNR.orders.htm

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Physician Dismisses Nursing Assessments, Patient Almost Loses Limb.
Rowe v. Sisters of Pallottine Missionary Society, 2001 WL 1585453 S.E.2e – WV
Summary: The patient was involved in a motorcycle accident in which his bike fell onto and injured his left leg. When the nurses assessing the patient could not detect a pulse in that leg, an ominous sign of circulatory failure. The physician when notified chose to dismiss this fact and discharge the patient. The patient would return soon after with worsening symptoms that would require emergency surgery. Should the nurses have initially pressed for further action, treatment?
http://www.nursefriendly.com/041013

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Extravasation Follows Chemotherapy Administration. Potential Complication or Nursing Negligence:
Iacano v. St. Peter's Medical Center, 334 N. j. Super. 547 – NJ (2000)
Summary: Intravenous therapy has inherent risks and potential complications. When you introduce chemotherapeutic drugs and known vesicants, those risks increase dramatically. In this case, a known risk, extravasation, occurred following administration. The question arises, could the nurses have acted sooner to prevent the extravasation and resulting tissue damage.
http://www.nursefriendly.com/nursing/clinical.cases/040130.htm

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Patient Falls While Ambulating Post-op, Negligence or Medical Malpractice:"One of the most important interventions post-operatively is to get a patient up and walking. It minimizes chances of complications such as DVT, Pneumonia, Pulmonary Emboli and Decubitus Ulcers. In this case, a patient fell while ambulating. It would need to be decided if a case could be made for simple negligence on the part of the staff, or true medical malpractice."
McBee v. HCA Health Services of Tennessee, Inc. 2000 WL 1533000 So.2d – TN
http://www.nursefriendly.com/nursing/clinical.cases/040109.htm

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January 29, 2002: Nurse Sued For "Too Many Sticks" How Many Attempts Is Too Many?:"Starting Intravenous Lines and Performing Venipunctures are basic nursing skills in the Acute Care or Hospital settings. In this case, a female patient would accuse a male nurse of negligence and causing a resulting injury when he needed three attempts to successfully start an intravenous catheter."
Coleman v. East Jefferson General Hosp., 747 So.2d 1044- LA (1999)
http://www.nursefriendly.com/nursing/clinical.cases/020129.htm

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September 4, 2001, Pathologic Fracture, or Patient Injured in Fall:
Summary: The patient in this case had an extensive Oncologic history including multiple metastases and a predisposition to pathological fractures. When the patient fell while transferring a wheelchair, the cause of the broken hip found after the fall was put into question.
http://www.nursefriendly.com/nursing/clinical.cases/2001/090401.htm

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May 13, 2001: Chronically Ill Child or Mother With Munchausens Syndrome
Summary: A child starting at the age of six months was diagnosed with ulcerations of the digestive tract. His treatment and complications would persist well into the age of seven. Identification of Munchausen victims is notoriously difficult under the best of circumstances. In this case, the victim was a child admitted to a Massachusetts Hospital for a Central Venous Catheter, Line infection. The suspicion, diagnosis and treatment were carried out promptly.
Adoption of Keefe, 733 N.E.2D 1075 - MA (2000).
http://www.nursefriendly.com/nursing/clinical.cases/2001/051301.htm

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October 22, 2000: Trauma Patient, In Shock And In Decline, ER Physician Does Not Transfer
Summary: When a patient from a trauma scene arrives at the hospital, initial assessments and evaluations are critical. In this case, a patient involved in a Motor Vehicle Accident was brought in with symptoms indicative of Shock. On evaluation the decision was made to treat the patient on site. The patient then would die soon after admission. Should the ER physician have transferred her?
http://www.nursefriendly.com/nursing/clinical.cases/2000/102200.htm

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October 15, 2000: Physician Restraint Orders Unclear On Transfer, Do You Apply In The Interim?
Summary: The use of Mechanical or Physical Restraints on confused patients is highly controversial. Due to substantial Death & Injury attributed to their use they are considered a last resort measure in providing for the safety of a patient. In this case, orders specifying what restraints and when they were to be used were unclear. In a patient that was clearly at high risk for injury, should they have been applied till the physician could have been contacted?
Tousignant v. St. Louis County, 602 N.W.2d 882 - MN (1999)
http://www.nursefriendly.com/nursing/clinical.cases/2000/101500.htm

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February 16, 2000 Nurse Advises "Reconsider Choice of Physicians" An Nurse's Ethical Dilemma.
In this case the nurse providing patient care noted a decline in the patient's condition, evidenced by weight loss, hallucinations, psychiatric symptoms, and acute distress. The findings were documented and attempts were made to contact the attending physician. The attending physician, however, failed to return any of telephone messages.
Deerman v. Beverly California Corp., 518 S.E.2d 804 - NC (1999)
http://www.nursefriendly.com/nursing/clinical.cases/2000/021600.htm

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January 13, 1999: Cytomegalovirus Test Result, Misinterpreted By Nurse. Did Negligence Lead to Child With Birth Defects?
Summary: Nurses access and report confidential and sensitive test results to case managers, insurance companies, physicians and other nurses as a matter of course each day. It is commonly accepted that only a physician can interpret what a test result implies for a specific patient. Nurses by training have a general knowledge of basic lab values and what they may represent. In this case, a pregnant woman with an active Cytomegalovirus infection was misinformed by a nurse reporting a result. Had an accurate explanation been given, a therapeutic abortion might have been performed.
Duplan v. Harper, 188 F.3d 1195 OK - (1999).
http://www.nursefriendly.com/nursing/clinical.cases/011300.htm

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October 17, 1999: Psychiatric Nurses "Miss" Festering Wound Infection? Is She Held To The Same Standard?
Summary: Registered Nurses in their training cover each of the accepted areas that a new graduate might be expected to work in. Once in the field, it is expected that additional and specific training to a Department or Specialty will be obtained. In this case, the Psychiatric nurses did not pick up on a festering infection in a patient that had tried to commit suicide. Was the fact that they were Psychiatric nurses a valid excuse?
Latshaw v. MT. Carmel Hospital, 53 F. Supp. KL - (1999)
http://www.nursefriendly.com/nursing/clinical.cases/101799.htm

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October 10, 1999: Nursing Malpractice Alleged When Suspected Breast Cancer Patient Doesn't Follow Up
Summary: Breast Cancer is a well-defined and treatable if not always curable disease process. Once suspicious findings-lumps, nodules, nipple discharge or other telltale signs of a problem are noted-prompt evaluation and follow-up care is essential. In this case, a patient with a family history of breast cancer presented with a "mass" and was evaluated. She did not follow-up as directed and when she later died of breast cancer, her estate would sue for "failure to diagnose, treat."
Michigan Ave. Not. Bank v. County of Cook, 714 N.E.2d 1013 - IL (1999)
http://www.nursefriendly.com/nursing/clinical.cases/101099.htm

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October 3, 1999: Grand Mal Seizure Follows Cervical Myelogram, Anticipated Risk or Nursing Negligence?
Cascio v. St. Joseph Hosp., 734 So.2d 1099 - FL (1999)
Summary: With a proper Informed Consent obtained, it is accepted that a patient is aware of potential risks & complications prior to a procedure. In this case, following a cervical myelogram, a patient developed seizures and suffered an injury. The physician would blame the nursing staff for causing an "increased risk" by not following procedures.
http://www.nursefriendly.com/nursing/clinical.cases/100399.htm

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September 26, 1999: Nursing Assistants Leave Client Alone, Patient Receives Second Degree Burns During Bath.
Registered and Licensed Practical Nurses frequently delegate responsibilities and tasks to Certified Nursing Assistants and Unlicensed Assistive Personnel. It is clearly recognized that they are responsible for the actions/inactions of those they supervise. In this case, two nursing assistants recognized injuries to a patient while giving a bath. When they failed to notify the nurse of the injuries, they would be reported and lose their certifications.
http://www.nursefriendly.com/nursing/clinical.cases/092699.htm

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September 19, 1999: Abusive Psychiatric Patient Restrained, Placed In Seclusion For Angering Nursing & Medical Staff?
Summary: In dealing with violent, abusive or angry psychiatric patients, the safety of the patient and staff are the priority concerns. When restraints or seclusion are deemed necessary, justification for the measures must be documented concisely. In this case, an unruly patient angered the nurse caring for him. When leather restraints were applied and maintained for a prolonged period of time, the patient would object and later sue for damages.
Alt v. John Umstead hospital 479 S.E. 2d 800
http://www.nursefriendly.com/nursing/clinical.cases/091999.htm

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September 12, 1999: Sleep Apnea Monitor Turned off or Ignored By Nursing Staff, Patient's Coding Goes Unnoticed.
Monitors and Monitored patients present special challenges to practicing nurses. Like a call bell, when alarms on a monitor are activated, they can signal benign or life-threatening events. In this case, a patient's monitors did not alarm as expected. The patient was in distress and would be found without respirations and pulseless by the nurse on duty.
Odom v. State Dept. of Health and Hosp., 322 So. 2d 91 -LA (1999)
http://www.nursefriendly.com/nursing/clinical.cases/091299.htm

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September 5, 1999: Sealed "Rape Kit" Reopened By Nurse. Evidence Inadmissible?
Documentation of observations and findings are basic to nursing practice. Our practice is governed by standards of practice and "protocols" to be followed. In this case, a nurse admitting a rape victim collected and placed in a "rape kit" DNA samples, evidence to be submitted for laboratory analysis. The evidence submission protocol would inadvertently be broken by the nurse. The defense for the rapist would argue this breach made the evidence inadmissible.
State v. Southern, 980 P.2d 3 - MT (1999)
http://www.nursefriendly.com/nursing/clinical.cases/090599.htm

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August 29, 1999: Surgeon "Loses Clamp" Behind Patient's Heart During Bypass.
Nurse's Responsibility To Pick Up?
Summary: During any surgical operation, there is an inherent "duty" owed to
the patient that the operation will be carried out competently. This
includes carrying out specified procedures and taking measures to prevent
"foreign" objects from being left in the body cavity. In this case, during a
coronary artery bypass grafting, a clamp slipped from the surgeon's sight.
It would be found on x-ray later sitting behind the patient's heart.
http://www.nursefriendly.com/nursing/clinical.cases/082999.htm

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August 22, 1999: Psychiatric Nurse, Sued By hospital After Developing Relationship With Client?
Wright v. Mercy Hosp. Of Janesville - 557 N.W. 2d 846 - WI (1996)
Summary: Doctors and Nurses by nature of their positions deal with patients when they are vulnerable, off-balance and emotionally needy. When the population includes the psychiatric patient, the potential exists for a client to develop "feelings" for the caregiver. In this case, a sexually abused mother of three was admitted for multiple mental disturbances. During the course of the treatment, a relationship developed and led to sexual encounters following discharge. When it came to light, the patient successfully sued. The hospital would attempt to recover damages against the nurse following her testimony in defense of the facility. This is commonly called a Subrogation action.
http://www.nursefriendly.com/nursing/clinical.cases/082299.htm

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August 15, 1999: Violent Psychiatric Patient Attacks Nurse,
No Legal Recourse Against Facility or Psychiatrist?
Charleston v. Larson, 696 N.E. 2d 793 – IL 1998
Summary: It would seem absurd, that if a physician admits and facility assigns a nurse to care for a known violent patient, that it has no legal obligation to protect that nurse against violence. In this case, a psychiatric patient sought admission to facility. On admission, he threatened to attack a nurse. When the patient would follow through on his threat, the nurse was denied legal recourse against the psychiatrist who could have taken precautions against the attack.
http://www.nursefriendly.com/nursing/clinical.cases/081599.htm

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August 8, 1999: Pregnant Prison Inmate Complains of Miscarriage, Corrections Nurse On Duty Ignores Symptoms?
Ferris v. County of Kennebec, 44 5. Supp.2d 62 –ME (1999)
Summary: Nursing assessment skills are one of our most valuable assets. They allow us to effectively evaluate our patients and communicate significant findings to physicians and other members of the healthcare team. In this case, a pregnant woman with a previous history of miscarriage complained of vaginal bleeding and abdominal discomfort. The assessment performed by the nurse fell negligently short of the required standard of care.
http://www.nursefriendly.com/nursing/clinical.cases/080899.htm

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August 1, 1999: Nursing Duty To Patient, "Does Not Guarantee" Safety Or Quality Of Care.
Summary: When a nurse accepts report and responsibility for the care of a patient a duty to the patient is also accepted. This duty is to provide a reasonable standard of care as defined by the Nurse Practice Act of the individual state and the facility Policy & Procedures. In this case, a post-op abdominal aneurysm repair patient was injured after falling from his bed to the floor. When a lawsuit was filed the court initially mistook expert testimony to imply the role of the nurse includes a guarantee of safety.
Downey v. Mobile Infirmary Med. Ctr. - 662 So. 2d 1152 (1995).
http://www.nursefriendly.com/nursing/clinical.cases/080199.htm

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July 25, 1999: Premature Child of Cocaine Addicted Mother Survives Abortion. Physician Order: Leave To Die?
The premature birth of a child under normal circumstances requires highly skilled nursing and medical care if the child is to survive. The birth of a premature child to a known Cocaine addicted mother greatly increased the risks of mortality. In this case, a child intended to be aborted is born alive. When the physician orders that the child be to left to die, it miraculously survives on its own. Were the nurses liable for "following orders?"
Hartsell v. Fort Sanders Reg. Med. Ctr. 905 S.W. 2d 944 - TN (1995).
http://www.nursefriendly.com/nursing/clinical.cases/072599.htm

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July 18, 1999: Good Samaritan Laws & Acts. Do They Cover Nurses Volunteering Nursing Care When A Citizen Goes Anaphylactic.
"Off-duty" healthcare professionals renderingEmergency aid are in most cases "covered" by the Good Samaritan Acts.  These are laws enacted in each state that provide some degree of immunity from liability for good faith efforts in giving emergency care.  In this case, a nurse and physician were sued for providing assistance in a volunteer function at a "first-aid" station. Good Samaritan "immunity" was not recognized by the courts.
Boccasile v. Cajun Music Ltd. 694 A 2d 686 - RI (1997)
http://www.nursefriendly.com/nursing/clinical.cases/071899.htm

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July 11, 1999: Nursing Home Rehabilitation Stay Proves Terminal. Was Quality of Care Given An Issue?
Nursing homes are frequently a patient's destination for rehabilitation following surgery.  Common conditions fitting this bill include large bone fractures, hip replacements and stroke. Following these acute episodes, the patients are too unstable to go home and not "sick" enough to have their hospital stays reimbursed by insurance companies.  The purpose of admission to a nursing home is to help the patient regain lost function, strength and health.  In this case, the patient would remain in the Nursing Home till her death of complications.
Lloyd v. County of Du Page, 707 NE.2d 1252 - IL (1999)
http://www.nursefriendly.com/nursing/clinical.cases/071199.htm

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July 4, 1999: Diabetic Coronary Artery Bypass Patient, Septic & Noncompliant.  Nursing Duty and Responsibility Questioned.
Patient noncompliance can present serious challenges to nurses  and physicians providing care.  If aware of the proper measures to be taken, what happens when the patient does not agree or comply with the course of treatment?  In this case, a patient after having a coronary artery bypass grafting developed a sternal infection. When advised by a nurse to return for treatment, the patient refused.
Kind v. State Ex Rel. Dept. of Health, 728 S.o. 2d 1027 -LA (1999).
http://www.nursefriendly.com/nursing/clinical.cases/070499.htm

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June 27, 1999: Elderly Patient Repeatedly Injured In Nursing Home "Accidents." Negligence, Coincidence or Abuse?
As the elderly population continues to increase, more and more families are faced with the decision to place loved ones in nursing homes.  When a family member is placed in a facility, a certain standard of care is expected.  In this case, a resident was injured repeatedly while under their care.  When the patient died a few days after being "dropped" the family sued.
Brickey v. Concerned Care of Midwest Ince. 988 S.W. 2d 592 MO (1999)
http://www.nursefriendly.com/nursing/clinical.cases/062799.htm

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June 20, 1999: Organ Donation Informed Consent, Is A Single Parent's Sufficient?
Organ donors are in high demand.  Frequently intended recipients can wait a lifetime for the critical matching organ.  In this case, two nurses obtained a consent from a child's mother.  When the father later expressed his disagreement, the child's corneas had been harvested and it was too late.
Andrews v. Alabama Eye Bank, 727 S. 2d 62 –AL (1999)
http://www.nursefriendly.com/nursing/clinical.cases/062099.htm

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June 13, 1999: Felony Child Abuse Conviction, Made Possible Thanks to Nurse's Documentation.
Child abuse is a "reportable" crime.  This means when a healthcare worker suspects in the course of their duties that a child has been abused, it must be reported.  Procedures are in place in hospitals and other facilities for the reporting of abused children. In this case, it was the expert documentation of a child's statements by a nurse, physician and field agent that made the conviction of an abuser possible.
State v. Gillard, 936 S.W. 2d 194 - MO (1999).
http://www.nursefriendly.com/nursing/clinical.cases/061399.htm

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June 6, 1999: Emergency Department Nurse Verbally Abused, Physician History Well Documented
Official tolerance for verbal abuse and sexual harassment is approaching zero.  It is clear that both are still prevalent in healthcare settings today.  Enforcing and reporting instances of abuse are critical to an end being put to the situation.  In this case, a physician had a "history" of verbal abuse in the facility involved.  It was the documentation of previous events that made formal action and administration of a suspension feasible.
Gordon v. Lewiston Hospital, 714 A.2d 539 – PA (1998)
http://www.nursefriendly.com/nursing/clinical.cases/060699.htm

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May 30, 1999: Patient Left Unrestrained, Patient Injured. Nurses Judgement Call
The decision to use or not use restraints must be made with caution and good judgement. Their intended purpose must be to protect either the patient or others who may be injured by the patient including the staff caring for the client. The ultimate determination of necessity is left with the physician. Often, the moment to moment necessity is determined by the nurse. In this case a nurse did not feel restraining the patient was necessary. When an injury occurred, the patient sued.
Gerard v. Sacred Heart Medical Center - 937 P. 2d 1104 (1997)
http://www.nursefriendly.com/nursing/clinical.cases/053099.htm

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May 23, 1999: Sponge Count Off, Patient Develops Sepsis, Surgeon Blames Nurse.
Sponge Counts are a basic and critical safety measure during a surgical operation.  In this case, the standard three counts were not performed.  A sponge was left in the patient that would later lead to infection.  When the issue went to court, the surgeon claimed "it was not his responsibility" to keep track of the sponges.
Johnston v. Southwest Louisiana Assn. 693 So. 2d 1195 –LA (1997)
http://www.nursefriendly.com/nursing/clinical.cases/052399.htm

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Editors Note: The urls to these cases are Permanent and Will Not Change. Feel free to link to any case you feel is helpful. To host any of our cases on your website or reproduce them in your publications, please contact Andrew Lopez, RN

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