Articles Posted in Nursing errors

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On Dec. 29, 2008, Camilla Hayes, 76, came to the emergency room at Rush Oak Park Hospital complaining of abdominal pain. The emergency room doctor, Dr. Joseph DiPiazza, did not order a complete cardiac workup. She was later diagnosed and treated for gastroesophageal reflux disease (GERD). However, Hayes was in process of being discharged from the hospital after four and a half hours in the ER when she suddenly collapsed and died. She is survived by two adult children. No autopsy was performed and the parties agreed that she most likely died from a sudden cardiac arrest based on her multiple risk factors for cardiac disease, including hypertension, high cholesterol, morbid obesity and a history of smoking.

The family filed a lawsuit against the doctor and his practice, claiming that Dr. DiPiazza was negligent in choosing not to properly evaluate Hayes’ symptoms from a cardiac standpoint, choosing not to diagnose her cardiac condition, choosing not to order cardiac enzyme tests and serial EKGs, and discharging her instead of admitting her to a telemetry floor for observation.

The family also maintained that the hospital nurses did not determine the exact location of Hayes’s burning discomfort at the time of triage and chose not to initiate the nursing standing orders for unexplained chest pain.

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 A 15-month-old child who required 24-hour care as a result of his extreme prematurity was under the care of a home health care nurse.  The nurse’s duties included keeping a watchful eye on the child to make sure he was properly ventilated. On the date of this incident, the child became detached from the ventilator. 

According to the lawsuit, the home health care nurse panicked and called the child’s father.  When the father came to the aid of the child, he began resuscitation efforts.  However, the child suffered cardiac arrest resulting in hypoxic brain damage.  The child is now in a persistent vegetative state. 

The family sued the home health care nurse claiming that she failed to manage the child’s oxygen saturation in a timely fashion, chose not to manage the child’s oxygen saturation, did not timely notice the dislodged ventilator and chose not to resuscitate the child in a timely manner.

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It is estimated that 250,000 people die each year in the United States as a result of medical malpractice according to the U.S. Department of Health and Human Services.  Approximately 80,000 Medicare patients suffer preventable adverse events that contribute to their deaths; as many as half of those deaths are due to emergency room errors. 

In 2003, the nonpartisan Congressional Budget Office stated that “181,000 severe injuries (attributable to medical negligence) occurred in U.S. hospitals [,]”.  These numbers show that medical malpractice deaths have worsened during the past ten years. Despite this increase, state governments and legislatures have tried to impede the amount of money recoverable to injured or killed persons and/or their families as the result of medical malpractice. 

For example, in Missouri, where I have been a member of the bar since 1976, nearly 1/3 of medical malpractice cases involve surgery in some way. The next largest percentage of medical errors reported there is 18.7% for misdiagnosis leading to severe injury or death followed by 13.2% involving falls or injuries during transport of patients. 

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A confidential settlement was reached with a hospital emergency room and doctors after a 58-year-old man underwent emergency surgery. The man went to the hospital emergency room after dislocating his hip prosthesis. During the emergency surgery, the attending anesthesiologist attempted unsuccessfully to place an endotracheal tube. 

The man, Doe, required an emergency tracheotomy.

Doe suffered oxygen loss resulting in a hypoxia brain injury because of the lack of oxygen. After being removed from life support, Doe was transferred to hospice where he later died. Doe was survived by his wife and two adult children.

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Continuity of care is paramount in patient healthcare. The goal is always to give the patient the best medical care while at the same time reduce medical errors. For the last 20 years hospitals and physicians have been using electronic health records (EHR).

Although the intent was noble, EHR has caused serious and even catastrophic injury and harm to patients because of poorly written software programs for healthcare providers. Sometimes the medical recording software does not allow for certain medical conditions, treatments and tests. In those cases, the medical providers simply use the drop down or other shortcut to comply with the entry requirements.

It used to be that narrative nursing notes would be important in providing details of patient care. But in most hospital settings, nurses simply use default screens on a computer to make their entries. Physicians often are not able to read the nurses’ remarks or notes. 

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Lillie Teague, 74, underwent an angiogram, which is an x-ray exam that uses a dye and camera to look at the blood flow in an artery or vein. Many angiograms are used to examine the arteries near the heart, lungs, brain and the aorta. The procedure requires the use of a thin tube called a catheter placed into a blood vessel in the femoral artery at the groin. The purpose for the angiogram is to find a bulge in a blood vessel or the narrowing or blockage in a blood vessel.

In this case, Ms. Teague began bleeding from the place where the catheter was inserted; at the entry site of the femoral artery. Bleeding at the femoral artery is a known complication for an angiogram, which was done here.

The defendant nurse was alleged to have chosen not to properly and appropriately respond to the need to control the bleeding for up to 30 minutes. This caused massive blood loss. It was alleged in the plaintiff’s complaint that because of the loss of blood, Ms. Teague consequently suffered a stroke.

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