Question

CASE 18: Failure to Record Patient’s Care

Mrs. Pellerin went to the emergency department at Lakeland Medical Center complaining of chest pain. An emergency department physician, Dr. Gruner, examined her and ordered a nurse to give her an injection consisting of 50 mg of Demerol and 25 mg of Vistaril. The nurse testified that she did not recall giving the injection, and did not deny giving it and her initials are present in the emergency department record. The nurse admitted that she failed to record the site and mode of injection in the emergency department records. She stated that she may have written this information in the nurse’s notes, but these notes were not admitted into evidence. The plaintiff testified that she felt pain and a burning sensation in her hip during the injection. The burning persisted afterward and progressively worsened over the next several weeks. The pain spread to an area approximately 10 inches in diameter around the injection site and the plaintiff stated that she could not sleep on her right side, work, perform household chores, or participate in sports without having pain. She also testified that she had a lump around the injection site and her skin was numb in that area.

Questions

1. Is this negligence? Explain your answer utilizing the evidence.

2. How would you argue for the plaintiff?

3. What are your defense options?

4. If you find the defendant responsible, what damages would you award, and for what reasons? If the award was provided in the case study, how much was the award and for what reasons?

Answer 1

Ans) 1) Negligence is defined as a failure to exercise proper or ordinary care, and a manufacturer might be held liable for negligence if it can be established that a lack of reasonable care in the production, design, or assembly of the manufacturer’s product caused a harm.

2) The plaintiff testified that she felt pain and a burning sensation in her hip during the injection- diameter around the injection site and intensified when plaintiff engaged in activities that required planting her right foot. She could not sleep on her right side, work, perform household chores, or participate in sports without experiencing pain. She also testified she had a lump around the injection site and her skin was numb in that area. Plaintiff further testified she consulted her gynecologist, Dr.

3) . After examining the area of the injection, he recommended she see a neurologist. Dr. Krefft found decreased sensation to pin pricks and cold in an area of two by four centimeters at the edge of plaintiff's hip. He diagnosed her with right cutaneous gluteal neuropathy (improper functioning of a nerve running right under the skin in the right buttock region). Dr. Krefft prescribed a medication for nerve pain. However, plaintiff returned on June 21, complaining of continuing pain despite taking the medication. At that time, Dr. Krefft recommended physical therapy, with Charles Reynolds. According to plaintiff's testimony, the physical therapy involved massages, ultrasound and use of a TENS unit (an electrical skin stimulator which helps block pain while it is being used). Mr. Reynolds testified he never felt any lump on plaintiff's body.

3) A nurse who is chronically overworked can make medication errors out of exhaustion. Additionally, lack of proper lighting, heat/cold, and other environmental factors can cause distractions that lead to errors.

4) Punitive damages are legal recompense that a defendant found guilty of committing a wrong or offense is ordered to pay on top of compensatory damages. They are awarded by a court of law not to compensate injured plaintiffs but to punish defendants whose conduct is considered grossly negligent or intentional.