Law and The Judicial Process

Chapter 5  Pg.67

The patient was admitted to the postpartum unit at 5:30 p.m. At the postanesthesia care unit where she previously had been, she showed signs of blood loss including low blood pressure and tachycardia. It would later be discovered that one of her uterine arteries had accidentally been cut as the surgeon was performing a planned cesarean section. The surgeon failed to notice the severed artery before he closed the incision and sent the patient to the postanesthesia care unit.

The nurse who admitted the patient on the postpartum unit documented no admission nursing assessment or vital signs for the patient, who was obviously having serious problems at that time. The first note on the chart was one made at 5:45 p.m. by the emergency center physician after he was summoned to the patient’s bedside by the postpartum nurse.

At trial, the nursing expert for the patient testified that the postpartum nurse fell below the acceptable standard of care when she failed to document an admission nursing assessment including vital signs upon assuming the patient’s care when the patient arrived on the unit. The defense attorney argued that given that the nurse took prompt action to summon the emergency center physician to the bedside, it is immaterial how the nurse’s failure to provide contemporaneous documentation had any effect on the patient’s outcome. The patient’s attorney was given 30 days to file a supplemental report from their nursing expert.


CHAPTER 6  Pg.96

Immediately after a laparoscopic bilateral hernia repair, the surgeon ordered an in-and-out urinary catheterization to drain urine from the bladder and to confirm that there was no blood in the patient’s urine, which would be indicative of a possible bladder injury during the surgical procedure. The surgeon then left the operating arena.

A registered nurse subsequently inserted a Foley catheter with an inflatable retention bulb rather than an in-and-out (straight) catheter. She then had a second nurse inflate the bulb while the catheter was still in the patient’s urethra. This inflation of the catheter bulb while in the patient’s urethra caused a tear in the urethra, requiring a second unsuccessful catheterization by the attending surgeon, and an eventual abdominal catheterization of the patient’s bladder by a urologist. The patient subsequently sued the two nurses, the attending surgeon, and the acute care setting for negligence.


Chapter 7  pg.115

The patient was in surgery to remove moles from her back and left eyebrow. She was lightly sedated and was receiving oxygen. When the surgeon activated the Bovie instrument to remove the mole near her eyebrow, the spark caused a flash fire that was augmented by the supplemental oxygen that the patient was receiving. The surgical team responded immediately and the fire was quickly extinguished. The patient, however, incurred second-degree burns to the left side of her face, leaving permanent scars and reducing her vision in the left eye.

She filed a lawsuit for negligence and fraudulent concealment against the surgeon, nurse anesthetist, and hospital. The initial trial court found in favor of the plaintiff, awarding damages for malpractice and an additional $425,000 in damages for fraudulently concealing facts about the incident from the patient. At the appellate level, the defendants argued that there was no concealment of the incident in that they did what was required of them; namely that they informed the patient that there had been a fire, detailed the injuries that were caused by the fire, and recommended appropriate treatment options to her.