Choking Death: No Negligence By Hospital’s Nurses.

Choking Death: No Negligence By Hospital’s Nurses.

Legal Eagle Eye Newsletter for the Nursing Profession

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November 2017

The nursing documentation expressly recorded that the patient’s upper denture was removed for surgery, then went back into her mouth before she left the recovery room.

The nurse and the patient-care technician on the med/surg floor testified that if a denture was out of the patient’s mouth they would always make sure that it was in a denture cup and enter a progress note that it was out of the mouth and in a denture cup. At least a dozen interactions with the patient including nine vital signs were documented that night during the early a.m. hours. Frequent checks were documented during the night that the patient was alert and oriented and was not in any distress.

The patient’s nursing assessment on the med/surg unit disclosed that at home she was completely independent in the care of her dentures, that is, she took them out, maintained them and put them back in her mouth without any help. There was no reason to believe the patient would have trouble or need stand-by monitoring or assistance with her breakfast, before her tragic accident. APPELLATE COURT OF ILLINOIS October 4, 2017

For a case we reported in September 2017 the Appellate Court of Illinois recently issued a new written opinion which contains a more thorough review of the evidence behind the decision to find no negligence by the patient’s nurses. See Patient Chokes, Dies: Court Finds No Negligence, Ruling Based On The Nursing Documentation. Legal Eagle Eye Newsletter for the Nursing Profession (25)9 Sept. ‘17 p. 8.

Around 7:20 a.m. the morning after late evening emergency eye surgery the patient choked on her breakfast pancakes and died in her room on the med/surg unit. When she arrived at the medical examiner’s office for the autopsy her upper denture was in a denture cup which came along with her body. That fact apparently led the family to believe that her denture was never replaced in her mouth after general surgical anesthesia the evening before and that that prevented her from chewing a bite of her pan-cakes completely before trying to swallow.

However, the Court accepted the testimony of the nurse who had been with the patient through the night, who was still there and responded to the 7:20 a.m. code although her shift had ended at 7:00 a.m. For the code she swept the patient’s mouth with her finger and removed her upper denture. Then she followed standard practice by putting it in a denture cup to go with the body to the morgue. At no time during the night did she notice that the patient’s denture was out of her mouth, which she would have recorded in a progress note if it happened.

The circulating nurse in the operating room, the evening before, carefully documented that the patient’s upper denture was removed before surgery and handed over to the recovery room nurse. The recovery room nurse wrote a progress note early that a.m. that expressly stated that the patient’s upper denture had been replaced in her mouth before she left for the med/surg floor. The nurses testified they would have documented that either or both dentures were not in the patient’s mouth, if that was the case. Caldwell v. Med. Ctr., __ N.E. 3d __, 2017 WL 4402041 (Ill. App., October 4, 2017).