Legal Eagle Eye Newsletter for the Nursing Profession(5)10 Oct 97  PDF Version

   Quick Summary: The nurse admitted in court she failed to chart the site and mode of an injection she gave a patient in the emergency room.

   The court accepted expert witness testimony from two nurses, that failing to chart this information is below the standard of care for nursing practice.

   While failing to chart the site and mode of an injection could not have affected how the injection was actually administered, it does tend to indicate that in this instance the nurse did not follow accepted procedure while carrying out her job.

   The nurse was allowed to testify about her customary practice for giving an IM injection. Her testimony after the fact reflected a correct understanding of where and how to give an injection.

   However, two physicians testified the patient’s injury could be consistent with a subcutaneous rather than intramuscular injection, and a third said that a nerve might have been struck by the tip of the needle.

   After weighing the evidence, the jury found the nurse negligent and awarded damages.  COURT OF APPEAL OF LOUISIANA, 1997.

   According to the court record in a recent case, a nurse gave the patient an injection of Demerol and Vistaril, per a physician’s orders, when the patient was seen in a hospital emergency room complaining of chest pains.

   For several weeks afterward, the patient had hip pain and a lump at the injection site. The patient claimed she was unable to work. A neurologist two months later formed a diagnosis of cutaneous gluteal neuropathy, for which physical therapy and a TENS unit were prescribed. The patient sued the emergency room nurse who gave the injection and her employer the hospital. The jury awarded over $90,000 in damages. The Court of Appeal of Louisiana upheld the verdict.

   The lawsuit alleged the nurse had injured the patient by administering the injection in a substandard manner. However, there was no direct proof in the trial about what actually caused the patient’s injury.

   The nurse testified it would have been her routine practice to use a one-and-one-half inch needle, to insert it into the skin over the gluteal muscle at a ninety-degree angle deep into the muscle, then to aspirate the syringe for blood, then to inject the medication.

   Several physicians were also called to testify. Their testimony taken collectively established that the patient’s injury could have been caused by a faulty subcutaneous rather than deep muscular injection of the drug Vistaril, or that a nerve could have been hit by the needle tip due to inaccurate location of the injection site.

   The critical testimony, according to the court, came from two nurses who testified as expert witnesses on the standard of care for nursing practice. They said it was below the professional standard of care for a nurse to neglect to chart the site and mode of an injection. This omission convinced the court the nurse must not have administered the injection properly. Pellerin vs. Humedicenters, Inc., 969 So. 2d 590 (La. App., 1997).

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