Evidence showed that poor nursing care at Pennsylvania Hospital of the University of Pennsylvania Health System, including failure to contact a physician as ordered when the patient's blood pressure dropped below 100 and the absence of documented nursing care for a 16.5 hour period after surgery, resulted in the death of a 55 year old woman following a routine hernia operation. At trial, medical records presented to the jury showed that after surgery, a resident examined the patient and noted in her chart that nurses should call a physician if the patient's blood pressure dropped below 100. The same records showed that later the same day, at 5:15 p.m., a nurse recorded a blood pressure of 90/60, but did not call a doctor. This was the last nursing note written in the chart for the patient until 9:45 the next morning, reflecting a gap in documented care of 16 and 1/2 hours. The 9:45 a.m. chart noted that the patient was "extremely sedated, requiring painful stimuli for arousal and with a blood pressure of 90/58."
Following the 9:45 a.m. note, the patient's morphine pump was stopped and she was transferred to the intensive care unit, where she died two and a half days later. Attorneys for the woman's family argued that the nurses violated the standard of care by not calling for a doctor when the patient's blood pressure dropped below 100. Although attorneys for the hospital disputed that the nurses' care was negligent, a nursing supervisor employed by the hospital testified that a doctor should have been called when the patient's blood pressure dropped below 100.
In addition to the allegations that the nurses were negligent for failing to call for a doctor, the plaintiff's attorneys argued that the patient was over-medicated with morphine. Evidence presented at trial showed that people with compromised livers, which this patient had because of a chronic alcoholism condition, process morphine 50% slower than patients with a healthy liver. Attorneys for the hospital essentially argued that the patient was caused by her alcoholism and related medical problems such as liver disease and high blood pressure.
A jury voted 10-2 to award the patient's family $1.2 million dollars, which was $900,000 more than the highest offer the hospital had made to settle the case prior to trial. The hospital has stated it will appeal the verdict.
Tuesday, January 27, 2009
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