Case 5 Index
Introduction
ED Bounceback
Outcome
Nurse Depositions
Nurse Expert Witnesses
Physician Depositions
Physician Expert Witnesses
Legal Outcome
Documentation Review
Medical Review
The patient’s family filed a lawsuit against the nurses involved in the case as well as the Emergency Medicine doctor who discharged him. The nurses worked for the VA, therefore the case was filed in federal court as opposed to state court. The EM doctor contracted with the VA through a locums company, so he was named separately.
The lawsuit against the nurses alleged that they should not have let the patient walk out of the ED, and that they should have made him use a wheelchair. If he had used a wheelchair, he likely would have not fallen and suffered a head injury. At deposition, the nurse reported that she offered a wheelchair to the patient, but he declined. She is being questioned by one of the attorneys in the case.
The other primary accusation against the nursing staff is that they should have advocated more forcefully with the doctor to obtain a CT scan. There was discussion among the nurses about their concern for the patient and potential need for a CT scan, but it was not documented. It appears they discussed this concern among themselves but not directly with the doctor. The attorneys insinuated that they should have demanded the doctor order a CT scan, and escalate this concern up the chain of command if he declined to order the CT. The nurses were also questioned about not escalating their concerns when the 2nd doctor decided to discharge the patient home, after the first doctor had indicated he should be admitted. The deposition is shown below. Note that several attorneys are asking questions and interjecting comments (“objection”, “form”, etc…) at various points.
Due to the fact that the nurses were named as defendants in the lawsuit, nurse expert witnesses were involved. The next page contains their opinions about the case.