Memorable CLNC® Cases

I Saved an RN from Going to Trial Based on a Physician’s Misdiagnosis

by Margaret Gallagher, RN, BSN, MSN, CLNC

Margaret GallagherAfter reviewing more than 800 medical malpractice cases, one case is most memorable. This case involves a 36-year-old patient who presented to the emergency department (ED) with a chief complaint of a neck injury after a fall from a boat. The RN defendant cared for the patient for a brief period of time in the ED just prior to transfer to a medical nursing unit. The patient was deemed stable by the ED physician prior to transfer. Early the next morning the patient was diagnosed with an acute vertebral artery dissection (VAD), locked in syndrome and quadriplegia. The RN who cared for the patient briefly in the ED was alleged to have failed to diagnose her neurological condition.

The attorney was thrilled with the settlement amount and said that it was my explanation of why the nurse met the nursing SOC that prevented the RN from going to trial.

I provided legal nurse consulting services for the defense of this nurse. My CLNC® services included a comprehensive literature review related to VAD, an assessment of the plaintiff’s medical records, an analysis of the deficiencies in physician performance and the deviations from the standards of care (SOC) by the RN. After my initial report I was asked to analyze and critique the deposition testimony of the plaintiff’s MD and RN experts.

In my opinion, the physician diagnosed the patient as a near-drowning victim and failed to appreciate the critical factors related to the mechanism of injury and the presenting symptoms of acute neck pain.

The RN assessed, planned and evaluated the patient’s care as it related to the physician’s diagnosis of respiratory impairment and not as an acute traumatic neck injury.

My attorney-client used my rationale in support of the RN’s actions at mediation and a confidential settlement was obtained. The attorney was thrilled with the settlement amount and said that it was my explanation of why the nurse met the nursing SOC that prevented the RN from going to trial.

Although I appreciated the five-figure payment for my consultation, the most rewarding aspect of this case was the privilege of defending an RN who did her best given the information provided by the physician.

I would encourage other CLNC consultants to carefully examine the roles of physicians and other professionals which may influence a bad patient outcome. The fact that the RN did not have to sit through weeks of trial testimony with the plaintiff and her family in attendance is just one positive reinforcement of my choice to practice as a CLNC consultant.

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