Nurses Ignore Patient Resulting in Fall and Severe Head Injury with Brain Bleed
The following excerpt from a Notice of Intent to File Claim, or more commonly called "Notice of Intent to Sue," is a recent case that the litigators at Erlich, Rosen, Bartnick & Cook, P.C., have begun on behalf of one of our clients. If you wish to discuss a medical malpractice claim please contact ERBC at either www.ERBClaw.com or 1–877–453–2840 for a free consultation.
Plaintiff, age 56 is a registered nurse who worked as an ICU nurse and rapid response team nurse manager. On the morning of 2–9–08 she was on her way to work when she was involved in a serious automobile accident as a result of icy conditions. Plaintiff suffered multiple injuries and fractures and was taken to Defendant Hospital in critical condition. Her injuries were below her neck and included a right shoulder fracture, broken ribs, pneumotharax, and lacerations to her spleen and liver. She was on mechanical ventilation in the ICU for several days before stabilizing to the point where she could undergo surgery.
Plaintiff underwent extensive shoulder repair surgery on 2–14–08 and following surgery was returned to ICU on the ventilator. On 2–16–08 she was extubated and on 2–17–08 her chest tubes were removed and she began to be assisted to the bathroom. Plaintiff was evaluated and accepted for the in house rehabilitation unit in the early morning of 2–18–08. There were no beds available in the rehab unit therefore Plaintiff was transferred out of ICU where she was monitored on a 2 to 1 nursing ratio directly to a medical surgical floor while awaiting a bed in rehab. On the medical surgical floor the patient to nurse ratio was about 8 to 1 and patient to nurses aide about 15 to 1. Plaintiff arrived on the medical surgical floor in the morning of 2–18–08.
Plaintiff was a very high risk for falling as she had her dominant right arm in a sling from her recent shoulder surgery, was still on heavy doses of narcotic pain killers, and had just been weaned off a ventilator after undergoing a traumatic accident and surgical procedures. She was banged up, bruised, and medicated.
Plaintiff does clearly recall the events of the evening of 2–18–08 and early morning hours of 2–19–08. As a result of her strange surroundings and medications she was wide awake and suffering from insomnia. She clearly recalls that she was last checked on at 10:00 P.M. on 2–18–08 and that she had not been put to bed yet as her room was still fully lit. She recalls getting no instructions from the nurse or aide as to using the restroom and in fact assumed that someone would be returning in a short period of time to put her to bed for the night. Three to four hours went by without any nurse checking on her and she had to use the restroom. Plaintiff, being a nurse herself, clearly remembers using her call light to summon assistance.
Plaintiff, being a nurse employee of the Defendant Hospital system, was very much aware of how the call lighting system operated. She specifically looked to see if a nurse or aide was going to respond to her call light. This is determined by a color coded system which lights up either green or yellow depending on the type of individual who answers the call light. It was neither a nurse or nurses aide who answered her call light just before two A.M. on 2–19–08 but rather a non medical health unit coordinator or unit secretary working the nurses station.
Plaintiff clearly recalls indicating to the lay person secretary or unit coordinator that she stated that, "I need to go to the bathroom." The response to her statement was: "OK, I will let them know you are going." Following this exchange the secretary or unit coordinator turned off the call light signal and it stopped blinking. Plaintiff, who was still medicated on narcotics and somewhat sleep deprived, interpreted this exchange as she should just use the restroom herself as no help was coming. She therefore got out of bed and began pushing her I.V. pole with her non dominant left hand. It was unwieldy and got caught on her bed. Plaintiff was unsteady on her feet and fell down striking her head on a wooden bedside chair as she fell to the floor.
Following her fall and cries for help the nursing staff and aides responded to her room. Plaintiff was face down on the floor essentially on her knees and good left hand between her bed and the chair. A nurse and two aides came into the room and immediately tried to lift her off the floor by her arms. Plaintiff screamed in pain and her right shoulder suffered a 70% tear of the long head of her biceps. She was eventually placed back in bed and sent down for a CT scan of her head. She suffered a subdural hematoma from the head injury with resulting cognitive deficits.
Before being finally transferred to the rehab unit the following day the nursing supervisor from the medical surgical floor came into her room and instead of apologizing for the shoddy nursing care yelled at Plaintiff for making them look bad and claimed that as a nurse supervisor herself she should have known better. This exchange left Plaintiff with the distinct impression that since she was a nurse the nurses and aides on duty figured she could take care of her herself and therefore there was no need to check in on her or treat her like an average patient.
As a direct and proximate result of the nursing staff at Defendant Hospital on the evening of 2–18 to the morning of 2–19–08 negligently failing to properly assess Plaintiff as a high risk for fall patient they then negligently failed to put into place the proper nursing care plan to prevent Plaintiff from falling that evening. The nursing care plan should have been to properly instruct Plaintiff that she was not to attempt to ambulate to the bathroom without assistance and also should have included either a bedside sitter, or if one was not available, a bed escape alarm. The failure to properly instruct Plaintiff on only using the bathroom with assistance coupled with the lack of a bedside sitter or a bed escape alarm proximately resulted in Plaintiff attempting to ambulate on her own to the bathroom without the nursing staff realizing she had gotten out of bed before her fall.
Furthermore, the failure of the nursing staff to properly realize Plaintiff was a high risk for falling led to the failure to implement a nursing plan of care that would include physically checking on Plaintiff once an hour and offering her bathroom assistance at these hourly checks. The failure to either check on Plaintiff once an hour or offer her bathroom assistance every hour proximately resulted in Plaintiff being left alone in her room for a period of three to four hours without any offer of assistance to use the bathroom. Consequently, Plaintiff had to use the restroom shortly before 2:00 A.M. on 2–19–08 and utilized the call light button to summon assistance.
The individual who answered the call light at the nurses station was not a medical employee but rather was either a health unit coordinator or a unit secretary. This individual indicated to Plaintiff that she would notify the nurses that Plaintiff was using the bathroom. Following this exchange she turned off the call light to signal the encounter was over. Plaintiff, a nurse herself, understood this exchange to mean that she should go to the bathroom on her own as no nurse or aide was being summoned. Therefore the failure of the nursing staff to check on Plaintiff at hourly intervals and offer bathroom assistance coupled with the untrained lay person answering the call light message and giving the apparent instructions to go ahead and use the bathroom on her own, proximately resulted in Plaintiff attempting to ambulate to the restroom which resulted in her falling and striking her head.
Following her fall the responding nurse and aides tried to lift Plaintiff off the floor without assessing her for injuries or her surgical wound sites and consequently caused further damage to her right shoulder which culminated in right shoulder replacement surgery on April 30, 2009 which has proximately resulted in additional months of physical therapy.
Furthermore, as a result of the head injury she sustained when she hit the chair/floor Plaintiff has suffered a closed head injury and cognitive damages that were not present following her initial automobile accident which are permanent in nature and have disabled her from being able to return to gainful employment.
