General Santos Doctors' Medical School Foundation, Inc.

Bulaong Subdivision, Barangay West, General Santos City 9500

Tel No.: (083) 302- 350

Telefax No.: (083) 552-9793

Nursing Department

COURT CASE: WHERE WERE THE NURSES?

_______________________________________________________

In Fulfilment of the Requirements in NCM 107-A

NURSING JURISPUDENCE

DATE:
OCTOBER 18, 2019
COURT CASE: WHERE WERE THE NURSES?

TWO DAYS AFTER undergoing bilateral knee replacement surgery, Dorothy Kline*
died of respiratory and cardiac arrest. Her family filed a malpractice suit against the
hospital alleging that negligence by the anesthesiologist and the nurses caused her
death.

The hospital sought summary judgment on the claim regarding the nurses, asserting
that no expert testimony had indicated that negligence by the nurses contributed to Mrs.
Kline's death. The court denied the motion, and the hospital appealed its decision.

Kline's family opposed the appeal, citing two depositions to the trial court by expert
witnesses. Ellen Rothman, RN, had indicated that the nurses had breached the
standard of care, and Samuel Vincent, MD, had testified about the cause of death.

The hospital claimed that their expert testimony wasn't enough to show that nursing
negligence caused Kline's death. It argued that Rothman had stated she wouldn't offer
an opinion on causation and Vincent had stated he didn't have an opinion on whether
the nurses had breached the standard of care.

The appellate court agreed that Rothman had indicated she wouldn't testify as to
causation but indicated that she "did provide testimony that the nurses breached the
standard of care" for a patient receiving epidural analgesia. Specifically, she said that
they'd failed to monitor and document Kline's vital signs, to adequately assess and
document her response to epidural analgesia, to notify the anesthesia department of a
change in her level of sedation, and to discontinue epidural analgesia according to
policy when arousing her became difficult.

And although Dr. Vincent's deposition was intended to shed light on the
anesthesiologist's practices, it too indicated deficiencies in the nurses' actions.
Explaining that the opioids could cause respiratory depression and that deepening
sedation could cause the tongue to obstruct the airway, he indicated that closer
monitoring would have detected Kline's slowing heart rate and breathing and dropping
oxygen saturation levels. "Missing the evidence of hypoventilation or airway
obstruction" he testified, led to respiratory and cardiac arrest from which she never
recovered.
The appellate court rule found a genuine issue of material fact as to whether the
nurses' negligence was the proximate cause of Kline's injuries and death. It concluded
that the trial court didn't err in denying the hospital's motion for summary judgment on
her husband's claim against the nurses.