Legal Eagle Eye Newsletter for the Nursing Profession
August 2015
A young woman suffered a psychological breakdown in the courtroom when her bail was revoked and she was ordered jailed on a charge of domestic violence.
She was taken to a hospital psych unit and was diagnosed with dipolar disorder. The psychiatrist ordered Lamictal 25 mg twice per day.
Lamictal carries some risk of serious, possibly fatal skin conditions, Stevens-Johnson Syndrome and Toxic Epidermal Necrosis.
After a few days she was discharged from the hospital directly to the county jail. In the jail she began to show signs of a serious skin condition. A jail corrections officer kept giving her the Lamictal. No doctor or nurse was on duty in the jail to assess her condition.
After a few days in jail the patient was taken to the E.R. at the same hospital where she was a psych patient, this time for her worsening skin condition. When her skin deteriorated even further she was moved to a university medical center’s ICU for nine days with a severe rash affecting ninety-nine percent of her body.
The patient filed suit against the first hospital and the county jail.
The US District Court for the Middle District of Alabama saw a problem with the fact the psychiatrist at the first hospital failed to explain the risks and benefits of Lamictal and did not get the patient’s informed consent.
However, the Court ruled that the nurses who gave the medication were not responsible for obtaining the patient’s informed consent. Informed consent is not a nursing responsibility.
It is still unresolved at this point whether the patient told the E.R. nurses during her second admission that she had been given Lamictal. The Court said it would be a breach of the standard of care for a nurse to fail to chart a medication the patient told the nurse she was taking.
The Court brought up the fact that the E.R. nurses did not review the patient’s records from her first hospitalization at the same hospital. However, since the patient’s lawsuit failed to make the allegation that that was a negligent error or omission the Court could not rule on the issue one way or the other. McBride v. Hospital, 2015 WL 3892715 (M.D. Ala., June 24, 2015).
More references from nursinglaw.com
http://www.nursinglaw.com/Stevens-Johnson-Syndrome-nurse.pdf
http://www.nursinglaw.com/Stevens-Johnson-Syndrome-medication-side-effects.pdf