Pediatric Apnea Monitor: On/Off Switch Off, Nurses Negligent, Court Rules

Legal Eagle Eye Newsletter for the Nursing Profession

May 1999

  Quick Summary: It is ordinary negligence for nurses not to check that the on/off switch on a pediatric apnea monitor is on.

   It is ordinary negligence for nurses not to make sure a crash cart is stocked with items for pediatric patients.  SUPREME COURT OF GEORGIA, 1998.

   In December, 1998 the Supreme Court of Georgia reversed the decision of the Court of Appeals we reported in December, 1997. (Pediatric Apnea Monitor: Nurse Must Switch It On, Respond Rapidly, Court Says. Legal Eagle Eye Newsletter for the Nursing Profession (5)12, Dec. ‘97 p.5.)

   The Court of Appeals had refused to overturn the jury’s verdict exonerating the hospital, even though it believed the nurses were at fault for not making sure the on/off switch was on.

   The Supreme Court threw out the jury’s verdict. It said the jury members were incorrectly instructed they had to find the nurses guilty of professional malpractice to render a verdict against the hospital. The Supreme Court ruled it is plain ordinary negligence not to make sure the on/off switch has been switched on for a medical device ordered by the physician that is essential to the patient’s wellbeing.

   The Supreme Court also ruled it is plain ordinary negligence for nurses not to appreciate that a crash cart must be stocked with items appropriate for pediatric patients. That is, it is a matter of professional judgment what items belong on a crash cart. However, according to the court, the general idea that the items that are stocked must include sizes appropriate for pediatric patients is a matter of common knowledge and is not the special province of persons with specialized professional education and training.

   In a nutshell, the Georgia Supreme Court’s ruling would make it almost automatic for a lawsuit of this nature to succeed against a hospital.

  The child had stopped breathing at home and was brought to the hospital’s emergency room. A physician admitted the child and ordered a pediatric apnea monitor.

   The child stopped breathing again, and it was not discovered for several minutes, despite the fact the child was on a monitor. Apparently the nurses had neglected to switch the monitor on. Then the code was delayed because items appropriate for pediatric patients were not to be found on the crash cart on the unit and had to be retrieved from elsewhere in the hospital.

   The incident, in the court’s judgment, could not be blamed on any failure by the hospital to train its nurses or inadequacy in the nurses’ professional qualifications. Knowing to switch on essential medical equipment does not require professional training or expertise, the court ruled. Dent v. Hospital, 509 S.E. 2d 908 (Ga., 1998).