However, the court determined that even if hourly circulation checks had been done, and the problem had been promptly reported to the physician, the physician would not have responded and done a fasciotomy in time to save the patient’s leg from amputation.  COURT OF APPEALS OF OHIO, 1995.

   A patient was admitted to the hospital with a leg injury from a fall. His leg was casted in the emergency room and he was admitted to the hospital. The next day he developed circulation problems with the foot of the casted leg. The cast was changed to relieve pressure. Over the next few days, further circulation problems were noted by the nursing staff and reported to the attending physician. The cast was modified on at least two more occasions to relieve pressure.

   Nevertheless, the patient’s circulation problems continued. At 2:00 am on the third hospital day the attending physician was notified that there was still a problem with the circulation in the foot of the casted leg. The physician arrived at the hospital at 5:00 am and determined that compartment syndrome had developed. The physician performed a fasciotomy at 5:30 am. However, the procedure was too late to save the patient’s leg from having to be amputated.

   The defense which the hospital raised in the lawsuit was that, even if it was assumed that the nurses’ failure to do hourly circulation checks and to report the patient’s continuing circulation problems to the physician on a timely basis was a departure from the accepted standard of care for competent nursing practice, the errors and omissions of the nurses were not the cause of the eventual harm to the patient.