Expert Testimony: Nurse Cannot Second-Guess Physician, Court Says

Legal Eagle Eye Newsletter for the Nursing Profession

September 1998

  Quick Summary: By law nurses are allowed only to make nursing diagnoses, which are diagnoses of conditions amenable to nursing interventions.

  There is a significant difference in the scope of nurses’ and physicians’ legal authority with respect to diagnosis and treatment. COURT OF APPEALS OF INDIANA, 1998. 

   The patient’s physicians misdiagnosed her cancer. Based on an incorrect characterization of the tumor, the physicians began chemotherapy with an agent known to have significant potential for cardiac toxicity. The patient suffered cardiac arrest and was revived, but needed to have an automatic cardioverter defibrillator implanted surgically.

   Nevertheless, the medical malpractice review panel ruled the physicians were not negligent in their choice of chemotherapeutic agent. When the patient sued the hospital where the physicians had staff privileges, the hospital showed the court the same expert medical reports the medical review panel had considered, and asked the court to dismiss the case.

   The patient countered with an affidavit from a nurse with impressive nursing credentials, that the physicians were negligent in their choice of chemotherapeutic agent.

   The Court of Appeals of Indiana ruled the case should be dismissed. The medical reports exonerating the physicians stood unchallenged, as a nurse is not legally qualified to render an opinion about a medical diagnosis. Stryczek v. Hospital, 694 N.E. 2d 1186 (Ind. App., 1998).