Legal Eagle Eye Newsletter for the Nursing Profession (6)3 Mar 98


Quick Summary: An overdose (of the wrong medication) is not a usual or expected occurrence in administering medications to nursing home residents.

The nursing home had complete control and management of the medication that injured the resident.

An overdose of the wrong medication is an occurrence which would not have happened if those in control of the medication had exercised due care.  SUPREME COURT OF OKLAHOMA, 1997.


   The resident had to be transferred from the nursing home to an acute care hospital in a hypoglycemic coma. An IV was placed in the dorsum of her foot in the hospital while treating her for the coma. She later developed gangrene at the IV site and needed an above-the-knee amputation. She filed a civil suit against the nursing home for giving her an overdose of tolbutamide which had never been prescribed for her.

   The Supreme Court of Oklahoma ruled the nursing home was liable for negligence. The legal rule of res ipsa loquitur ("The thing speaks for itself.") means this resident only had to prove she was given an overdose of the wrong medication. This was established unquestionably from the physician’s notes in her hospital chart, the court said.

   There was no need, the court ruled, for the resident to know specifically by whom, how, when or why this serious medication error occurred. Residents had no independent access to any medications. The resident’s attorneys got testimony from a nurse that all medications were stored in a locked med cart at the nurse’s station and were administered to residents only by licensed nurses. That was all the proof the court needed.

   This resident was being weaned from dependence on pain meds and was a well-know drug seeker. She was alert and ambulatory and often was visited by family and friends. She could obtain drugs from the outside. However, this was not an acceptable alternative explanation how this resident could have overdosed on this medication, the court ruled. Harder vs. F.C. Clinton, Inc., 948 P. 2d 298 (Okla., 1997).