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LEGAL EAGLE EYE NEWSLETTER For the Nursing Profession Request a complimentary copy of our current newsletter What is our mission? What publication formats are available? How do I start a subscription? Can I cancel and get a refund? Does my subscription renew automatically? |
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Legal Eagle Eye Newsletter
For the Nursing Profession
PO Box 1342 Sedona AZ 86339
(206) 718-0861
Patient Leaves AMA: Court Rules Out Nursing Negligence As Cause Of Death.
The emergency department nurses did violate the standard of care by failing to follow to the letter the hospital's protocol for a patient leaving the hospital against medical advice (AMA). The hospital's AMA protocol required the nurse or physician to discuss with the patient and/or the family the potential risks and complications that might occur if the patient left before being discharged. The protocol further required the nurse or physician, after fully explaining the potential risks and complications, to have the patient sign the hospital's AMA release form or document in the physician's or nurses' notes the patient's refusal to sign.
However, there is no evidence the nurses and physician did not make a full and adequate effort to ad-vise the patient of the gravity of his medical situation before he left the hospital. The is no evidence that having the patient sign the hospital's AMA release form would have prevented his subsequent death from the coronary condition the hospital tried to treat.
COURT OF APPEAL OF LOUISIANA April 5, 2017The patient was on an overnight chartered bus excursion from his home in Texas to a casino in Louisiana. He passed out the morning of the day after his arrival at the casino and had to be taken to a hospital by ambulance. In the emergency department his history revealed a past myocardial infarction and coronary bypass surgery. His current vital signs, EKG and lab work showed he had just had another myocardial infarction.
The emergency physician explained the gravity of the situation to the patient and his sister who was with him and told them they wanted to keep him until he could be transferred to a better equipped facility for a full cardiac workup. The patient, however, repeatedly told the emergency department nurses he wanted to leave. He was worried about getting back to the casino before the bus left for his home in Texas. The nurses tried hard to convince him to stay at the hospital. Then the nurses strongly urged him to go to an emergency room as soon as he got home. A nurse finally took out his IV and let him leave. He left without signing the hospital's AMA release form.
On the bus back to Texas he became unresponsive. The driver pulled over and called an ambulance, but it was too late. The patient died shortly after arriving by ambulance at the nearest hospital.
The Court of Appeal of Louisiana acknowledged the opinion of the family's expert physician that the hospital's nurses violated the standard of care by not following to the letter the hospital's protocol for a patient leaving AMA. The patient did not sign the necessary paperwork and his refusal to sign was not documented in the nursing progress notes as required. However, the nurses did all they could and were required to do to convince the patient to stay. A technical violation of the standard of care as expressed in the hospital's AMA protocol did not cause the patient's death.
Baez v. Hospital, __ So. 3d __, 2017 WL 1251909 (La. App., April 5, 2017).