Health Plan Nurses Phone Assessment Faulted: Patient Needed Care Immediately.

Health Plan Nurse’s Phone Assessment Faulted: Patient Needed Care Immediately.

Legal Eagle Eye Newsletter for the Nursing Profession

December 1999

The Supreme Court of Minnesota ruled that a nurse or physician monitoring a patient during pregnancy must be aware of signs and symptoms of pregnancy-induced hypertension and preeclampsia.

The court said when a patient complains of a headache, swelling of her hands, legs, ankles, eyes, etc., and no improvement occurs when she stays off her feet, the prevailing standard of care requires medical personnel to instruct the patient to seek immediate medical attention because such signs and symptoms can be early indications of pregnancy-induced hypertension or preeclampsia, a major cause of maternal and fetal morbidity.

The court said prompt medical attention is necessary to monitor the fetal heartbeat and stress level and to make the ultimate decision whether to induce labor or do a cesarean to save the life of the fetus.

The court faulted a health plan’s phone triage nurse and the nurse midwife with whom she consulted for not telling a patient to come in at once. The patient called when she awoke with swelling in her lower legs. She was only told to lie on her left side, eat extra protein, report any new symptoms and keep her appointment in three days. The next day she had a headache, chest pain and a tight abdomen but still was not told to come in until later in the day. When she did come in her fetus was delivered stillborn.

Having faulted the nurse, the court still dismissed the parents’ wrongful death lawsuit on a legal technicality. The parents’ medical expert’s opinion was true and correct, but the parents’ lawyer did not file the full particulars of the expert’s opinion with the court within the deadline mandated by state law. Lindberg v. Health, 599 N.W. 2d 572 (Minn., 1999).