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


Quick Summary: The nurses failed to recognize or deal with the patient's cardiac tamponade, although the nurses’ notes following improper insertion of a central venous catheter meant they were seeing recognizable signs of cardiac tamponade.

Despite several label warnings printed on the manufacturer’s package insert for the central venous catheter cautioning medical personnel to be alert for signs of cardiac tamponade, neither the attending physician or the nurses discovered the condition until the day the patient died.  COURT OF APPEALS OF TEXAS, 1997.


   The patient’s care providers were having grave difficulty managing his end stage renal disease. Peripheral venous access sites had been damaged severely by dialysis, so a central venous catheter was inserted to give medications. The physician inserted the catheter too far and perforated the heart, according to the court record.

   he patient died some days later. The family sued for wrongful death. The Court of Appeals of Texas ruled the hospital’s nurses were partly to blame for the death.

   The court did not delve into clinical details for when nurses should suspect cardiac tamponade or what to look for. It did rule it to be within the scope of competent nursing practice to be able to detect it. Hall vs. Huff, 957 S.W. 2d 90 (Tex. App., 1997).