Medication With Toxic Side Effects: Court Finds Evidence Of Nursing Negligence.

Medication With Toxic Side Effects: Court Finds Evidence Of Nursing Negligence.

Legal Eagle Eye Newsletter for the Nursing Profession

September 2018

According to the patient’s nursing expert, the hospital’s nurses should have reviewed background information on the patient’s medications to check for potential toxic side effects. It was the hospital’s responsibility to make medication data available to the nurses through printed publications or a computer based formulary that the nurses could access.

The nurses documented that they were administering a specific antibiotic to the patient and that she had been taking it before she came to the hospital. However, beyond knowing its name the nurses apparently had no idea what the medication actually was or its potential side effects. The nurses should have known the antibiotic was potentially toxic to the liver and with a patient being treated for liver disease they should have brought that to the attention of the treating physicians.

However, the nurses’ omission was not the legal cause of harm unless the patient can prove the physicians would have changed course based on information from the nurses. COURT OF APPEALS OF TEXAS August 16, 2018

The Court of Appeals of Texas recently revisited a case we reported in December 2017. See Liver Toxicity: Court Refuses To Fault Patient’s Nurses Legal Eagle Eye Newsletter for the Nursing Profession (25)12 Dec. ‘17 p.7. In its prior ruling the Court dismissed the patient’s case, but only provisionally, with permission for the patient’s lawyers to seek out and present additional evidence to support the case. Now the Court has accepted a new opinion from a nursing expert that the nurses were negligent.

However, proof is still lacking that the nurses’ negligence was the legal cause of harm to the patient. But again the patient still has permission to seek out and present additional evidence, if any, on that point.

The patient was sent to the hospital’s emergency room by her general practitioner for a workup for elevated liver enzymes. Four days earlier a nurse practitioner in the same clinic had prescribed an antibiotic for fever, cough and congestion with a known potential for liver toxicity. The emergency room physician admitted the patient and the hospitalists worked her up for viral hepatitis, all the while continuing the antibiotic. After a few days of no improvement of liver function, still on the antibiotic, a liver biopsy was done in which an artery was cut, causing severe complications.

In its recent ruling the Court accepted the patient’s nursing expert’s opinion that the patient’s nurses had the responsibility to recognize that one of the patient’s medications could cause liver problems, the very reason she was in the hospital. It was a nursing responsibility to realize the medication was potentially toxic, to bring that to the physicians’ attention and to suggest the antibiotic be stopped. Proof is still lacking, however, that the physicians would have changed course based on information from the nurses. Curnel v. Hospital, __ S.W. 3d __, 2018 WL 3883402 (Tex. App., August 16, 2018).