Legal Review and Commentary - Nauseated patient falls off table: $15,000 verdict

Patient suffers cuts, memory loss

News: While on an X-ray table following an angioplasty, a severely nauseated, unattended patient fell from the table and struck his head. He ended up with two black eyes, memory loss, and a cut that required stitches. He was awarded $15,000.

Background: In December 1999, the 60-year-old man was taken to a hospital emergency room with complaints of chest pain. He was diagnosed as suffering from a myocardial infarction and underwent an angiogram. The angiogram revealed a blocked coronary artery, and an emergency angioplasty was performed.

During both the angiogram and angioplasty, the man complained of severe nausea, which may have been caused by either the heart attack or the medication he was given for his heart condition. He was given additional medication to control the nausea.

While on the X-ray machine table following the angioplasty, the man continued to complain of nausea and was given an additional dose of Compazine. Shortly afterward, he complained again and turned his head to vomit. As he turned, he fell from the X-ray table, which was about four feet high, and struck his head. The resulting cut on his forehead required stitches, and the next day he had two black eyes. In addition, he claimed to have suffered partial memory loss following the incident because he was no longer able to remember frequently called phone numbers.

At the time of the incident, two hospital employees were attending to him — one nurse and one X-ray technician. The nurse testified at trial that she was near the foot of the X-ray table charting the patient’s vital signs when the patient fell. The X-ray technician had left to get a receptacle and gloves to assist the patient and was returning through the doorway. Neither was at the X-ray table’s side when the patient turned over to vomit.

The patient alleged the health center employees were negligent in caring for him and that had they been in keeping with the standard of care, he would not have been able to fall from the X-ray table.

In this jurisdiction, before proceeding to trial, such action first must go through nonbinding review by an independent medical review panel. The panel of peers, which in this case were three nurses, determined there had been a deviation in the standard of care one would have expected under the circumstances. The defendant argued that although the patient should not have fallen from the table while under the nurse’s and technician’s care, the harm was minimal. There were no subsequent medical bills relating to the memory loss.

What this means to you: Unlike the nursing home industry, hospital risk management underwent a tremendous change during the 1970s. The revolution was inspired in part by the increasing verdicts against hospitals. It was at that point risk management and exceptionally good quality assurance programs became institutionalized and were included in the standards for review by the Joint Commission on Accreditation of Healthcare Organizations, becoming an integral part of the institution’s structure.

"Generally, hospital protocols and procedures would address the patient care situation presented in the case," says Susan Lind, corporate risk manager for American Baptist Homes of the West in Pleasonton, CA. "Given the patient’s known nausea and the fact that he was on an X-ray table without rails, one can presume that the patient should not have been left alone under the circumstances. As the jury found, the incident was probably outside the standard of care. Fortunately for this patient, the harm caused by the deviation from the standard of care was seemingly minimal."

Reference

Stefan Rentz v. St. Margaret Mercy Healthcare Centers, Lake County (IN) Circuit Court, Case No. 45D01-9610-CT-1035.