Law and Ethics for Medical Careers, 3rd Edition

1
Law and Ethics for Medical Careers, 3rd Edition

• Expert Testimony (4)
• Standard of Care (4, 5)

2
The Case

• The patient entered the hospital in December of
  1991 for treatment of a collapsed lung. During
  his stay the patient developed progressively
  worsening subcutaneous emphysema.

3
The Suit

• The patient filed a malpractice action based on
  negligence of the hospitals nursing staff for
  failing to
• Document his complaints of pain.
• Document his response to medication.
• Monitor his breathing.
• Palpate his chest.

4
The Trial

• At trial, the patient offered the expert
  testimony of a registered nurse.
• The trial court allowed the admission of the
  nurses testimony on standard of care but refused
  to allow her to testify on causation.

5
What Do You Think?

• To what extent to you think an RN could offer
  expert testimony?
• What testimony could an RN give in court
  regarding standard of care?
• Who would be qualified to give testimony
  regarding the cause of the patients condition?

6
The Courts Decision

• Only a physician was qualified to testify if the
  alleged negligence had caused a worsening of the
  patients condition.
• Since no expert testimony was given on the
  causation, the patient was unable to establish a
  case.
• The trial court granted summary judgment to the
  hospital.

7
The Appeal

• The court determined the critical issue to be the
  timing of the patients diagnosis of subcutaneous
  emphysema.
• The physician made the diagnosis of subcutaneous
  emphysema three days after admission to the
  hospital.

8
What Do You Think?

• What role does the nursing staff have in
  determining a diagnosis?
• Could the nursing staff have facilitated a more
  speedy diagnosis? Why or why not?
• Do you think the court upheld the appeal and
  denied a nurses expert testimony as to causation?

9
The Outcome

• A physician made the diagnosis three days after
  admission to the hospital.
• It would not be legally permissible for a nurse
  to assert in trial testimony that the patient
  could be diagnosed before such time.
• Such an assertion would imply that the nurse had
  made her own unsupported medical diagnosis.

10
The Outcome, continued

• The appeals court upheld summary judgment to the
  hospital.
• Finagan v. Labe, 666 A 2d 333 (Pa. Super. Ct.,
  Oct. 19, 1995).