Nurse Administers "Underdose" of Clot Busting Drug Ordered by Doctor Leading To Progression of Stroke-Malpractice or Ordinary Negligence?

This month an appellate court covering Tompkins County, New York addressed the issue of whether a nurse's error in administering medication ordered by a doctor would be resolved under an "ordinary negligence" or a "medical malpractice" standard of law. The plaintiff arrived at an emergency room with a clinical presentation of stroke confirmed by CT scan which revealed an embolic (clot) stroke (as opposed to a hemorraghic or bleeding stroke) in the left cerebral artery. The treatment of an embolic stroke includes blood thinners or the clot busting drug called tissue plasminogen activator ("tPA"), if the stroke symptoms are present for less than 3 hours. Time is of the essence in treating an embolic stroke.

A physician entered an order directing that the patient be administered an intravenous infusion of 90 milligrams of tPA with 10% of the medication delivered in the 1st minute and the remaining 90% over the next 59 minutes. Unfortunately, a nurse charged with implementing the doctor's order programmed the initial dose to be given over 11 minutes rather than in 1 minute. The error was discovered and corrected after 3 minutes and 30 minutes later the patient showed signs of distress so the tPA was stopped. An MRI taken the next day showed that the clots remained in the cerebral artery. The patient was ultimately left with significant cognitive and expressive deficits. The Court denied the defendants motion for summary judgment (dismissal of the complaint) finding that a jury should consider and decide the issues of departure and causation - whether any departure deprived the plaintiff of a substantial opportunity to attain the benefits of tPA based on its improper administration.

The Court also held that that the claim of a nursing error in complying with the doctor's order on dosing was a malpractice claim and did not constitute a negligence theory stating the nurse "was assisting the physician by administering the prescribed medication and was an integral part of the process of rendering medical treatment to the patient." The Court also explained that: "Conduct may be deemed malpractice, rather than negligence, when it constitutes medical treatment or bears a substantial relationship to the rendition of medical treatment by a licensed physician".... This distinction has an impact on the statute of limitations, how the jury will be instructed on the law and even the amount of fees charged by the attorney. Holland v Cayuga Medical Center at Ithaca, 2021 N.Y. Slip Op. 03896

Ronald C. Burke, Esq

Trial Attorney with 30+ Years of Experience Attorney Ronald C. Burke, Esq. has more than 30 years of experience and has focused his career on representing clients in cases involving personal injury, medical malpractice and legal malpractice. He is a seasoned trial lawyer and has won many seven-figure settlements and verdicts for his clients over the years, including many case victories listed among the largest in the history of the New York State. He has been featured in the news and is a regular lecturer for the New York County Lawyers Association, as well as having lectured before the New York State Bar Association. Ron is also an attorney with Kelner & Kelner, a New York personal injury law firm. Awards and Accolades Mr. Burke's awards and accolades are many. Among them, he has been included in New York Super Lawyers® each year since 2010, and he has received the highest-possible AV® Rating from Martindale-Hubbell®. Verdict Search, a part of the New York Law Journal, frequently recognizes his notable successes after winning some of the highest settlements and verdicts in past years. He was also featured in their list of the "Top New York Verdicts " and "Top New York Settlements." He is a member of the New York State Bar Association and is licensed to practice law in the U.S. District Court for the Southern and Eastern Districts of New York, as well as before the United States Supreme Court. When Attorney Burke is not handling legal malpractice cases, he is highly involved in the local community. He was a member of the Village of Rockville Centre Volunteer Fire Department, has served on the local school board and as Chairman of the local Zoning Board. Learn more about Attorney Burke and how he can skillfully handle your malpractice case by contacting the Law Offices of Ronald C. Burke, Esq. right away to schedule your complimentary case evaluation. Our firm is here to help! Contact a New York Legal Malpractice Attorney Our firm provides each client's case with thorough preparation and aggressive representation, ensuring that you win the best possible results for your case whether it is settled or goes to trial. As a seasoned trial lawyer, Mr. Burke can provide the strong and relentless representation you need to establish negligence in a legal malpractice case and to recover any damages you may have suffered. Our firm can recover compensation for pre-trial and trial malpractice, violations of fee arrangements, loss of income, pain and suffering, and much more. Contact us today!


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