People trust nurses. In fact, in 2019—for the 18th year in a row—Americans rated the honesty and ethics of nurses highest among professionals. An overwhelming 85% of Americans said that nurses’ honesty and ethical standards were “high” or “very high,” somehow building upon the 84%t who said the same in 2018. (Car salespeople are on the other end of the spectrum, just in case you were wondering.) Stated simply, these numbers are incredible. But what good do they do you when something goes wrong?
The answer to that question is blunt: not much.
As Medicine and Nursing Changes, the Law Regarding Nurses Might Not
Almost 100 years ago, the N.C. Supreme Court rejected an attempt to hold nurses liable for medical malpractice in a decision called Byrd v Marion General Hospital. At the time, the Court explained that nurses were “not supposed to be experts in the technique of diagnosis or the mechanics of treatment.” Therefore, it concluded, patients couldn’t sue nurses for the mistakes that they made.
As the N.C. Court of Appeals recently noted, “Medicine is quite different today than in the early twentieth century…” “[S]o, too,” the Court continued, “is the knowledge and skill of nurses in their varying fields and specializations.” But have those changes in medicine and nursing led to changes in the law? According to the Court of Appeals, they have not.
A Heart-Breaking Example of Anesthesia Gone Wrong
In the fall of 2010, a mother took her three-year-old daughter to the emergency room for upper-respiratory and ear infections. During her treatment, the child’s heartrate was higher than normal. So medical professionals referred her to a cardiologist.
The cardiologist determined that the child’s increased heart rate caused her heart to develop cardiomyopathy, a disease that makes it hard for the heart to pump blood to the body. The cardiologist recommended that she undergo a procedure to fix her heartbeat.
Before the procedure, an anesthesiologist and a registered nurse anesthetist administered the child’s anesthesia. Specifically, they chose to administer the anesthesia with a mask rather than a needle in hopes of avoiding extra stress. In doing so, they induced her with “sevoflurane,” an anesthetic that can cause a person’s blood pressure and cardiac output to drop.
Shortly after doing so, the child went into cardiac arrest. The medical professionals were able to revive her after 13 minutes. But, as a result of the complications, she suffered permanent brain damage, cerebral palsy, and profound developmental delay.
The Child’s Family Attempted to Hold the Nurse Accountable for the Shortcomings
The daughter’s family filed a lawsuit, brining claims against several individuals and entities, including the nurse and his employer-hospital. The family alleged that the nurse’s actions fell below that of an ordinary registered nurse under similar circumstances. Such a claim—one alleging that someone’s actions fell below the standard of expected of a similarly licensed professional—is comparable to malpractice claims frequently brought against other professionals, such as medical-malpractice claims against doctors, legal-malpractice claims against lawyers, and so on.
But the Mecklenberg County Superior Court Judge Robert C. Ervin refused to allow the jury to reach a decision as to whether the nurse’s conduct fell below the ordinary standard of care expected of nurses like him. In Judge Ervin’s view, such evidence has long been barred under North Carolina law.
The Court of Appeals Ruled that 100-Year-Old Decision on Nurses Still Controls
In an opinion issued on June 16, the N.C. Court of Appeals agreed. The opinion, authored by Judge Richard Dietz, first recognized that the Court was bound by the nearly 100-year-old Byrd decision. “Had Byrd left room for evolving standards as the field of medicine changed,” Judge Dietz wrote, “this may be a different case.”
But, because the N.C. Supreme Court had “rejected the notion that nurses can be liable for medical malpractice based on their diagnosis and treatment of patients” nearly 100 years earlier, he explained, the judges’ hands were tied. “On issues where our Supreme Court already has spoken, we do not make law, we follow it.”
Judges Wanda Bryant and Philip Berger, Jr., agreed with Judge Dietz.
People undoubtedly trust nurses, but they need to know that the legal options are limited when that trust is misplaced.