Causation in Medical Negligence Cases in Florida

In a 2012 case, a medical center appealed after it was found liable for medical and nursing negligence that had caused a patient’s death. It argued that the plaintiff failed to show its nursing staff was negligent or that if the negligence had not happened, the woman more likely than not would have survived.

The case arose when a 45-year-old woman experienced head pain and went into a state similar to a coma. Her husband called an ambulance. The paramedics measured her vital signs, which were close to normal and stabilized her and took her to the defendant medical center. They diagnosed her with a grand mal seizure.

On the way, she became conscious enough to ask paramedics to take off the mask. Before arriving at the hospital she had another seizure, which brought to her another state similar to a coma. The paramedics recorded her vital signs as near normal. She was brought to the emergency room that evening.

Later at trial, the nurse testified regarding the medical records. Her primary assessment of the patient was made in the evening. She found that the patient was “level one” —requiring the most intensive care. She treated the woman not according to the level on her chart but based on vital signs.

The ER physician ordered that the woman be given intravenous valium to prevent seizure. She was given a heart medicine and a vasoconstrictor. He made an unsuccessful attempt to intubate her. She went into cardiac arrest and was pronounced dead.

An expert in cardiology testified for the plaintiff at trial that the woman could have survived if she had been given appropriate treatment. He testified that it was apparent she was unraveling once her vital signs were recorded in the ER. He believed she had suffered from a pulmonary embolism that could have been survived with proper treatment.

A nurse testified on nursing care and stated that recording the woman as level 2 and failing to take vital signs immediately was far below the standard of care. She also testified that the nurses should have questioned the physician’s valium order.

The hospital made a motion for directed verdict as to vicarious liability for the doctor and nursing staff. No evidence was presented that the nursing staff’s conduct caused or contributed to the doctor’s failure to intubate. The trial court denied his motion and then the hospital and doctor presented their defense.

The jury returned a verdict finding the doctor and hospital negligent. The court entered final judgment for the plaintiff. The hospital appealed. The court explained that to prevail in medical malpractice, a plaintiff had to establish (1) standard of care, (2) breach proximately caused the damages claimed, (3) breach proximately caused the damages claimed. The court explained that the third element was missing.

The court explained that someone must show more than simply a decreased chance of survival because of how a defendant behaved. A plaintiff has to show that whatever the defendant did or did not do probably would have affected the outcome. In this case, the plaintiff did not show that the nursing care’s breach of the standard of car had caused the death. Rather, he showed that the doctor’s failure to intubate her when her vital signs were crashing was negligent and if he had intubated her, she would have survived. For that reason, the court reversed.

If you are hurt due to medical negligence or nursing errors, the experienced attorneys of Friedman, Rodman & Frank may be able to help. Contact us at (305) 448-8585.

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