Deposition of Emergency Room Nurse - Medical Malpractice Lawsuit

This the deposition of one of the treating ER nurses in a medical malpractice case. This nurse was named as a defendant in the case. (She was not a defendant at trial.) Our client was a middle-aged man who went the ER after injuring his knee and leg. How did he injure his leg? He was working at the Social Security Administration building. He was on his way to the parking lot when he was injured. The SSA has a gate that prevents people from driving into the SSA loading dock. The loading dock is equipped with a safety gate that can spring up out of the ground in order to prevent a vehicle from entering into the loading dock. As he was walking out of the loading dock, another employee activated the gate just as Mr. Tolson was walking across the gate which was down at the time. The metal gate sprung out of the ground, lifting Mr. Tolson into the air and trapped him in the gate. His left leg was twisted and intertwined in the gate. The manner in which his body moved is depicted in the attached demonstrative animation of the occurrence. As Mr. Tolson was trapped in the gate, someone from the SSA noticed him and came to his aid. Paramedics arrived on the scene and told him, “Don’t look at your leg.” He was transported to St. Agnes Hospital by ambulance. The paramedics documented his history that he stepped over into a security gate, that his foot got stuck inside the gate, that his body twisted, and that all of his pain was in his left knee. This is how the injury happened: Trial Animation of Amputation Injury Malpractice He arrived at St. Agnes Hospital by ambulance and was triaged at 1522 hours. The triage nurse noted that he sustained a leg trauma at work, she noted a deformity, that he was unable to move his left foot, pain scale 7/10, and positive for pedal pulses. He was sent to the Urgent Care part of the emergency room. Based on the testimony of doctor and the PA, neither took a history from the victim. The PA examined the plaintiff. The history taken by her is somewhat strange. She thought that his was struck by an overhead door. Her notes indicate, “left leg caught up in a barrier door.” She did document numbness, paraesthesia, and sharp pain. One of the theories being advanced by the defense was he did not provide an adequate history describing the mechanism of injury that would suggest a dislocated knee. However, regardless of the history provided, the PA suspected a dislocated knee. All the experts agreed that if you suspect a dislocated knee, you have to rule out an injury to the popliteal artery. The PA never performed any type of laxity exam on Mr. Tolson’s knee before or after the X-rays were done. The chart would suggest that she never even reviewed the knee X-rays. She concedes that upon discharge, the only neurovascular assessment she did of his leg was to take the pulse in his foot. According to our vascular surgeon expert and treating doctor, his injury would have been apparent in the Emergency Room. If he was examined properly, the injury to his popliteal artery would have been discovered in the Emergency Room. Two days later, he returned to St. Agnes with continued complaints. Despite two back-to-back vascular bypass operations, his foot was not able to be saved. He was then transferred to the University of Maryland Hospital where he underwent a left foot amputation, then an above-the-knee amputation. Our Concern with This Nurse's Care Our client said he told this nurse he could not feel her touching his foot with family members present. She said she would, “let the doctor know.” This complaint was not relayed to the doctor, nor was his complaint of a cold foot ever documented in the medical chart. Still, this nurse was not a defendant at trial. Big Issue That Generates Controversy One issue in this testimony is how this nurse pushes the idea of charting by exception. Who knows how this nurse was prepped by her lawyer for trial? But health care providers are often prompted to push this idea by their lawyers that they were charting by exception when there are pieces missing in the medical records. In the comments, there are a lot of nurses and doctors who attack (and some that defend) this notion. We brought a medical malpractice action against the doctors in Baltimore City. After a hard-fought trial, the jury awarded our client $5.2 million. More Information on this Case You can find the deposition of the defendant's emergency room doctor claimed this doctor's care was within the standard of care here: Deposition of Defendant's ER Doctor Expert The deposition of another ER nurse (who was not named as a defendant) can be seen here: Deposition of Emergency Room Nurse in Medi... And the defendant physician's assistant here: Defendant Physician's Assistant's Videotap...