Mom suing nurse after suffocation accident

[MunoRN]

This Mother Is Suing a Hospital for Millions After She Accidentally Killed Her Son

A mother in Oregon is suing Portland Adventist Medical Center for $8.6 million after she accidentally smothered her four-day-old baby in a hospital bed.

Monica Thompson says that, a few days after her son Jacob was born in August 2012, the hospital put her newborn in bed with her so she could breastfeed him. But Thompson says in the lawsuit that the baby was put there in the middle of the night, while she was heavily medicated. Thompson drifted off, and when she woke up, Jacob was unresponsive...

Thompson, who is suing both the hospital and the individual nurse involved in the incident, said she was still drowsy and groggy” from her medication when she realized her son was not moving, her lawsuit states. The suit says Thompson called for a nurse, and when none came, she carried her son to the hallway and frantically yelled for help.”

[bagladyrn, RN]

All nutrition whether for an adult or infant requires a doctor's order. So yes it is permissible granted there is a doctor's order. Most likely, this nurse did not call the doctor to get an order to feed the infant. You, however, are missing the entire point. The nurse has a role to keep her adult patient pain free and her newborn patient safe during the feeding. A patient on ambien should not be in the bed with an infant. End of story.

No I am not missing the point. In many small to midsize hospitals there is no "well baby" nursery. The space exists but no staffing is allotted. A baby away from the mother is generally watched at the nurses station desk. Again, who do you think watches that child when her nurse is attending to her other patients? In many small to midsize OB depts. there either is no charge nurse or she has her own full patient load.

In standard charting in a number of hospitals one must chart exactly when, for how long and for what purpose the child was removed from the room with the guideline that the total removal should be less than an hour.

OB is a different kind of setting. I'm giving you this viewpoint as one who has worked in at least 30 different hospitals in 12 different states over the last 20 years as a contract nurse.

Personally I think the best way to reduce these incidences is to mandate that hospitals bring back the well baby nursery nurse to help monitor and to give parents a good option if they choose to have respite.

[MunoRN, RN]

When my first kid was born, our nurse gave us a goodie-bag from a formula manufacturer with bottles of formula, coupons, and promotional brochures, I found that pretty astounding at the time but apparently it wasn't unusual. My understanding is that there has been movement away from this promotion of formula unless there is a need for formula, and instead that breastfeeding has been encouraged whenever possible. Maybe I'm wrong, but my understanding is that when it's appropriate, breastfeeding is far superior to formula, so if our job is to promote health then why wouldn't we be encouraging breastfeeding?

[MunoRN, RN]

Going back to the effects of lawsuits on healthcare costs, lawsuits are generally quoted as less than 1% of total costs and since tort reform would not do away with lawsuits all together, you're looking at potential savings of a fraction of a fraction of 1%. That doesn't mean it's not worthwhile, a small portion of $3 trillion is still a lot of money.

There is no single definition of "defensive medicine" so the costs it accounts for varies widely, but it's commonly blamed for around 1-2% of our healthcare costs.

[MunoRN, RN]

All nutrition whether for an adult or infant requires a doctor's order. So yes it is permissible granted there is a doctor's order. Most likely, this nurse did not call the doctor to get an order to feed the infant. You, however, are missing the entire point. The nurse has a role to keep her adult patient pain free and her newborn patient safe during the feeding. A patient on ambien should not be in the bed with an infant. End of story.

Like all MD orders, a legally competent patient or their decision maker is free to decline to follow those orders, MD orders pertaining to diet and nutrition are more accurately described as suggestions.

[GoodDay2017]

I agree. Bring back well baby nursery to all postpartum departments. Juggling 4 hig acuity couplets, moms who "hit the wall" at night, no family to help, or Dad is exhausted, they need a break. Being their nurse with 3 other couplets (One on Mag, SGA with unstable temps or one withdrawing) and no nursery nurse - we have to keep newborns at the nursing station and pray your peers will help watch while charting & holding baby, can get to be too much many nights! It is just not safe.

[klone, MSN, RN]

I agree. Bring back well baby nursery to all postpartum departments. Juggling 4 hig acuity couplets, moms who "hit the wall" at night, no family to help, or Dad is exhausted, they need a break. Being their nurse with 3 other couplets (One on Mag, SGA with unstable temps or one withdrawing) and no nursery nurse - we have to keep newborns at the nursing station and pray your peers will help watch while charting & holding baby, can get to be too much many nights! It is just not safe.

I'm sorry for those of you who work in units that don't follow AWHONN's staffing guidelines. I'm pretty dogmatic about it. It's RARE that our nurses have 4 couplets, and CERTAINLY not if they moms or infants who aren't totally normal stable SVD or POD#2.

[JKL33]

But also, I think a lot of nurses do not realise the power of ambien. The other night my nurse friend got an order of ambien to give her patient at 4am. She was running to the Pyxis to grab the Med and I asked "isn't it too late to give ambien? She can become delirious and crazy without a full nights sleep." She still gave the ambien.

In our mother baby story here- the first problem is why are we waking the mother up once she has taken ambien? Read the label on ambien and then come in the defence of the nurse.

And the provider who wrote the order, right? I agree with you, though, I rarely have heard nurses OR physicians act like ambien is any different than taking a benadryl or melatonin.

Anyway, aside from anything and everything else, I think it will come down to ambien-related claims. I don't know how easy those will be to defend, since hospital/physician/nurse would be the entities responsible for knowing detailed information about ambien, not the patient. It will be said that the physician/nurses were in the position responsible for assessing the overall safety of the situation, and (whether we like it or not) that would be correct.

I'm sure the lawyer is all over the ambien prescribing and use information, and it just won't look good.

I'm very sad for the nurse who is individually named though. I imagine a situation where so much is out of the control of the individual nurse - - all the various factors people have been commenting on here, and maybe more that is facility-specific. I still do not understand how a nurse gets named and the provider/orderer doesn't.

[canoehead, BSN, RN]

Not sure if this was hyperbole - I have never heard of a nurse being fired simply for giving a bottle of formula.

I have seen nurses getting a very severe talking to when the lactation consultant finds out a pacifier was given, let alone a bottle. I have no doubt that a series of those incidents would lead to a job loss.

[Kooky Korky, BSN, RN]

I have seen nurses getting a very severe talking to when the lactation consultant finds out a pacifier was given, let alone a bottle. I have no doubt that a series of those incidents would lead to a job loss.

Well then the LC can just hustle her bustle on up to the ward and pitch right in, time of night notwithstanding!

A bottle is one thing but no pacifier!!!!!??????!!!!! Oh, NONONONO.

[Tjoneslpn]

This is not my area. I don't think the nurse is to blame to the point of being sued. But I, as a nurse I am a firm believer in knowing your patients AND their meds (including any and all prns given) as well as using common sense and throw in a little trusting yourself and going with your gut maybe! Personally, if I have a mother who is ordered Ambien, I'm going to note the last time it was administered. If it was given tonight and I have to take her baby in to feed and wake her up, personally I would stay an extra minute or 3 to make sure shes actually alert and oriented enough to complete the task at hand, even suggest moving from the bed to a chair if necessary to ensure mothers level of consciousness I guess you can say. If I'm comfortable enough to leave the baby unattended with mom, I myself would make it a point to peek in frequently to check on mom and baby! Not necessarily go in and make my presence known, but a minimal peek my head in on my way down the hall. I know things happen, nursing happens, and we can't necessarily keep a planned schedule to check say every 5 mins, but surely as much as possible and as often as possible, but definitely be more attentive to her because of the Ambien and knowing the effects/possibilities. If I can't make it ask a coworker. And document, document, document. Better safe than sorry.

I myself know personally how dangerous, if you will, Ambien can be as I myself was taking it post MVA and was completely unaware of not only most of the conversations I had after taking it, but if some of my actions. The last time I ever have or ever will take it was when I as usual took it after I was in bed just before shutting the light off for the night. When I woke up in the morning, I was sitting up in my chair, lights on, and my laptop open in my lap and no idea or recollection of how, when or why. As if that wasn't confusing and frightening enough, there was a cigarette butt in the middle of my keyboard, in my lap, obviously had been lit and burned not just the tobacco but half of the filter as well and 6 keys on my keyboard were completely melted where the cigarette laid and burned. Someone was watching over me that night as my house somehow didn't burn to the ground with me in it!

I've also in different LTC settings have had all kinds of interesting experiences and conversations with patients on Ambien. Maybe I'm wrong but I myself feel that a little more attention should be paid to patients who have been given this drug no matter the circumstances but ESPECIALLY if you're putting a baby in their care. I just feel that's common sense and good nursing judgement. Being more attentive and more frequent checks when warranted taking extra time to assess the situation to begin with like in this situation, I believe there is a good chance this baby's death was preventable, or he at least stood a better chance.

If mom was A&O enough she should have requested a bottle feeding if she was too tired. But she may have had a "normal" interaction with the nurse and its then the nurses responsibility to assess the situation and closely monitor after handing over the infant to ensure all really is well and mom wasn't just sleep talking (some conversations I've had with people on Ambien were ligit until I stepped back and watched the patient right after and they were fast asleep again. Example: someone requested a PRN pain med during rounds, gave pain level and location, etc. I brought the med and a drink back and they had dozed off while I was gone but awoke as I came back in the room. I handed them their pill cup and drink, they said thank you and goodnight, put the pill in their mouth, I walked to the doorway, but stood there watching and waiting for them to take a sip of water which never happened. They went right back to sleep. I had to wake them again to swallow it, which actually they spit it out saying they didn't need it don't remember asking for it and spit it out (or at least what hadn't dissolved in their mouth already). In the morning they remembered absolutely none of it. I notified my supervisor, wasted the remainder of the pill, she assessed the patient as well both at the time and again in the morning and we both charted in detail.

Again I don't think the nurse is at fault, especially if following p&p. Most definitely not to the point of being sued. I do however believe that not just in this situation, but in general, nurses are too into a routine/habits, and follow p&p (which you absolutely should), but many times COMMON SENSE (and natural/gut instincts even seem to get left at the door, or are just lacking all together).

Again, maybe I'm completely wrong. Its just my personal thoughts/opinion and experience... For whatever its worth!

[DoGoodThenGo]

When my first kid was born, our nurse gave us a goodie-bag from a formula manufacturer with bottles of formula, coupons, and promotional brochures, I found that pretty astounding at the time but apparently it wasn't unusual. My understanding is that there has been movement away from this promotion of formula unless there is a need for formula, and instead that breastfeeding has been encouraged whenever possible. Maybe I'm wrong, but my understanding is that when it's appropriate, breastfeeding is far superior to formula, so if our job is to promote health then why wouldn't we be encouraging breastfeeding?

That *movement* away from formula became more like a stampede here in NYC after then mayor Bloomberg pushed another one of his nanny state initiatives:

Mayor Bloomberg pushing NYC hospitals to hide baby formula so more new moms will breast-feed | New York Post

Bloomberg's breast-feeding plan: Will locking up formula help new moms? - CNN

[MunoRN, RN]

That *movement* away from formula became more like a stampede here in NYC after then mayor Bloomberg pushed another one of his nanny state initiatives:

Mayor Bloomberg pushing NYC hospitals to hide baby formula so more new moms will breast-feed | New York Post

Bloomberg's breast-feeding plan: Will locking up formula help new moms? - CNN

New York's "Latch-On Initiative" just encourages good healthcare, I don't really see a problem with that.