A hospital in Alabama had no access to it's EMR and most of it's patient monitoring systems were not functioning for more than 3 weeks. Despite this the hospital claimed publicly that it's ability to care for patients was not impaired and apparently continued to perform non-urgent cases and refused to divert patients who could be diverted.
A delivery occurred where a nuchal cord went unnoticed (umbilical cord that strangulates a baby during delivery) due to the monitoring system being down (although it was still printing out strips). The result was brain damage and the baby eventually died.
Ideally someone was still monitoring the strip printout, even though the monitoring system had effectively replaced the strip and was no longer part of the routine. Although this occurred in an overall environment of what sounded like chaos and such errors seemed predictable without mitigating the risks.
I'm really curious about how the ransomware thing became a large part of the central allegation here. It seems that if there is indeed some kind of negligence involved, then at its most basic it is simply failure to monitor the patient one way or another. As you two have noted, a safe delivery doesn't strictly require central monitoring capability.
I'm not trying to state anything -- just -- was it the lawyer that came up with this? The plaintiff's belief? Something a hospital representative said? Something the OB said? Elsewhere it is reported that the OB text the OB nurse manager asking for help understanding why she wasn't notified [of any aberrancies with the strips].
The plaintiff seems focused on the allegation that if she would've known that the ransomware attack had altered the hospital's monitoring capability she would have gone elsewhere. That could be unfortunate claim if the hospital successfully argues that they did not have an obligation to notify. On the other hand, they could get themselves in a bind if they argue that central monitoring isn't required, because what is required one way or another is adequate monitoring.
Concur. I don't buy this. I did OB in hospitals w/o central monitoring before they were a thing everywhere. No babies died during my tenure in such hospitals. We watched the strips carefully. This is BS.
I'm a little skeptical that there were no adverse events related to this prior to the newer monitoring systems.
I doubt these systems aren't cheap, so if they serve no purpose why do hospitals purchase them?
Specializes in Nurse Leader specializing in Labor & Delivery.
9 hours ago, MunoRN said:
I'm a little skeptical that there were no adverse events related to this prior to the newer monitoring systems.
I doubt these systems aren't cheap, so if they serve no purpose why do hospitals purchase them?
There are always adverse events related to not properly monitoring the strip and being able to interpret the fetus's wellbeing from the data in the strip. But that happens WITH central monitoring as well. It's just less likely because you have a dozen pairs of eyes viewing that strip, rather than just one (or apparently in this case, none).
Why do hospitals purchase them?
A) I already explained the purpose they serve earlier in this thread, and B) they come automatically with the OB EMR. When you upgrade from paper charting to an EMR, you automatically get the central monitoring software.
Specializes in Nurse Leader specializing in Labor & Delivery.
As to why the plaintiff latched onto the ransomware as being the reason for the infant's death - because suing the individual nurse for negligence for not properly monitoring the strip is not as lucrative as suing an entire hospital. Just my guess.
Thank you guys for weighing in. I’ve never worked in OB so I couldn’t really make heads or tails of the complaint. Hearing your thoughts has been enlightening. And while I’m glad the individual nurse isn’t being targeted by the lawsuit, I am also not clear really on how the attack is directly at fault. Even at my incredibly disorganized clinic, we do have the concept of paper charting for backups if there’s a power outage or whatever.
My first job as teenage LPN in 1977 was L&D. We had fetal heart monitors then. Huge machine that beeped very loudly with fetal heart beat with external monitor. They also had scalp electrodes for internal monitors. The scalp electrodes were more accurate but were placed by RNs. The screw part resembled an upholstery tack. You could not turn the volume off, you could hear the beeps at the nurses station. And if mom shifted position & beeps stopped due to elastic band that holds monitor was out of place, we went right away to check mom, the paper strips ran continuously. Laboring moms on the monitors were checked every 15 minutes. Sounds like people have relied on central monitors at nurses station & have forgotten to check patients periodically. .
Specializes in Nurse Leader specializing in Labor & Delivery.
On 10/7/2021 at 5:31 PM, CommunityRNBSN said:
And while I’m glad the individual nurse isn’t being targeted by the lawsuit...
Based on the court document posted above, it looks like she was. I'm assuming that defendants A-K are nurses who were in the chart of the mom during labor, and the infant afterwards.
JKL33
7,043 Posts
I'm really curious about how the ransomware thing became a large part of the central allegation here. It seems that if there is indeed some kind of negligence involved, then at its most basic it is simply failure to monitor the patient one way or another. As you two have noted, a safe delivery doesn't strictly require central monitoring capability.
I'm not trying to state anything -- just -- was it the lawyer that came up with this? The plaintiff's belief? Something a hospital representative said? Something the OB said? Elsewhere it is reported that the OB text the OB nurse manager asking for help understanding why she wasn't notified [of any aberrancies with the strips].
The plaintiff seems focused on the allegation that if she would've known that the ransomware attack had altered the hospital's monitoring capability she would have gone elsewhere. That could be unfortunate claim if the hospital successfully argues that they did not have an obligation to notify. On the other hand, they could get themselves in a bind if they argue that central monitoring isn't required, because what is required one way or another is adequate monitoring.