Orillia nurse found responsible in $10million suit

[nic900]

I don't know all the details. I wonder if anyone has information so we can all learn from it.

http://www.thebarrieexaminer.com/ArticleDisplay.aspx?e=2833581&

[Neveranurseagain, RN]

According the the article, the nurse AND the hospital is responsible. This article has in depth details:

$10M suit names SMH - The Orillia Packet & Times - Ontario, CA

[Kooky Korky, BSN, RN]

Is an epidural required for a C Section to be done?

[Orange Tree]

I'm just confused....this article has a little bit more information:

Jury mulls over $10M hospital lawsuit - The Barrie Examiner - Ontario, CA

While the first twin was born without problems, the second twin was in breach (feet first) and an emergency C-section was needed -- but without an epidural in place, there was a deadly delay.

A further delay made matters worse when no operating room was given advance notice.

The mother ended up on a stretcher in the hallway, waiting for an epidural and waiting for the operating room to be prepared. By the time her second baby was born, 61 minutes had passed and the baby was born blue and not breathing. It took 10 minutes to revive him -- but by then, severe brain damage had developed.

But lawyers for the nurses and the hospital insisted Dr. Olupona should have prepared in advance for the inherent risks that come with the birth of twins; that he should have ordered the epidural in advance; and that he should have called ahead to have an operating room ready.

While some experts testified it was up to the doctor to make the preparations, other experts testified it was up to the nurses to monitor the baby's heart rate which would have alerted them that the baby was in distress -- however, nurses claimed the doctor never informed them that one baby was in breach.

[lkwashington]

The problem I have why would a doctor ask a nurse to place a epidural. If I am not mistaken I thought another doctor does that. I would have informed my charge nurse and/or supervisor. Why would the doctor leave the patient anyway. Working as a OB nurse is a great job. I remember my OB instructor told me it can come and bite you in the butt if you dont watch what is being done. A nurse must DOCUMENT!!DOCUMENT!!!DOCUMENT!!!

[wondern, ASN]

Wonder how short staffed or experienced they were at the time for such a breakdown to occur???

[lkwashington]

It appears to me that communication could have been the problem. The nurse should have more on her game. The doctor didnt have game at all. I feel sorry for the mother and the infant.

[Elvish, BSN, DNP, RN, NP]

There are a couple things that stand out to me here:

1) It doesn't sound like the doc told the nurses to put in an epidural. It sounds like he left standing orders to start one if Mom wanted it (some places have written order sets to cover this). Not all that unusual. It could be an anesthesiologist or a CRNA to put it in, so technically I guess it could have been a nurse to place it. But it doesn't sound to me like the floor nurses placed it. Just to clear up confusion.

2) If there as truly an emergent situation, necessitating a crash section why oh why did they piddle around waiting for an epidural? Why not put her under general and get the baby out?

3) The article misspelled 'breech'. Bothers my OCD.

4) I realize not every facility has the means for this, but this makes me so so glad for dedicated L&D ORs.

[tyvin, BSN, RN]

Is it because it happened in Canada that the nurse would be allowed the decision to actually institute action for the epidural on the verbal orders of the doc? If so then it was argued that the doc did give the nurses verbal orders to be able to start an epidural in his absence if the patient wanted one. Also that the patient did request one but didn't receive it.

Also; as another poster pointed out, why did they wait so long to perform the C-section? 61 minutes to set up an OR and prep the patient?

[klone, MSN, RN]

Is it because it happened in Canada that the nurse would be allowed the decision to actually institute action for the epidural on the verbal orders of the doc?

No, it's not just Canada. Many facilities and doctors have "standing orders" for epidurals with all labor patients.

[kakamegamama]

I've never worked anywhere that a nurse can place an epidural. The anesthesiologist placed them. The nurse would even contact the doc if the med needed to be increased. Is it within the scope of practice for a nurse to place an epidural? Has that changed in the past 5 years?

[wtbcrna, MSN, DNP, CRNA]

"When it was apparent that the second twin was in breach and in stress, it was too late, Oatley said, telling the jury Goodwin lay in pain in the hallway waiting for an anaesthesiologist and an operating room to be ready." From one of the articles posted.

This was in Ontario and I am not sure that they have practicing nurse anesthetists there. So, I am guessing the issue with the nurses is they are being blamed because they didn't contact anesthesia soon enough to get the epidural before the patient started to deliver?...

I am confused how even having epidural would have saved time if they were waiting an anesthesiologist anyways. In the U.S. you have to have an anesthesia provider for a C-Section to provide the basic standard of care, but maybe Canada is different.

By the way nurses/CRNAs do epidurals all the time, and where I work the nurses/CRNAs do the vast majority of them.