The line between med error and crime?

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Specializes in Geriatrics, Cardiac, ICU.

When do you cross it?

I mean, I hear every nurse will make at least one and if a nurse tells you they haven't, they are lying.

So, what determines whether or not you are charged with a crime or if it is simply an error? Does the patient have to suffer permanant damage or die?

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Specializes in Nephrology, Cardiology, ER, ICU.

I would say that it is intent. Did you intend to harm someone? Sometimes in our line of work, patients can get hurt. There was a front page article in our local paper on Saturday about an error that occurred in our hospital - a devastating error that impacted a person forever. It was not criminal. However, it could be interpreted as careless. I am unsure as I was not even aware of the issue.

Few nurses and doctors are charged with crimes when it comes to patient care. Mistakes do happen as we are all human. However, when you willfully or knowingly hurt someone, then there is criminal intent.

Good question...btw

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Specializes in icu, neuro icu, nursing ed.

although one's intent may be "to do good" and "to do no harm", bad things can happen.

these "bad" things can end up in a malpractice suit. worse, they can end up in criminal court, especially when the district attorney is looking to make a name for h/herself by prosecuting a high profile case. (high profile case means lots of free "face" time in the media -- especially likely during an election year).

these "bad" things can also end up in civil court (remember O.J. Simpson).

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Also, if it turns out the nurse was under the influence at the time of the error it can be considered criminal.

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Specializes in Maternal - Child Health.

these "bad" things can end up in a malpractice suit. worse, they can end up in criminal court, especially when the district attorney is looking to make a name for h/herself by prosecuting a high profile case. (high profile case means lots of free "face" time in the media -- especially likely during an election year

I agree wholeheartedly with this reply.

There was a case in Colorado about 5 years ago in which 3 nurses were prosecuted by the DA for a med error involving improper administration of PCN to a newborn who subsequently died. The case highlighted a cascade of errors system-wide that led to the baby's death, only one of which involved the nurses. (Non-English speaking patient who presented in labor on the weekend at a hospital not affiliated with the prenatal clinic she had attended, so no records were available; RPR testing not available on the weekend; Concern on the part of the medical staff that the mother could not be reached or would not return to the clinic with the baby for antibiotic treatment if the baby was syphillis (+); Error made by the doc/NP who wrote the antibiotic order; Error made by the pharmacist in filling the order; Error made by the covering doc/NP contacted by the nursery RN to clarify the order; Error made by the NICU RN who administered the drug.

Guess who was prosecuted? Only the nurses. As I recall, 2 made plea agreements out of fear of losing their livelihood. 1 fought the charges and was found not guilty, as there was no evidence of intent to harm or negligence that rose to the level of a criminal act.

But I'm sure the DA got his face on the news and lots of name recognition out of it.

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Specializes in ER, NICU, NSY and some other stuff.

Here is a link to the story to which you are referring Jolie. It was actually 9 years ago. I remember it from when I was a new Grad.

http://www.nurseweek.com/features/98-5/crime.html

The point of the prosecutor was that making a med error is one thing, stepping outside of your scope (changing a doctors order) and deviating from the standard of care is quite another.

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Specializes in icu, neuro icu, nursing ed.

in the colorado incident, michael cohen, founder of institute for safe medication practice (www.ismp.org ) found fifty systems problems that contributed to the med error. links supplied.

http://www.psnet.ahrq.gov/resource.aspx?resourceid=1500

lessons from the denver medication error/criminal negligence case: look beyond blaming individuals.

smetzer jl, cohen mr. hosp pharm. 1998;33:640-657. in october 1996, a medication error at a denver-area hospital resulted in the death of a newborn infant. the error involved the intravenous administration of a large dose of penicillin g benzathine, which is only to be given intramuscularly. the three nurses involved in the error were indicted for criminally negligent homicide, and blame for the death focused on them individually. in analyzing the error, the authors (experts from the institute for safe medication practices) discovered more than 50 latent system failures that contributed to the death. the authors discuss the need to look beyond individuals and focus on the multiple system failures that often result in medication errors.

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Specializes in Geriatrics, Cardiac, ICU.

Thanks for the replies. This is one of the things that worries me about becoming a nurse in this society being the way it is with a lot of people so quick to sue.

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Specializes in Psychiatry.
Thanks for the replies. This is one of the things that worries me about becoming a nurse in this society being the way it is with a lot of people so quick to sue.

:yeahthat: :yeahthat: :yeahthat:

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Specializes in Nephrology, Cardiology, ER, ICU.

I live in IL which has the highest lawsuit rate in the country. It is unbelievably evil here. In the ER where I work, everyone wants to sue us. Most folks are just angry, under the influence or mentally ill. However, it is a concern. I am very careful to chart, chart, chart.

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Specializes in Critical Care.
(high profile case means lots of free "face" time in the media -- especially likely during an election year).

Yeah, ask the DA running for re-election near Duke University about that . . .

No matter what the facts actually are - the DA is milking it for all he can get.

~faith,

Timothy.

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There was a case in Fort Worth last year where a doctor was found guilty of criminally negligent homocide (I think) because she did something to a breathing tube to cause a patient to die. Can't remember the details, but the doctor's defense was that the patient was actively dying, the breathing was just agonal respirations, and she wasn't going to take up a scarce ICU bed with that patient. It was a nurse who told on her, but the doctor didn't deny anything, just said it was proper. The jury disagreed, as did the medical board (she lost her license).

What do you folks think about that?

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