Legal Nurse Consultant Discusses Child’s Brain Damage After Tracheostomy

This case involves a child who was born with Pierre Robin Syndrome. The child had a cleft palate and a compromised airway and also had various heart and lung abnormalities. The child underwent a tracheostomy to repair his breathing and also underwent surgery to repair his cleft palate. After the surgery, the child’s doctor ordered that nursing staff suction his tracheostomy tube every two hours and as needed. The nurse on duty did not follow the doctor’s orders and secretions accumulated in the tracheostomy tube and occluded the child’s airway. The next morning, the child suffered a prolonged respiratory arrest which caused irreversible brain damage with spastic quadriplegia. The child’s parents sued the hospital claiming that the nurse had been negligent in failing to follow proper procedures for tracheostomy care. A legal nurse consultant testified at trial that the nurse did not meet the proper standard of care because she did not follow proper medical procedure and caused the child’s breathing to be interrupted.

Question(s) For Expert Witness

1. Can the parents of a child with a cleft palate sue a hospital if the nurse on duty fails to follow proper procedures for suctioning the child’s tracheostomy tube?

Expert Witness Response

A tracheostomy is a surgical procedure in which an opening is made in a patient’s trachea and a plastic tube is inserted to provide an artificial airway through which the patient can breathe. The purpose of such suctioning the tracheostomy tube is to remove blood and other secretions that may accumulate in the tube and close the patient’s airway. In many cases like this one, the child who has had a tracheostomy is placed in the pediatric intensive care unit of the hospital so that they can receive twenty-four-hour post-operative monitoring by a nurse. In some other cases, the child is attached to a pulse oximeter, which can monitor the child’s oxygen saturation levels and will emit a signal when the child’s breathing is interrupted. The nurse on duty in this case did not meet the proper standard of care because she failed to anticipate and take precautions against the risk of the child suffering post-operative airway management problems. For the nurse to have met the proper standard of care in this case, she would have had to more carefully and regularly suction the tracheostomy tube as required by the doctor’s order.