Nurse expert witness advises on case involving a hospital patient who received wrong medication

A nurse expert witness advises on a case involving a hospital patient, located in North Dakota, who was admitted to the defendant hospital for a fracture. The treating physician wrote orders for the plaintiff’s treatment and care, including medication orders. The medication orders included, but were not limited to, an order for hydrocortisone pills twice a day. The plaintiff had been using hydrocortisone to regulate his pituitary gland for about 40 years.

The plaintiff alleges that the hospital pharmacy transcribed the hydrocortisone order as hydrochlorothiazide, a diuretic, and dispensed it. The plaintiff asserts that the nursing staff failed to recognize the error on the record and administered it. The plaintiff received the incorrect medication for three days before the error was discovered.

One day after beginning the medication, the plaintiff experienced a hypotensive episode and was transferred to the cardiac care unit. The plaintiff suffered heart failure and has suffered a diminished life capacity.

The plaintiff asserts claims for negligence and professional negligence, contending a prudent nursing staff would have appropriately transcribed the physician’s orders, would have recognized the transcription error and would not have administered the wrong medication.

Plaintiff asserts that he has endured great amounts of pain and suffering and will continue to do so, has incurred significant medical expenses, has sustained loss of enjoyment of life, has endured mental anguish and emotional distress and has remained in a weakened physical state and will continue to experience the same and other miscellaneous and economic damages.

Question(s) For Expert Witness

What is the standard of care and was it breached?

Expert Witness Response

In my medical opinion, the applicable standard of nursing care was to appropriately and accurately verify the pre-printed medication sheets with the physician's orders, as well as verify the appropriate medications prior to administration and to act in a responsible manner for the total well-being of the patient. The applicable standard of care was breached by the hospital nursing care providers. The actions that should have been taken or omitted in order to comply with the standard of care consisted of the following:

• That the pre-printed medication sheets should have been cross-checked with the physician's orders to verify their accuracy

• The medications administered should have been verified with the physician's orders

• To act in a responsible manner for the total well-being of the patient

As a result of the breach of the standard of practice, the plaintiff received the wrong medication causing significant sequelae.

The expert is a registered nurse.