Nursing Home Expert RNs Not Qualified to Discuss Patient Cause of Death

Court: United States District Court for the District of KansasJurisdiction: FederalCase Name: Funk v. Pinnacle Health Facilities XXXII., LPCitation: 2018 U.S. Dist. LEXIS 196660

The nursing home expert witnesses, retained by the plaintiff, opined on the causation. However, the defendant argued that the experts lacked the qualifications to testify about the cause of death.

Facts

The plaintiffs filed a wrongful death suit against the defendant, the operator of a nursing home. They alleged that the decedent died because of a fall suffered in the nursing home. The plaintiffs sought to prove causation with the help of two nursing home expert witnesses. The defendant challenged the testimony of the plaintiffs’ experts, arguing that the plaintiffs had failed to show how the fall caused the death of the deceased.

The Plaintiff’s Nursing Home Expert Witnesses

One of the plaintiffs’ nursing home expert witnesses was a registered nurse with a bachelor’s degree in nursing and education. The other was a licensed practical nurse who had 28+ years of experience caring for the elderly. She obtained a nursing degree after finishing a year-long vocational-technical program in nursing.

The plaintiffs argued that the nursing home experts had extensive experience working with elderly patients over the years. Thus, according to the plaintiffs, the experts were qualified enough to testify about causation. They cited evidence to show that the nursing home experts could show the problems with nursing falls and how they could lead to bone fractures, along with preventive measures taken to prevent them. The plaintiffs cited cases in which nurses had been allowed to testify as expert witnesses as to bedsores. They contended that nursing fall was also a nursing problem like bedsores and the duty for preventing and treating nursing falls rests primarily with nurses.

Discussion

The court noted that there was not enough evidence in the case to support the plaintiffs’ conclusion that registered nurses or licensed practical nurses are qualified enough to testify as to medical causation in general, or even in cases where medical causation is determined through a complicated etiological process. Furthermore, the court observed that the plaintiffs had not cited any authority which had allowed a nurse to testify as an expert witness as to the medical causation of death.

Additionally, the court noted that though prevention of falls in nursing homes is a problem for nurses, the defendant’s motion raised the issue of whether the nursing fall caused the death of the deceased, and not whether the fall was because of a violation of the standard of care. The court was of the opinion that the determination of causation from the nursing fall in the present case would have required considering the effect of the fall on an elderly patient who already had a lot of ailments, as well as the effects of surgery, along with the effect of a second fall after the surgery.

The court believed that the plaintiffs had failed in showing that determining the cause of death falls within the education, training, or expertise of nursing home experts, noting that “while a registered nurse may possess the education and skills necessary to testify as to the standard of care of a patient’s treating nurses, a nurse is not competent to testify as to the patient’s cause of death,” citing Davies v. Holy Family Hosp.

Ruling

The court granted the defendant’s motion to exclude the testimony on the cause of death offered by the plaintiffs’ nursing home expert witnesses.

Key Takeaways for Experts

This case illustrates the importance of aligning your expertise to the facts of the case. In this case, the nursing home expert was found unqualified to opine on medical causation. A registered nurse in a nursing home may possess the education and skills necessary to testify as to the standard of care of a patient’s treating nurses. However, a nurse is not competent to testify as to the patient’s cause of death.