Patient Suffers Permanent Injuries from Urinary Catheter

This case involves patient who had a foley catheter ordered for urinary retention. The patient was taken by ambulance to the ER with complaints of pain since having a catheter placed by a home care nurse. The ER physician instructed patient to use a topical anesthetic and follow up if his pain worsened over the coming days. The patients family called defendant with complaints of pain where catheter was placed and that the anesthetic he received for the ER was not helping. It was at this point that the patient let his nurse know that he wanted the catheter removed, however the patient’s physician declined this request. Eventually, the patient was taken to ER and a penile abscess was found Later that afternoon patient underwent debridement, and was diagnosed with gangrene. He was discharged from hospital to extended care facility a few days later, where he eventually died.

Question(s) For Expert Witness

1. Please explain your experience in home healthcare ?

2. Are you experienced in caring for patients with a foley catheter?

Expert Witness Response E-000911

I was the Director of Nursing for a private home-care agency for almost 5 years. Often we were the only providers in the home. A nurse is responsible for assessing the patient condition each time she sees the client. She should educate the patient regarding health management. She should also advocate for the patient. In this case this would have involved several possible options: educating regarding complications of Foley catheters and when to seek medical advice, communicating with the MD asking for urine culture and urinalysis, sending the patient back to the ER, recommending a second opinion. It sounds like he developed quite an intra-abdominal infection with fistulas.