Plaintiff’s horrific medical ordeal began with what was supposed to be a simple surgery to repair a hernia. Of course, there is the potential for complication with any medical procedure, but those experienced by plaintiff here were especially extensive.
First, he developed a serious infection that required additional treatment. Ultimately, he was forced to undergo at least 15 more surgeries. After all this, defendant doctor placed the patient on a type of total nutrition supplement, which is to be introduced intravenously.
This type of supplemental nutrition is only supposed to be temporary, unless a person is so sick or the condition so severe as to warrant it for longer. It requires a doctor’s prescription, and must be tailored to suit the specific needs of each patient. While there is a base solution that is commercially sold, the prescription form has a host of additives (or items to be subtracted) that will ensure each patient gets the nutrition they need.
When patients need this type of intensive care, they are usually assigned teams of professionals, which include the doctor, a dietician, a pharmacist and a nurse.
Here, the vast majority of the nutritional supplements given to the patient lacked an essential vitamin called thiamin (Vitamin B1). As a result, patient developed a condition known as Wernicke’s encephalopathy, which resulted in severe and permanent brain damage and disability.
In looking back at those nutrition supplements, it was clear on the order that thiamine was explicitly absent from the packets. The prescription was signed by the doctor. However, the doctor insisted he never actually read them. He simply signed them, relying totally on the dietician to determine the components required. He conceded this even though his signature is a legal requirement in order to dispense these nutrition supplements as a prescription drug.
Plaintiffs settled with all other defendants out-of-court. However, the medical malpractice lawsuit against the doctor pressed forward.
Defendants asserted the doctor had not breached the applicable standard of care for a general surgeon, indicating it is common for a surgeon to rely on a dietician to ensure the nutrition packet contained what the patient needed. An expert witness testifying for defense noted that just because a doctor signs something does not mean he or she accepts that document as fact. “That’s not how it works,” the witness testified.
In fact, another expert witness for defense testified a doctor would generally never know what a nutrition supplement form states, even though he or she is required by law to sign it. According to that witness, it was simply an administrative process.
Ultimately, the jury found based on this that the doctor had no duty to read the nutrition supplement forms, even though he was required by law to put his signature to it.
Plaintiffs appealed, but the appellate court affirmed.
Although noting that plaintiff’s argument was compelling and the situation tragic, they could not find that the trial court erred in this case. Justices did not plaintiff likely could have moved to bar the expert witness testimony of those physicians who testified for the defense with the argument that the testimony was beyond their proper scope as there were essential questions of law as to whether reading an order that a doctor is legally required to sign is within the purview of expert medical testimony. The court noted that in every other legal context it could find addressing such matters, all individuals – even those who are illiterate – are responsible for knowing the effects of documents they sign. However, plaintiffs didn’t raise this issue at trial, and thus it couldn’t be considered on appeal.
Ultimately, had the medical professionals involved communicated with one another – or had the doctor simply read the documents he was required to sign – plaintiff’s injuries likely could have been prevented.
Contact our Carolina personal injury lawyers at Lee Law Offices today by calling 800-887-1965.
Crider v. Cattie, March 17, 2015, North Carolina Court of Appeal
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