Failure to advocate for a patient opens nurses up to health care liability claim

In a recent case out of the Texas 5th Court of Appeals, the court allowed a case to go forward against a nurse and the nurse’s employer, a nursing home, at least partially because the nurses involved in the case failed to adequately advocate for the patient.  The patient, who had multiple medical issues, developed bronchitis which progressed to pneumonia that was not responsive to oral antibiotics.  After several days, the patient declined and was transported to the hospital, where the patient was found to be in critical condition and eventually died.

Texas has some interesting procedural hurdles that are a result of tort reform, namely under the Texas Civil Practice and Remedies Code, section 74.351 there is a requirement that an expert report is served on the defendant that addresses the applicable standard of care, the manner in which the care failed to meet the standard and the causal relationship between the failure to meet the standard and the injury, harm or damages.  In this case, the defendants attacked the third element, the causal relationship.

The key to this appeal was that the court clearly indicated the nurses have a professional responsibility to advocate for their patients.  The expert report was extremely critical of all of the nurses at the nursing home involved in the case and singled out a family nurse practitioner for special mentions, especially since that nurse was the provider that initially diagnosed the pneumonia.  The court effectively indicated that a failure to adequately advocate for their patients, including insisting that a physician see a patient, then following a facility chain of command if the physician refuses.

I could find no indication that these nurses have been reported to the Texas Board of Nursing and additional information may come out at trial that exonerate these nurses, but it is important for nurses to remember that they do have an independent professional responsibility to advocate for their patients, even if it puts them at odds with the attending physician on the case.


The 5th Court of Appeals decision is here.

One Response to Failure to advocate for a patient opens nurses up to health care liability claim
  1. criminal defense lawyers los angeles
    August 30, 2010 | 4:27 pm

    I think that’s absolutely horrible that the nurse is being sued for this. What if the patient made the choice to died on their own by refusing treatment? Or they been so sick so long they’re tired of treatment and want to go in peace. I feel like that is taking advantage of the law.