Staff Avoiding Blame
This case is about Merryl B., a seventy-nine-year-old woman who suffered a right lower leg spiral fracture in a Midwest hospital. There was no documented incident in the hospital record consistent with such a fracture.
While reviewing the record, I found a nurse's note stating that while being transferred from the stretcher to her regular hospital bed after coming back from the physical therapy unit, Merryl screamed in pain and was complaining of her leg hurting ever since. After conferring with an orthopedic surgeon, we concluded that the nature of the fracture indicated that she had fallen between the stretcher and the bed, with her foot caught in the side rail, and had twisted her leg suddenly and forcefully.
The two nurses apparently did not want to take the heat for this obvious negligence and conspired to put Merryl back in bed and just note that she inexplicably started screaming and shouting obscenities. This was a clever ruse since Merryl had been confused and agitated before and was verbally abusive. They figured that if there were an injury, other staff members would discover it days later, and the patient would not remember when it occurred and/or would not be a credible witness.
The scheme worked out as planned. The staff were accustomed to Merryl's screaming, and no one checked her complaint until a physical therapist found that there was a real problem with the leg three days after the incident.
What could these three women's families have done? It is hard if not impossible to be present every second of your loved one's hospital stay. Rather, these scenarios show that you need to make a careful assessment of the environment and personnel before leaving him or her behind in a hospital.