The following blog entry is written from a defendant’s position as trial approaches. Reviewing this kind of briefing should help potential plaintiffs and clients better understand how parties in a medical malpractice case present such issues to the court.
(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this medical malpractice/personal injury case and its proceedings.)
DR. BLACK’S DECLARATION OMITS VITAL FACTS
Dr. Black’s declaration, through careful wording, attempts to create the picture that when any patient presents to XYZ Hospital and they are seen by a nurse practitioner, a supervising physician is automatically involved every time, working hands-on with that patient, second-guessing the nurse practitioner, and fully handling and managing that patient’s care. Nothing can be further from the truth. Nurse practitioners, by their special status as mid-level practitioners are allowed (and even expected) to have a certain degree of autonomy in rendering care to patients. In fact, page 1 of the Frequently Asked Questions Regarding Nurse Practitioner Practice states that a nurse practitioner is still practicing legally when the supervising physician is 50 miles away.
Further, XYZ Medical Center’s Standardized Procedures for Nurse Practitioners, that Dr. Black has mis-cited in his declaration, in actuality goes to great lengths to describe the degree and type of autonomy that nurse practitioners have. On page 4 of the Standardized Procedures, at the very onset of the General Policies, the first sentence states it is the intent of this document to authorize nurse practitioners at XYZ Medical Center Emergency Department to implement the Standardized Procedures without the immediate supervision or approval of a physician. (Emphasis added.) Page 6 of the General Policies provides that the nurse practitioner will be responsible for the preparation of a complete medical record for each patient contact per existing office policies. Moreso, under the “Supervision” heading, the nurse practitioner is authorized to implement the Standardized Procedures in this document without the direct or immediate observation, supervision or approval of a physician, except as may be specified on individual healthcare management standardized procedures.
Under the “Consultation” heading, the rules regarding when a nurse practitioner must consult with a physician clearly state on page 7 the situations wherein a physician must be consulted. These requirements are mandatory for nurse practitioners only. Thus, it is up to the nurse practitioner to seek out the physician for a consultation, if such is required under these guidelines, not the other way around. It is not a physician’s duty to seek out a nurse practitioner and provide an unasked-for consultation. Physicians are not required to wander the halls, looking for patients whose very existence they are unaware of, seeking to provide consultations every time a nurse practitioner treats a patient.
Making Dr. White liable in this action opens the door of liability to an untenable extent and could conceivably create liability for any other physician that happened to be present in the emergency room at the time that plaintiff presented. There is no statute, case decision, or guideline that establishes such open-ended liability. Dr. White was present at the time that plaintiff presented at XYZ Medical Center and nothing more. As part and parcel of his administrative duties, Dr. White signed off on nurse practitioner Paul Brown’s medical charts, one of which happened to be plaintiffs
Plaintiff cannot maintain this action for professional negligence against defendant White because plaintiff has failed to establish any disputed material fact that defendant White failed to meet the standard of care as it pertains to plaintiff. The declaration of plaintiffs expert puts forth several facts that would serve to create a triable issue of material fact were they in opposition to a motion for summary judgment from either XYZ Medical Center or nurse practitioner Paul Brown, however they are ultimately irrelevant as and against Dr. White. As David Black’s declaration relies upon irrelevant facts and is based upon a highly incomplete summary of the guidelines governing nurse practitioners at XYZ Medical Center, his declaration should be disregarded in its entirety. Dr. White was not negligent or in violation of the standard of care by simply signing plaintiffs medical chart as part of his administrative duties. Based on the foregoing, defendant White respectfully requests that this court grant his motion for summary judgment.
For more information you are welcome to contact Sacramento personal injury lawyer, Moseley Collins.