Everyone who works in healthcare should know that patient falls should never occur in a hospital or nursing home setting. That’s why they’re called sentinel or never events.
A recent opinion entered by Houston’s 14th Court of Appeals illustrates how fall prevention is a responsibility shared by physicians and nurses. The case is styled Dhruti B. Patel, MD v. Michael Baker, Individually and As Representative of the Estate of Deanne Baker; No. 1421-00177-CV, 14th Court of Appeals.
How did the emergency room incident lead to a tragic outcome?
The patient went to Houston Methodist Hospital’s emergency room because she was experiencing generalized weakness. While at the hospital, she was examined by Dr. Dhruti Patel, a hospitalist physician. Dr. Patel documented a history and physical, noting her orders that the patient could have activity as tolerated and could get up with assistance. Two days later, Dr. Patel discharged the patient from the hospital with orders to ambulate (walk) with assistance or an assistive device.
What legal challenges did the plaintiff face in the medical malpractice lawsuit?
As with any Texas state court medical malpractice lawsuit, the plaintiff had to comply with tort reform requirements to produce medical expert reports early in the litigation. These reports must establish the applicable standards of care, who violated the standards of care and how, and how such conduct proximately caused harm to the patient.
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How did the plaintiff overcome objections and secure a victory?
At the trial court level, Dr. Patel objected to the adequacy of a medical expert report served by the plaintiff, contending that it wasn’t sufficient in its description of the standard of care, how it was breached, and proximate causation. The trial court overruled the objections and denied the motion to dismiss. As allowed by Texas law, Dr. Patel kept the trial court proceeding on hold while he pursued an interlocutory appeal to the Houston Court of Appeals on the sole issue of whether the plaintiff’s expert report was sufficient under the tort reform law.
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What key findings in the medical expert report supported the plaintiff’s case?
The plaintiff’s medical expert report written by Benny Gavi, MD, a clinical assistant professor of medicine at Stanford University, provided crucial insights. Here are some excerpts of his report:
- The patient had multiple risk factors indicating that she was at a high risk for falls.
- Dr. Patel, the hospitalist, was obligated to identify the patient as a high fall risk and communicate appropriate orders for condition, including fall precautions.
- It wasn’t sufficient for the emergency physician to recommend fall precautions for the patient. A recommendation does not amount to an order, and another physician’s recommendation could not discharge the duty of Dr. Patel, the hospitalist physician. Further, when a hospital simply places some fall precaution measures in place, it does not relieve the admitting physician of his duty to make the appropriate orders to ensure patient safety. Dr. Patel needed to provide specific orders regarding transfers, namely, that they should be properly assisted by appropriately trained personnel.
- The patient’s cardiopulmonary arrest and death were consequences of severe deconditioning following the patient’s fall and pelvic and hip fracture.
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How did the expert report fulfill the requirements of the statute?
With this level of detail, there’s no doubt in my mind that the expert report fulfilled the two-full purpose of the statute: (1) it informed the defendant of the conduct in question; and (2) demonstrated to the trial court that the claim has merit.
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What should you do if you’ve been seriously injured due to poor hospital or nursing home care in Texas?
If you’ve been seriously injured because of poor hospital or nursing home care in Texas, then contact a top-rated, experienced Texas medical malpractice lawyer for a free consultation about your potential case.
