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My first lawsuit – part 2

** This follows from the previous blog post**

A week later a 10 pound package came for me in the mail – it was a copy of the patient’s entire medical record. It took me almost an hour to find the part that had to do with the paralysis event, but as I read through the chart I saw my note and then gasped.

My note was simple: it documented my physical exam findings, the time I first found him paralyzed, the time I called the surgical team, the time it took them to get to the patient’s room. It was all clearly written and nicely documented. But the entry just above mine was from a nurse who had apparently turned the patient earlier that morning to wash his posterior. She noted that the patient was having some neck pain afterwards and that she had given him some Tylenol.

Then came my note.

And then came another note from the nurse, dated 3 months after the incident, and labeled “addendum:”

“Paged Dr. Jones to evaluate patient with complaint of inability to move lower extremities. Dr. Jones responded that she would examine him after rounds. I told Dr. Jones that it was an emergency but she said the patient would need to wait.”

I was horrified. That’s not at all what happened – the nurse was clearly afraid that she would be held responsible since she was the one who had moved the patient earlier that morning, possibly displacing his (recently operated upon) spine and causing a bleed. She obviously wrote the note to make it look as if the irreversible paralysis was due to the slowness of my response.

And so I felt helpless and very afraid – is this what will end my medical career? I thought about all my years of training, how careful I always tried to be, how much I cared for my patients – and would it all end with this insanity?

As it turned out, I had to prepare for a deposition. I studied every angle of the case, read every piece of the chart, sweated it out for many weeks. And then I got another call from the lawyer one day: “They’re settling out of court. You don’t have to come in. Just forget about it.”

I was relieved, but angry. I also felt very sorry for the patient. But most of all I wondered about the legalities of practicing medicine – how vulnerable we docs are, how a complication can be seen as malpractice… and how another healthcare professional can be so damaging. Sometimes practicing medicine scares me – lives are at stake, and even the best intentions can lead to life-altering events.

This post originally appeared on Dr. Val’s blog at

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5 Responses to “My first lawsuit – part 2”

  1. ValJonesMD says:

    Yeah, isn’t that amazing that they allowed such a late addendum? I was also very surprised. Does every hospital have their own rule about addendums, or is there a legal standard? I have no idea – but it’s really scary.

  2. Anonymous says:

    What has happened to the nurse?

  3. Anonymous says:

    I guess nobody knows what happened to the nurse. If there are no consequences for this kind of dishonest, self-serving behavior, it will just continue.

  4. ValJonesMD says:

    Nothing happened to the nurse (as far as I know – I’ve heard that she’s still working at the hospital). Since the case never went to trial, there were no consequences for her. The hospital attorney did tell me that her note strengthened the patient’s case and that it caused the flurry of investigation that resulted in the settlement. While I am very sympathetic to the patient who had a terrible (and unexpected) outcome – the physicians in this case did nothing wrong. In fact, there’s no way to know if the nurse’s moving the patient had anything to do with his bleed either. Sometimes these things happen spontaneously.

  5. bebev says:

    I really feel sorry for Dr Jones, having to deal with her first experience in a law suit. I am sure that both she and the nurse were feeling very vulnerable, and I would guess that the truth of the matter would probably rest somewhere between their two stories. But, if Dr Jones felt helpless and very afraid…perhaps she might give more than a passing thought to how really helpless and afraid that poor patient must have felt!!!! Having had some experience as a patient having spinal surgeries, I can tell you that it takes a real act of faith and courage to put ones self in the hands of even the most competent and caring surgeon. I would like to think that if I had had such a “life altering event”, that my Dr’s first thought would be more along the lines of “How can I help this patient and how can I prevent this happening to another patient?”…instead of “I sure hope this won’t hurt me legally.” Yes, some patients are law suit crazy, but I wonder how many law suits are filed in an effort to just get someone to admit that perhaps they had erred and that they genuinely are sorry that the patient has been further injured.

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