Malpractice

&
Negligence
in Nursing
LECTURE BY: DR. ALLAN N. YYNGENTE
Case Scenario

▪ Stephen ________________, a 2 year old boy, has Down Syndrome

and Tetralogy of Fallot,
a congenital heart defect that causes low oxygen levels in the bloo
d and blue color to the skin
. Thus, the term "blue baby."

▪ Because of his condition, Stephen experiences irregular heart

rhythms that prompted his parents, Tyrone and Sarah, to have him
confined at the hospital on December 10, 2014.

▪ They said he was getting better until a nurse allegedly did

something wrong during his treatment.
Case Scenario

▪ Stephen's parents said they saw the nurse hastily putting a

cannula or tube into the child's humidifier and oxygen tank without
checking the pressure. The doctor only instructed for the two-year-
old for an X-Ray.

▪ After the incident, the baby suddenly had a hard time breathing
and water went out of his nose and mouth. But, the nurse kept on
pushing in the cannula.

▪ His father, also a nurse, knew something was wrong.

Case Scenario

▪ "Binabalik pa niya 'yung cannula para siguro bigyan ng oxygen

baby ko, or nataranta na rin siguro siya, 'di niya alam anong
gagawin niya. Kahit may tubig pa, pinipilit niyang ibalik," Tyrone
explained.

▪ "Nagbubula na 'yung bunganga niya, inatake na siya. Nag-start na

siyang mangitim," the mother then shared.

▪ It was only 15 minutes after that the baby was revived. But the
parents said they are now worried that Stephen's brain has been
affected.
Case Scenario

▪ "Naninigas pa rin katawan niya. Effect daw 'yun ng pagrevive sa

kanya thrice," Sarah added.

▪ They have already sent a complaint to the hospital's

administration. But they still see the nurse on duty.

▪ They have also filed a complaint before the National Bureau of

Investigation against the hospital for not taking action regarding
their issue. They will also let the Department of Health know about
the incident.
Case Scenario

a) If you found yourself in a comparable situation

and were directly responsible for the patients care,
how would you act ? And,
b) If you were the nurse manager on duty, how
would you respond?
Concept of Law

▪ Law is a rule of conduct, just, obligatory, laid by

legitimate power for common observance and benefit. It
is a sciences of moral laws founded on the rational
nature of man which regulates free activity for the
realization of his individual and social ends under the
aspect of mutual demandable independence.
Concept of Law

INTERNATIONAL
CRIMINAL LAW LAW

LAW

POLITICAL LAW PRIVATE LAW

Concept of Law

▪ Criminal Law which defines crimes, treats of their nature, and

provides for their punishment
▪ International law which regulates the intercourse of nations
▪ Political law which treats of the science of organization and
administration of government
▪ Private Law indicates a statute which relates to private matters
that do not concern the public at large
Malpractice and Negligence
▪ Malpractice in the usual sense
implies the idea of improper of
unskillful care of a patient by a
nurse or any other professional
(lawyers, doctors, dentists, etc.).
Malpractice also denotes
stepping beyond one’s authority
with serious consequences.
▪ Negligence is the failure to use
such care as a reasonably
prudent and careful person would
use under similar circumstances.
The law of negligence therefore
deals with injuries or a wrong
caused by one person towards
another.
Malpractice and Negligence

▪ Accordingly, Reid (2003) explains that Medical malpractice can

occur when a health care professional fails to exercise the degree
of care that a reasonable health care professional would exercise
under the same or similar circumstances. In other words, medical
malpractice is negligence committed by a health care
professional.
Malpractice and Negligence
Malpratice
▪ An example of malpractice is the
giving of anesthesia by a nurse or
prescribing medicines. Under the
Philippine Medical Act, this will
be classified as within the
purview of the medical practice.
Negligence
▪ Most negligence lawsuits are
civil, not criminal, cases. A
person can be found negligent
even though they did not actually
intend to harm the injured party,
because negligent conduct is
behavior that results in
unintended harm.
Most Common Cases of Negligence in Nursing

Philippines: China:
1) Misdiagnosis 1) Lack of Consent or Notification
2) Medication Error 2) Misdiagnosis
3) Procedural Error 3) Delay in Treatment
Elements of Negligence

Four elements of Negligence

▪ Duty of Care
▪ Breach of Standard Care
▪ Injury or Death
▪ Proximate Causation
The doctrine of res ipsa loquitur

▪ There are instances of medical malpractice or medical negligence

that involve the application of the familiar doctrine res ipsa
loquitur.
▪ The doctrine of res ipsa loquitur, which directly translates to “the
thing speaks for itself”, governs cases where negligence is clear by
a simple examination of the injury or the circumstances
surrounding the medical treatment given, such as where a gauze
or a pair of scissors are left inside the body cavity after it has been
sutured, or blood of a different type is infused to a patient.
The doctrine of res ipsa loquitur

▪ Three conditions for the application of res ipsa loquitur are:

1. the injury would ordinarily not occur unless someone were
negligent,
2. the instrumentality causing the injury was within the exclusive
control of the defendant, and
3. the incident was not due to any voluntary action on the part of
the plaintiff.
Tort law

▪ Reid (2003 ) has classified compensation and deterrence for the

purposes of tort law. An understanding of the purpose of tort law
requires an appreciation of the goals of compensation and
deterrence. Both compensation and deterrence are public policy
factors that the court considers in every medical malpractice case.
▪ However in China, a third purpose for this law is imperative. And
that is for the prevention of retributive hospital violence.
Who Can be Held Liable for Nursing Negligence?

▪ Liability for nursing malpractice depends on many factors. One of the

main concerns is whether the nurse acted at their own discretion or
whether they were simply following instructions from a superior (like a
doctor or surgeon). The persons that can be held liable for the nurse's
malpractice may include:
The Hospital
A hospital can be liable for the nurse negligence if:
▪ the nurse was acting for the benefit of the hospital
▪ the nurse was an employee of hospital and being supervised by hospital
▪ the nurse was doing a job instructed by hospital
▪ No other independent doctor instructed the nurse
Who Can be Held Liable for Nursing Negligence?

The Attending Doctor

An attending doctor that is supervising the nurse may also be liable
for the nurse's negligence if:
▪ the doctor was present at the time of nurse malpractice
▪ the doctor was supervising the nurse
▪ the doctor had control of nurse's job and could have prevented the
nurse's conduct
Aiken, Dandry, Tonia .Legal, Ethical, and
Political Issues in Nursing Second Edition.
Nurse Attorney Resource Group, Inc.
Louisiana State University Health Sciences
Center School of Nursing— Adjunct Faculty
New Orleans, LA, 2003 (On
Malpractice .Medi-Smart 2003)

http://www.nursefriendly.com/041013
“Nursing & Healthcare Directories on: The
Nursefriendly Nursing Malpractice Case
Studies By Date ( 1995-2001)”

Reid, Anna Jane. Law All Nurses Should

Know. 2003
Li H, Wu X, Sun T, Li L, Zhao X, Liu X, et al.
Claims, liabilities, injures and compensation
payments of medical malpractice litigation
cases in China from 1998 to 2011. BMC
Health Serv Res. 2014 09 13;14(1):390.
http://www.gmanetwork.com/news/
news/nation/402462/parents-of-2-year-old-
patient-at-heart-center-cry-malpractice/
story/
 END

HAVE A GREAT DAY!