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Failure to Report a Change in a Patient’s Condition

June 2020 //  by Matt Menzer

change patients condition

When you’re being treated for a medical condition or injury, you assume you’ll be monitored. You expect your nurses and doctors to keep a close eye on whether you’re getting better or worse. If something changes in your condition, you want your health care professionals to do something about it immediately. 

A form of medical malpractice is when a nurse or other medical professional fails to report a change in a patient’s condition. Certain changes are a sign that something is going wrong and needs to be addressed. But if a physician isn’t informed, there’s nothing they can do to stop you from suffering a serious or fatal injury. 

If you believe you or a loved one have been the victim of medical negligence in Hawaii, talk with an experienced medical malpractice attorney. Matt Menzer can review your case and explain how to sue a medical professional for malpractice. 

Who Monitors a Patient’s Condition?

Responsibility for monitoring a patient’s condition depends on the clinical setting. When you’re checked in to a hospital or other medical facility, nurses typically monitor your condition on an ongoing basis. Doctors will check in less frequently—though how often the attending physician checks on you depends on your injury and the severity of your condition. 

Nurse’s Failure to Report a Change in a Patient’s Condition

Nurses and Nurse Assistants typically have the most contact with you when you’re in the hospital. They are trained to observe you, check your vitals, and notice any change in your symptoms. They are required to update your charts with the latest information, and if your condition has changed significantly, inform your physician. 

What Changes Should a Nurse Report?

Every patient is different. A change that should be reported for one patient might not warrant concern in another. It depends on your condition or injury, common changes during treatment, and common signs of a problem. Nurses are trained to notice and record changes in patients’ conditions, report those changes, and respond when necessary.   

There are many types of changes a nurse should report promptly, including behavioral changes. If you are confused, disoriented, or agitated, this could be a sign of a worsening condition or a medical emergency. 

Many possible changes to be reported are physical, including bleeding, blood pressure, body temperature or fever, blood glucose levels, urine output, chest pain, bruises or skin discoloration, difficulty breathing, oxygen levels, muscle spasms, muscle weakness, loss of movement, facial droop, vision loss, severe headache, and increased pain. 

A nurse might also notice a change in your speech. You might be slurring your words, forgetting words, or saying the wrong words without realizing it. This can indicate a neurological problem. 

Modified Early Warning Score (MEWS) for Clinical Deterioration

Nurses are taught the MEWS system for identifying a decline in a patient’s condition. There are usually early warning signs, and the sooner a nurse catches the signs, the more likely doctors are able to help you avoid a serious medical event, like a heart attack. This system is to be used in conjunction with the nurse’s best judgment, but it’s been shown to be more effective than judgment alone. 

The MEWS System looks at five things: blood pressure, temperature, heart rate, respiratory rate, and level of consciousness/responsiveness. The primary care nurse assigns scores for each indicator based on your vitals and observations, then calculates your MEWS score. The higher your score, the greater the likelihood you need intervention or to be transferred to the intensive care unit. 

Early detection systems have been created for certain types of patients and conditions as well. And some medical facilities use customized methods. Your medical malpractice attorney will investigate what nurses in that facility or region are taught to use when monitoring patients.    

Why a Nurse Might Fail to Report a Change in a Patient’s Condition

If you or a loved one were hurt because a nurse didn’t report a change in your or your relative’s condition, you want to know why. What went wrong? Why wasn’t the doctor told about the change so they could do something? 

There are several reasons why a change in a patient’s condition might go unreported. A nurse might: 

  • Fail to check in on a patient routinely or when requested by the patient.
  • Fail to check all of a patient’s vitals.
  • Fail to appropriately document the change in the patient’s vitals.
  • Check a patient’s vitals but fail to calculate a MEWS score.
  • Rely on their judgment instead of a patient’s MEWS score.
  • Notice a decline in a patient’s condition yet fail to inform the physician as soon as possible. 

Proving a Medical Malpractice Claim for Failure to Report a Change in Patient’s Condition

A nurse failing to report a change in your or your relative’s condition increases the likelihood of a serious medical event and death. When the early warning signs go unnoticed, your condition can deteriorate quickly and significantly. You could suffer another injury, like a heart attack, or an infection might turn to sepsis, or your illness might get so bad as to cause permanent disabilities. 

To demand compensation for medical malpractice, you’ll have to prove several elements in your claim. You must prove the nurse owed you a professional duty of care and their conduct was not how a reasonably careful nurse would have acted under the circumstances. In some cases, your lawyer might find evidence that the nurse did not follow the hospital’s standard procedure or known best practices. 

More specifically, you’ll need to prove that your condition changed, this change was significant, and the nurse failed to report the change to the attending physician. Your medical malpractice attorney will work with a medical expert to review your medical records. The medical expert will offer an experienced opinion on how the nurse’s conduct deviated from the standard of care. 

Talk with a Hawaii Medical Malpractice Lawyer Today

If you were hurt or lost a loved one because a nurse failed to notice or report a change in condition, talk with an experienced medical negligence attorney in Maui as soon as possible. Matt Menzer at Menzer Law Firm has 30 years years of experience handling medical malpractice claims. He knows Hawaii’s medical tort laws, including how to first file a claim with the Medical Inquiry and Conciliation Panel. 

Contact Menzer Law Firm for help through the online form or by calling 808-400-3726. Our offices are located in Wailuku, HI, but we represent individuals and families in medical malpractice cases throughout the neighbor islands.

Previous Post: « How to Sue a Hawaii Hospital or Doctor for Malpractice
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