The plaintiff's decedent, age seventeen, injured his left shoulder and arm while lifting an object that weighed several hundred pounds. Three days later the decedent awoke complaining of pain and went to an emergency room with complaints of left shoulder pain radiating to the wrist, nausea, vomiting, mild headache and a cough. X-rays were negative and a spinal tap showed no signs of infection. Blood cultures were also drawn and sent to a laboratory.

The decedent was discharged with Motrin and Flexeril for pain and was instructed to wear a sling, ice his arm and follow up the next day with his pediatrician. The lab then notified the unit clerk in the emergency department of a preliminary blood-culture report that revealed gram-positive cocci in clusters. The defendant registered nurse was responsible for reviewing blood-culture results. She knew that the hospital's policy and procedure manual required her to review the patient’s records for appropriate therapeutic medication, review them with the charge physician on duty, notify the patient’s physician of any necessary changes, fax the results to the physician’s office, and notify the patient.

The defendant nurse notified the emergency room physician of the preliminary positive blood-culture results and contended that the physician instructed her to wait for the final microbiology report before notifying anyone, although the physician denied this. The blood-culture results were not reported to the decedent, his family or his doctor.

The decedent went to his doctor's office where he was diagnosed with a strain of the left upper extremity and fever of unknown etiology. The decedent’s doctor was eventually faxed the positive blood-culture results and sent the decedent by ambulance to a hospital where he remained in the intensive care unit, received multiple intravenous antibiotics and extracorporeal membrane oxygenation. The decedent developed a necrotizing pneumonia, he progressively deteriorated and then died.

The matter was arbitrated, with the arbitrator finding negligence by the nurse and physician. A $827,363 award was given.

With permission from Medical Malpractice Verdicts, Settlements & Experts; Lewis Laska, Editor, 901 Church St., Nashville, TN 37203-3411, 1-800-298-6288.