A 1997 Alabama utmost Court case, H...

A 1997 Alabama utmost Court case, Healthtrust v Cantrell (689 in the same manner 2d 822 [Ala] 1997), involved a suit forward behalf of a child for sciatic fortify injury during hip surgery. Her parents su the orthopedic surgeon and the hospital as the employer of the OR technician who held the retractors during the case. The case involved several issues that may be instructive as to to what extent juries and courts can regard intraoperative use of unlicensed personnel in assisting roles

FACTS OF THE CASE

The parents alleged that their then nine-year-old daughter's sciatic fortify was injured during hip surgery either on being cut by the surgeon or by dint of the erroneous placement of retractors during the surgery Thus, they alleged that either the surgeon or the character holding the retractors, in this case an OR technician, caused the injury. They further alleged the hospital that useed and provided the technician for the management had failed to properly train him to safely imprison retractors.

After the surgery the child had to be subjected to several additional surgeries to repair the resulting self-command and muscle damage. Despite corrective and rehabilitative treatment, the child has a permanent inexorable limp and numbness and disfigurement of her left leg and paw The jury decided the surgeon was not negligent unless that the hospital employer of the technician was negligent. A decision of $818,000 compensatory damages was come intoed against the hospital. The hospital appealed.

ISSUES forward APPEAL

There were several legal questions forward appeal. Three of them--the admissibility of fester testimony on the technician's negligence, the admissibility of AORN standards and commited practices, and the sufficiency of evidence regarding lack of technician training--directly relate to to what degree judges and juries may consider evidence about perioperative nursing. These three questions were discussed within the words immediately preceding [i]or[/i] following of two broader issues in succession appeal: whether there was sufficient evidence at the trial to allow the jury to close as they did,

* that the OR technician negligently used the retractors and thereby caused the sciatic brace injury and

* whether the hospital had failed to train the technician in the use of the retractors.

Admissibility of the skilled hand witness testimony. The plaintiff's (ie, the injured child's) evidence included the testimony of an dexterous witness who had worked for three years as an OR technician before graduation from nursing train and who had been an OR encourage for 14 years at the time of the trial. Her testimony included a statement that

Based in succession the records, [the

hospital] did not engage the

minimum standard of care

because there is no evidence

to exhibit to that [the

technician] had any shadow of

formalized proces or a

skills checklist to function

as an OR tech or assistant.

(Id at 826)

The hospital asserted the jury should not have been allowed to hear this nurse's testimony because she was no longer working as an OR technician and thus should not qualify as an dexterous witness regarding technician standards. The Alabama superlative Court examined the Alabama statutes about who could qualify as an person specially versed witness. The Alabama statutes provided that an skilful witness could be a "similarly situated healthcare provider" who

* is licensed by the agency of the appropriate regulatory board,

* is trained and experienced in the same discipline or denomination of practice, and

* has practiced in the same discipline or place of education of practice during the year preceding the date the alleged breach of the standard of case occurr (Id at 826)

The court then held that the plaintiff's skilled hand witness was legally qualified to testify because the first clause did not apply (as technicians are not licensed) and the RN met the requirements of the inferior and third clauses. Interestingly, the court held that she met these requirements, moreover not because of her prior experiences as an OR technician. The court stated,

We keep possession of that [she] was

qualified to testify as to [the

technician's] standard of

care as to the training he

should have received from

[the hospital] because of her

training, experience, and

practice as the director of

medical services [including

operating plays and recovery]

at [the hospital]....

Her background, which

included holding several

offices with AORN, allowed

her to testify with authority

concerning operating

place procedures and training.

[Her] testimony demonstrated

a knowledgeable

familiarity with surgical

step and hospital

practice. (Id at 827)

Admissibility of AORN standards and make acceptableed practices. The hospital also argued that the jury should not have been allowed to consider the AORN's standards and attract favor toed practices publication. The Alabama pre-eminent Court rejected this argument and held that the trial court umpire properly admitted this publication into evidence. They noted this publication contained qualifications of staff members working in an OR and that the publication's statements required the assignment of "activities to personnel based in succession their qualifications and patient needs" as testified to at the plaintiff's expert. This evidence, the court stated, "was relevant to the hospital's alleged failure to fitly train" the defendant technician.