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Georgia Hospital Not Liable for Patient’s Death Despite Nurse’s Failure to Follow Orders

Medical malpractice requires proof that a doctor, nurse, or other healthcare provider deviated from the accepted “standard of care,” and that as a direct result of that deviation, the patient suffered some injury. Unfortunately for victims, proving causation is often more difficult than it might first appear. When it comes to malpractice, judges will not apply “common sense,” but rather look for expert testimony to support or refute the existence of causation.

Edokpolor v. Grady Memorial Hospital Corporation

Consider this recent decision by the Georgia Court of Appeals. This case involves a woman who died while under the care of the defendants, a hospital and one of its nurses. The victim had a long history of cardiac disease and spent the last month of her life in the defendant hospital.

The victim’s doctors determined she needed a colonoscopy. As part of this procedure, a doctor prescribed the administration of Golytely, which is a “liquid bowel preparation medication,” according to court records. Normally, Golytely is taken orally, i.e. swallowed by the patient through the mouth. But in this case, the prescribing doctor said the drug should be administered via the patient’s nose-to-stomach feeding tube.

For some reason, the defendant nurse ignored the doctor’s instructions and proceeded to administer Golytely to the victim orally. Later that same day, the victim “aspirated,” triggering a “code blue” situation that led to the defendant’s death six weeks later. The official cause of death was determined to be “aspiration pneumonia.”

The victim’s family subsequently filed a wrongful death lawsuit against the defendants, alleging their medical malpractice caused the victim’s death. The defendants moved for summary judgment. The trial court granted the defense motion, which the Court of Appeals later affirmed.

As the Court of Appeals explained in its September 14, 2018, opinion, the only evidence offered in support of the plaintiff’s lawsuit was an expert witness affidavit prepared by a doctor who said the nurse’s failure to “follow the doctor’s orders to administer the Golytely through the [feeding] tube rather than by mouth,” was the “proximate” cause of death because the victim “had aspirated the Golytely” into her lungs. But according to the Court, there was no corroborating evidence to show that aspiration occurred during ingestion. To the contrary, it could have happened after the drug was already in the victim’s stomach.

According to the defense’s expert testimony, “nausea and vomiting are known risks of Golytely, regardless of how the medication is ingested.” In other words, even if the nurse had followed the doctor’s instructions and administered the drug through the feeding tube, aspiration could still occur, resulting in the same outcome–the victim’s death. The burden was on the plaintiffs and their experts to prove otherwise, which the Court of Appeals said they did not.

Actually, the plaintiffs did attempt to file an amended expert affidavit offering “new and expanded opinion testimony.” But the trial court rejected the affidavit, which was filed after it already issued its judgment. The Court of Appeals similarly rejected this “belated attempt” to “supplement or revise” the record.