Can A Nurse Be Sued For Malpractice?

Nurses can be sued for malpractice or negligence based on their actions or inactions. About 18% of closed medical lawsuits between 2018 and 2021 included RNs, LPNs, nursing assistants, and nursing students (American Journal of Nursing, 2022). In August 2022, the North Carolina Supreme Court struck down a 90-year-old precedent that had protected nurses from liability, meaning nurses there can now be sued even for following a physician’s orders. It is not common for nurses to be sued, but understanding when it can happen and what to do if it does is a practical necessity.

Defining Medical Malpractice

Malpractice is a type of negligence: a failure to provide the proper standard of care that results in harm to the patient. Treatment errors are mistakes made during care delivery, such as administering the wrong medication or performing a procedure incorrectly.

Each state has its own rules governing medical malpractice. Those rules determine whether a claim for a nurse’s negligence is considered malpractice or not, and that depends on the services at issue, where they were performed, and other staff involved.

Actions and inactions that commonly lead to malpractice claims:

• Failure to monitor the patient and respond promptly to a change in vital signs
• Failure to update the chart with changes or accurately record the patient’s condition
• Failure to ensure medical equipment is working properly
• An error in treatment administration or routine care, such as taking blood pressure or drawing blood, that causes injury

There are cases where inaction is appropriate. For example, withholding digoxin when a patient’s pulse is below 60 beats per minute may be clinically correct. But if the nurse does not document the pulse rate and the reason the medication was held, they can be sued for negligence and cited for failure to administer without cause.

Common Claims Against Nurses

Nurses can be named in malpractice suits alongside other practitioners. A review of closed malpractice claims found the top allegations against nurses were inadequate patient monitoring (45%), medication mistakes (18%), patient falls (14%), and pressure injuries (10%).

When inadequate monitoring was alleged, it resulted in patient death 49% of the time. Medication errors are serious: nearly 40% of malpractice lawsuits include a drug administration error.

Communication failures also drive claims. In one case, a family brought a wrongful death lawsuit against a nurse who failed to notify the physician when the color and odor of a patient’s emesis changed. The patient died shortly after.

In another case, an 80-year-old man fell in a nursing home, was transported to the emergency room confused and incontinent, and fell again in the ER, sustaining a right hip fracture requiring surgical repair. The patient had not been placed within direct sight of the nurses’ station. The case settled, with the nurse responsible for 45% of the total settlement.

What to Do if You Are Sued

Do

• Notify your nursing supervisor immediately so the hospital’s malpractice insurer can be informed. Failing to report promptly can result in denial of coverage.
• Get legal representation from an attorney who knows medical malpractice law in your state.
• Review all patient records and locate consent forms, incident reports, charts, and other relevant documentation.
• Preserve all additional evidence: emails, photos, videos, and notes related to the case.
• Identify a trusted colleague who can attest to your credibility and professional conduct.
• Present only the facts in any communication with opposing counsel or during depositions. Assumptions do not help your case.
• Learn the legal terminology and the plaintiff’s arguments. Work with the system rather than against it.
• Address your stress. Compartmentalize where you can, focus on supporting your defense, and engage in self-care: counseling, exercise, and a support network.

Do Not

• Speak with the patient, the patient’s family, or the plaintiff’s attorney about the case without your attorney present.
• Withhold information from your defense team. Gaps in disclosure raise suspicion.
• Ignore the lawsuit or try to manage it on your own. Malpractice law is complex; handling it without counsel puts you at serious risk.
• Post anything about the case on social media. Even deleted posts leave a digital record that opposing counsel can subpoena.
• Make statements that could be construed as admissions, including “I did nothing wrong,” “I know I’m 100% right,” or “I’m sorry.”