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Malpractice and the APRN
In cases of malpractice, are nurse practitioners held to the medical standard of care when prescribing medications for clients, or would they be held to a standard of care applicable to advanced practice?
A 62 year old, normotensive, 70 kg man reported to Kelsey-Sebold clinic with a 30 minute duration of c/o chest pain. The APRN examined the patient and ordered a cardiac profile. When the laboratory values returned normal, he conferred with the MD re: ordering an ECG and echocardiogram, who instructed the APRN to discharge the patient as is without the additional tests because he had no apparent risk factors for CV disease. The next day, the man reported to a local ED with severe dyspnea and chest pain; troponin levels were elevated and the 12 lead ECG showed both anterior and inferior wall AMI, with presumably different time points in the extension of each AMI, according to ST elevation and Q waves. Six months later he had an AICD implanted for heart failure. The patient sued the Kelsey-Sebold clinic, MD, and APRN for failure to properly diagnose and treat, claiming that an ECG should have been performed and serial laboratory values should have been done.
- Was the APRN negligent? The clinic? The MD?
- If any, what were the breaches in standard of care by the APRN?
Buppert, C. (2014). Nurse Practitioner’s business practice and legal guide (5th Ed.).
Sudbury, MA: Jones and Bartlett Publishers.