Published on:

The defendant moved for summary judgment to dismiss the complaint…cont

Contrary to the concurrence’s claim, the courts are not suggesting that, in all cases, a professional registered nurse must possess the same knowledge of pharmaceuticals that the court properly demand of those who are authorized to prescribe them. Nor are the courts creating any new duty for registered professional nurses. Rather, our holding is informed by the fact that, in this case, as concerns the lack of epinephrine, plaintiff’s allegation of malpractice does not depend on a finding that The personal injury defendant should have taken extraordinary steps or made inquiry into an area of medicine that far exceeded the knowledge ordinarily expected of a nurse. To the contrary, the notion that a nurse should be aware of the importance of having epinephrine available when administering medication in the home setting is not a difficult one to embrace. After all, the fact that epinephrine is the antidote to anaphylaxis is widely known among laypeople. Indeed, many individuals who care for a child with severe allergies, or who have a spouse or partner prone to anaphylatic shock, are known to carry a dose of epinephrine in pockets and purses, regardless of their medical background.

Moreover, the administration of epinephrine is far from a radical procedure. Rather, the medicine is easily transportable in the form of auto-injector devices, commonly known as epi-pens, and apparently easily administered, as evidenced by the fact that the Legislature has expressly authorized summer camp personnel to use them. This fact further undermines the already inconsequential statement by the concurrence that the monograph LH cited, saying that epinephrine should always be available when Solu-Medrol is administered, does not establish that this recommendation has actually been followed in the general practice of home infusion therapy. In other words, the idea of having a dose of epinephrine available in cases where, as here, a person may encounter a substance known to cause anaphylaxis, is so obvious that common sense would seem to dictate that it be routine. Indeed, it is so intuitive, even to a layperson, that the antidote for anaphylaxis should accompany a medicine known to cause anaphylaxis, that lack of empirical proof that this recommendation is followed by the medical community should hardly compel the dismissal of the complaint. This is especially true in this case, where defendant has not offered any plausible reason why a physician would not prescribe epinephrine for use by a home infusion nurse if, in her role as coordinator of the delivery of patient services, the nurse suggested that it was medically indicated.

The concurrence invokes Education Law § 6902 in arguing that, by holding that the defendant should have inquired into the availability of epinephrine, the court are holding her to a standard in excess of what is required by statute. As conceded by the concurrence, however, the definition of the practice of the profession of nursing as a registered professional nurse, as provided by § 6902, encompasses a wide variety of tasks.

That the definition does not mention prescription medication is irrelevant to the issues in this case. Certainly that part of a registered professional nurse’s job which the Legislature has identified as the provision of care supportive to or restorative of life and well-being is broad enough to embrace inquiring into the availability of epinephrine during home infusions of medications known to cause anaphylaxis. Moreover, the court notes that the definition of nurse practitioner also does not include any mention of prescription medication. Although the court recognized that nurse practitioners are separately authorized to prescribe medicine under certain circumstances, it is evident that these definitional sections were not intended to provide exhaustive descriptions of what nurses can and cannot do.

That a home infusion nurse live up to the standards established by the Court of Appeals in B v B is critical. Home infusion nurses work without the resources normally available in a medical office or hospital setting. The issue in this case is what steps must a nurse with no readily available support take to ensure that any and all reasonably foreseeable problems can be addressed so as to minimize patient harm. Nurses have become a crucial element in the provision of medical care. As recognized by the Court of Appeals in B v B, no longer are they automatons who operate by rote, but professionals who are expected to be proactive in their work, while always deferring to the reasonable directives of the doctors they work with. There is sufficient evidence in this record that The defendant failed to comport herself in accordance with this more modern model of nursing, and that if she had, the disaster that befell plaintiff and her family could have been averted. Consequently, the court finds that the motion court correctly denied the defendant summary judgment.

Accordingly, the order of the Supreme Court, Bronx County, entered on or about October 29, 2009, which denied defendant the defendant’s motion for summary judgment dismissing the complaint and all cross claims as against her, should be affirmed, without costs.

Contact Information