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News: While recovering from back surgery, an elderly patient became chilled and requested hot tea. The tea was very hot and burned the patient’s lips and breasts.
Prior to trial, the hospital settled with the woman for $150,000.
Background: A 75-year-old woman was admitted to a hospital for elective, lower-back surgery. The surgery was performed in the morning. She had been anesthetized for the surgery. When she awoke, she was taken to the recovery room. After a few hours, she was returned to her noncritical care room. During the next 12 hours, she was given substantial amounts of pain medication and several sleeping pills.
At about 2 a.m. the morning after surgery, she asked a nurse for hot tea. When the nurse returned with the cup of tea, the patient said it was not hot enough and asked that it be heated further. The nurse advised her that the tea was hot enough. The nurse said the patient acknowledged the comment.
Before the patient took her first sip, the nurse left the patient’s room. Moments later, the patient took a sip. The tea burned her lip and she spilled some on her chest, burning her left breast and chest, resulting in second- and third-degree burns to approximately 5% of her body.
The woman claimed the defendant hospital and its nursing staff’s care fell below the standard of care in serving a cup of very hot tea to an elderly and heavily medicated patient recovering from major surgery performed only 16 hours earlier. She maintained that the tea had been served at an unsafe temperature. The plaintiff also claimed that she should not have been left alone and unassisted under the circumstances.
In addition, the patient claimed that four to six needle procedures would be required to attempt to alleviate the pain from the burned skin to reduce the scarring. She also alleged that the permanent scarring and disfigurement over a large portion of her left breast could have been avoided or at least mitigated had the hospital immediately treated her with aloe vera.
The defendant hospital disputed the nature and extent of the plaintiff’s injuries. The hospital maintained that the injuries, if any, were not severe and certainly did not merit the outpatient needle procedures sought by the patient.
Prior to trial, the hospital settled with the patient for $150,000.
What this means to you: Hospitals are not only responsible for providing quality medical care services, but must also provide a broad range of general health care services, including large- and small-scale food and beverage preparation for their patients and staff.
While food services are increasingly being handled or managed by outside vendors, when patients need something to eat or drink between regular meals and during periods when the large-scale food operations are not open, preparing and providing supplemental foods and beverages often becomes part of the nursing staffs’ duties.
In this scenario, the first questions facing the risk manager is where did the nurse get the tea and how was it heated.
"At a minimum, hospitals and health care facilities should have procedures for the use of appliances used to heat food or liquids for patients. Specifically, while microwaves in patient care areas have been the subject of controversy over the years, if microwaves are in fact allowed and used, the only temperature setting that should be allowed is low. Alternatively and perhaps in addition to temperature regulations, food thermometers should be available to test the foods and liquids prior to giving them to patients," states Isabelle Smith, risk manager, Tampa (FL) General Hospital.
"Only patients who are allowed to have additional food and liquid should be given such. In the absence of any dietary restrictions, it would generally be up to the unit nurse to assess the patient’ s level of consciousness and ability to feed or drink by themselves. Under the circumstances of the present case, I am not so sure that even if the nurse had stayed with the patient that the outcome would have been any different. The tea would still have been too hot, the patient would have still spilled it, and the injury would have ensued," says Smith.
"However, when incidents of burns or trauma to the skin occur at the hospital and they are not related to the patient’s underlying condition, it does behoove the facility to consult with an expert to immediately address the situation. Obviously, if additional harm has been done, all measures to appropriately address and treat the harm must be explored. And documentation in these incidents is the best silver bullet for mitigating damages in the long run. In this instance, it does not seem that the extent of the plaintiff’s injuries were adequately documented or accessed by the hospital given the dispute regarding the extent and nature of the injuries and the follow-up care required," adds Smith.
"Any time an institution settles after disputing the nature and extent of a patient’s claimed injuries, those on the outside looking in may wonder what they were thinking. However, in this particular case, burns do leave scars and it seems that the picture must have been worth $150,000, not just a thousand words," concludes Smith.
Settled prior to filing suit in Los Angeles County (CA).