Legal Pearl: Can a Physician Be Liable for Bad Advice Given By a Nurse Practitioner?

A 25-year-old newlywed presented to a walk-in clinic after having fallen and injured his leg while hiking in the nearby national park on his honeymoon.

A nurse practitioner examined the wound, which was deep and contaminated with soil. She administered a local anesthetic to the patient’s leg, irrigated the wound, removed dirt, leaves and other foreign material, cleaned the wound thoroughly and then sutured and dressed the leg.

When she was done, she handed the patient a prescription for cephalexin with instructions to take the antibiotic if an infection occurred. She noted the treatment protocol in the patient’s file, but did not call the on-call physician to go over it with him. She simply left it for the physician to sign off on, as required by the clinic protocol.

Within 2 weeks, the patient's wound became severely infected to the point where he required hospitalization and several skin grafts. He had permanent muscle loss in his leg due to necrosis of the area surrounding the wound. At the suggestion of his wife, the patient consulted with a plaintiff’s attorney.

Were the health care providers negligent?

(Discussion on next page)