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Poor Response to Infant’s IV Injury Results in Settlement

In this case a newborn girl suffered an IV infiltrate, which means the IV fluid entered the surrounding tissue. Because it was not timely discovered and treated, the girl lost motion in her foot and suffered permanent scarring.

The IV line in her right foot was used to infuse calcium gluconate. Over the next two days, an entry into her medical record during each shift indicated that the IV was running well. But on day 3, during the overnight shift, the nurse noted an IV slough with a darkened area at the IV site.

Later that day, the patient was transferred to the ICU. A transfer note specified the time the infiltrate was noted and commented that the IV site had been checked prior to transfer; however, those details did not appear in the patient’s chart.

In addition, the nursing flow sheets from the shift when the infiltration was discovered, and the one preceding it, contained scratch-outs and re-writing over the original IV infusion numbers.

When they came in that morning, the parents discovered their daughter’s injury and were upset that the staff had not notified them. When questioned by the parents, the staff characterized the injury as a blister.

The parents were then told three different stories by physicians.

One of the physicians said the IV medication was very caustic — and was typically given for babies with heart problems. The parents had not been told their daughter had heart problems and she, in fact, did not.

Another physician indicated the problem originated in the community hospital.

A third physician told the parents that the infiltrate should not have occurred — and that he would not blame them if they took their child out of the hospital immediately. Two days later, when the child was discharged, her parents were surprised by the extent of her injury.

The baby was discharged in good condition with the exception of the IV infiltrate on her foot. Her parents were very angry about an injury that they thought could have been prevented. The parents’ trust in the institution and its clinicians eroded when physicians and nurses blamed one another for the injury.

These parents brought suit against the nurse who cared for the baby when infiltration occurred. The nurse’s failure to monitor the IV resulted in considerable scarring and subsequent loss of motion as their daughter grew older. The suit was settled for $100,000.

This was a successful suit based on the following factors:
A review of the medical record revealed poor documentation of care rendered to the infant. Documentation was poor for the monitoring of the IV site. There was no documentation of the discussion with the family, and the medical record had been altered.
The lack of documentation of the IV checks made this case difficult to defend. Good documentation supports good care

The clinicians did not initiate, nor suggest any treatment related to the patient’s infiltrate. The first priority should be to attend to the patient’s medical needs. When appropriate, doctors must obtain medical consultation and arrange for consultants to forward necessary follow-up information.

The caregivers did not inform the parents about the infiltrate prior to their next visit at the hospital. When the parents discovered the injury on their own, they were told it was a minor injury. The physician or clinical staff should have apprised the family of the situation and helped them to understand the implications. No one did.

For more on medical safety issues, see the library of articles by Daytona Beach medical malpractice attorney.





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