The Most Common Malpractice Claims Against Nurses: Medication Errors, Patient Neglect, and Documenta

Nurses play an indispensable role in patient care, often serving as the first line of defense against medical errors. However, when mistakes occur, nurses can face malpractice claims just like doctors. While nursing malpractice cases may not always be as widely publicized as physician-related claims, they are equally significant and can lead to patient harm, legal consequences, and professional setbacks.

Nursing malpractice typically involves:
✔ Medication errors that cause adverse effects or even fatality.
✔ Negligence or failure to provide appropriate patient care.
✔ Failure to document crucial medical information.

This article will explore:
✔ The most common malpractice claims against nurses.
✔ Real-life examples illustrating how these errors happen.
✔ How nurses can shield themselves from legal risks.
✔ Preventive measures to enhance patient safety.

By recognizing these risks, nurses, nursing students, and healthcare professionals can take proactive steps to mitigate these potentially catastrophic errors.

1. What Is Nursing Malpractice?

Nursing malpractice occurs when a nurse fails to meet the standard of care, leading to patient harm. For a malpractice claim to be valid, the following key elements must be established:

✔ Duty: The nurse had a professional obligation to the patient.
✔ Breach of duty: The nurse deviated from standard nursing practices.
✔ Causation: The error directly resulted in patient injury or harm.
✔ Damages: The patient suffered physical, emotional, or financial distress due to the mistake.

Although doctors often bear the brunt of medical error blame, nurses can also face lawsuits, license suspension, or even job termination due to malpractice.

2. The Most Common Malpractice Claims Against Nurses

A. Medication Errors: The Leading Cause of Nursing Malpractice Claims
Administering medication is a critical nursing responsibility, but it is also one of the most error-prone aspects of patient care.

✔ Wrong medication given to a patient.
✔ Incorrect dosage administered.
✔ Failure to check for allergies or drug interactions.
✔ Misinterpretation of a physician’s prescription.
✔ Administering medication via the wrong route (IV instead of oral).

Example Case: A nurse in a hospital accidentally administered 10 times the prescribed dose of insulin, causing hypoglycemia and coma. The patient’s family sued, and the hospital settled for millions of dollars.

Why It Happens:

• Fatigue and excessive workload leading to concentration lapses.
  
  
• Failure to double-check medication labels and dosages.
  
  
• Distraction in high-pressure hospital environments.

How to Prevent It:
✅ Follow the “Five Rights” of Medication Administration (Right Patient, Right Drug, Right Dose, Right Route, Right Time).
✅ Always verify high-risk medications (insulin, opioids, anticoagulants).
✅ Seek clarification if a prescription is unclear.

B. Patient Neglect and Failure to Monitor
Nurses are responsible for continuously monitoring patient conditions and ensuring timely medical interventions. Failure to do so can result in severe patient harm and malpractice claims.

✔ Neglecting to reposition bedridden patients, leading to pressure ulcers.
✔ Ignoring call bells or emergency alarms.
✔ Delaying care for deteriorating patients.
✔ Failing to monitor IV lines, catheters, or ventilators.

Example Case: A nurse failed to assess a post-surgical patient who complained of chest pain. The patient later suffered a fatal heart attack, and the family sued the hospital for nursing negligence.

Why It Happens:

• Understaffing results in rushed or inadequate patient care.
  
  
• Failure to prioritize high-risk patients.
  
  
• Breakdowns in communication between nurses and doctors.

How to Prevent It:
✅ Adhere to hospital protocols for patient monitoring.
✅ Report any significant changes in patient condition immediately to the physician.
✅ Maintain comprehensive and accurate patient records.

C. Failure to Document: A Hidden Legal Risk
Accurate documentation is not merely a nursing requirement—it is a legal safeguard. If a record is missing from the patient’s chart, it is considered nonexistent in legal proceedings.

✔ Omitting documentation of medication administration.
✔ Failing to record changes in a patient’s condition.
✔ Neglecting to document critical observations or test results.
✔ Incomplete nursing notes on patient care.

Example Case: A nurse forgot to document that a patient refused medication. When the patient’s condition worsened, the hospital was sued for negligence, despite verbal instructions being given.

Why It Happens:

• Heavy workloads causing documentation delays.
  
  
• Assuming another nurse will record the necessary details.
  
  
• Overreliance on memory rather than immediate documentation.

How to Prevent It:
✅ Document all patient care actions immediately.
✅ Use precise and objective language—avoid personal assumptions.
✅ If a patient refuses care, record the refusal and inform the physician.

D. Failure to Communicate with Physicians and Colleagues
Miscommunication is a leading cause of medical errors, and when nurses fail to relay critical patient information, it can lead to delayed or inappropriate treatment.

✔ Not reporting abnormal vital signs or lab results to doctors.
✔ Failing to provide essential details during shift handovers.
✔ Neglecting to clarify unclear physician orders.

Example Case: A nurse observed a patient’s oxygen levels dropping but failed to notify the physician. The patient later suffered a respiratory arrest, leading to a malpractice lawsuit.

How to Prevent It:
✅ Always report significant patient changes immediately.
✅ Use SBAR (Situation, Background, Assessment, Recommendation) for clear communication.
✅ Never assume a doctor is already aware of the issue—always confirm.

3. Legal Consequences of Nursing Malpractice

Nurses found guilty of malpractice may face:
❌ License suspension or revocation.
❌ Job termination.
❌ Lawsuits resulting in financial penalties.
❌ Criminal charges in severe cases.

Fact: In some jurisdictions, nurses can be sued personally, even if the hospital shares liability.

4. How Nurses Can Protect Themselves from Malpractice Claims
✅ Adhere to hospital protocols and avoid shortcuts in patient care.
✅ Document thoroughly—medication administration, assessments, and refusals must be recorded.
✅ Communicate clearly with doctors and colleagues—report all concerns promptly.
✅ Participate in continuous training on medication safety and patient care.
✅ Understand your legal rights and malpractice insurance coverage.

Final Thought: Nurses play a critical role in patient safety, and small errors can have severe consequences. By staying vigilant, well-trained, and cautious, nurses can reduce malpractice risks while safeguarding their careers and patients.