September 21, 2020

The State of Michigan Court of Appeals (“Michigan Appellate Court”), in its unpublished opinion dated August 13, 2020, stated: “Defendant is correct that the evidence showed that defendant’s nursing and medical staff undertook several interventions that were aimed at providing additional ventilation and oxygenation for Blackwell in order to save his life. The record also demonstrates that Ring [plaintiff’s nursing expert] has criticized defendant’s nursing staff for not undertaking the appropriate measures to secure an airway for Blackwell and to provide oxygen for him. In our opinion, the divergence in the evidence creates genuine issues of material fact to be resolved by the trier of fact, not only with regard to determining what measures were in fact undertaken, but whether the measures were undertaken correctly, in a timely fashion, in the correct sequence from a medical standpoint, and whether the interventions reasonably likely would have saved Blackwell’s life. Accordingly, defendant was not entitled to summary disposition of the nursing-malpractice claims under MCR 2.116(C)(10).”

The Underlying Facts

Thirty-year-old Jason A. Blackwell (“Blackwell”) died on March 17, 2012 in the Intensive Care Unit (ICU) of the defendant hospital after his tracheostomy tube became dislodged and several members of the defendant’s staff were not able to secure an airway (i.e., at approximately 6:20 a.m. on March 17, 2012, Blackwell suffered respiratory distress. When the attending nurse, Sara Enser, R.N., was unable to rectify the situation by herself, a Code Blue was called, but multiple intervention efforts by the defendant’s medical and nursing staff were unsuccessful in securing an airway. Blackwell died at 6:44 a.m.).

The Michigan medical malpractice wrongful death plaintiff alleged malpractice against the defendant hospital based on its development and implementation of its Code Blue policy, and additionally for nursing malpractice. Following discovery, the defendant filed several motions for summary disposition challenging the qualifications of the plaintiff’s expert witnesses and the causation element of the plaintiff’s nursing-malpractice claims. The trial court’s rulings on these motions led to the plaintiff’s appeal.

Michigan Appellate Court Opinion

The Michigan Appellate Court stated: “In our opinion, Ring’s testimony regarding how defendant’s nursing staff breached the standard of care, taken together with Dr. Allen’s testimony regarding how the failure of defendant’s staff to appropriately intervene to secure an airway for Blackwell, and the reasonable inferences drawn from this evidence, all viewed in the light most favorable to plaintiff, demonstrate that genuine issues of material fact exist with regard to the causation element of plaintiff’s claim of nursing malpractice … Specifically, Dr. Allen testified that a tracheostomy tube is more likely to become dislodged when a patient is moved rather than simply as a result of a patient coughing. Viewed in the light most favorable to plaintiff, Dr. Allen’s testimony can be seen as establishing that Nurse Enser may have dislodged Blackwell’s tracheostomy tube when she moved him. Nurse Enser, as well as other nurses, were present after Blackwell’s tracheostomy tube became dislodged. Dr. Allen testified that there was “nobody present who could” understand and “fix the situation,” which he opined led to Blackwell’s death. Consequently, based on Dr. Allen’s testimony, if Nurse Enser or another person present at the Code Blue had been able to understand and fix the situation then Blackwell would not have died. Thus, viewed in the light most favorable to plaintiff, there is a dispute of material fact regarding whether Blackwell died as a result of nursing malpractice, because the evidence established a causal link between the alleged breaches of the standard of care by the nursing staff and Blackwell’s death. In other words, factual disputes remain concerning whether, but for the nursing staff’s failure to perform the interventions Ring testified were required by the standard of care, an airway would have been secured for Blackwell, thereby enabling him to survive the Code Blue … Accordingly, the trial court erred by granting summary disposition as to plaintiff’s claim for nursing malpractice.”

Source Blackwell v. St. Mary’s of Michigan,  No. 346652.

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