A patient, who had a contrast infiltration from an IV placed in her left hand in preparation for a CT scan, brought a medical malpractice action against a hospital. The district court granted the hospital’s motion for summary judgment, holding that the patient could not prove her claim because the patient’s expert, a registered nurse, was not qualified to testify as to the hospital physician’s standard of care and could not prove that any alleged negligence on the part of hospital employees caused any injury. The Court of Civil Appeals reversed the district court’s judgment, concluding that a question of fact existed as to whether the hospital non-physician employees were negligent and caused the patient’s injury.
The Supreme Court of the State of Oklahoma stated in its April 28, 2026 Opinion: “The issue before this Court is whether Bean met her evidentiary burden by relying on expert testimony from a nurse to support her allegations of medical negligence against Hospital. We hold that Bean failed to prove a prima facie case of medical negligence. Bean’s claims against Hospital physicians fail as a nurse is not qualified to give expert opinions on the standard of care for physicians. Further, Hospital nurses cannot be held liable for complying with or failing to question a physician’s order if there is no evidence that the physician breached the applicable standard of care in issuing the order. Finally, Bean did not properly establish a causal connection between an alleged breach in Hospital’s standard of care and her injury.”
The Oklahoma Supreme Court explained: “Where the expert witness does not have the same education, training, or experience as the defendant medical provider, all of which are generally necessary to render an opinion of benefit to a jury, the witness is generally not qualified to serve as an expert. See 12 O.S. Supp. 2025, § 2702. The functions of physicians and nurses differ significantly. Physicians are authorized “to prevent, diagnose, correct, or treat . . . any disease, illness, pain, wound, fracture, infirmity, defect, or abnormal physical or mental condition.” 59 O.S.2021, § 492(C)(3)(a). In contrast, registered nurses are limited to making nursing diagnoses and performing treatments that fall within a nursing regimen, including completing physicians’ orders. 59 O.S. Supp. 2025, § 567.3a(2). As a result, there is a notable difference in the scope of diagnostic and treatment authority between the two professions, and that difference is the reason that nurses cannot opine as to the standards of care for physicians.”
“Here, Nurse Hadaway is a registered nurse who has a master’s degree in adult education. She holds board certifications in nursing professional development and infusion nursing. However, Nurse Hadaway has never worked as an emergency room physician. She does not have the authority to make medical diagnoses or prescribe drugs, including hyaluronidase. The Gaines case does not apply to the present case, as Nurse Hadaway is attempting to provide expert testimony regarding the standard of care applicable for an emergency room physician’s order to place a second IV in a patient with a recent history of heart surgery, as well as physicians’ orders for the treatment of a radiocontrast media infiltration. Nurse Hadaway is not qualified to offer such opinions. Specifically in this case, she is not qualified to offer expert opinion as to Hospital physicians’ orders regarding a second IV, the timing of the administration of the antidote (hyaluronidase), and the use of a heat compress to treat the infiltration. Our holding aligns with other jurisdictions, which similarly do not allow nurses to testify about a physician’s standard of care. Without expert testimony regarding the standard of care, Bean cannot prove that Hospital physicians failed to properly exercise or perform a duty to protect Bean from injury. Bean’s medical negligence claims fail to the extent they are predicated on the physicians’ actions.”
Claims Against Nurses Also Fail
Furthermore, “Bean claims that Hospital nurses are directly liable for their failure to question the physicians’ orders. Specifically, Bean alleges that Hospital nurses were negligent in following the physician’s orders to place a second IV, failing to insist that the physician order hyaluronidase earlier, and complying with the plastic surgeon’s order to administer heat to Bean’s hand. To prove this claim under Strubhart, Bean must first establish that Hospital physicians’ instructions were negligent. This requires her to establish that Hospital physicians breached the standard of care, which she cannot do without an expert opinion. Since Bean does not have an expert witness to testify about the standard of care expected from physicians, her direct claims against the nurses for failure to question the physicians also must fail.”
The Oklahoma Supreme Court held: “We conclude that Bean did not establish medical negligence against Hospital. Her claims against Hospital’s physicians are unsupported because a nurse is not qualified to provide expert opinions on the standard of care expected from physicians. Additionally, Hospital nurses cannot be held liable for following a physician’s orders or for failing to question those orders if there is no expert evidence that the physicians violated the applicable standard of care in issuing them. Lastly, Bean did not adequately demonstrate a causal link between any alleged breach of the Hospital’s standard of care and her injury. Accordingly, we vacate COCA’s opinion and affirm the district court’s judgment.”
Source Bean v. St. Francis Hospital, 2026 OK 27.
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