Oral arg. – COA – Aug. 26, 2015

At 1:30, the COA will hear the case of  Della Sumrall and Roy Sumrall v. Singing River Health System

Della Sumrall was admitted to Ocean Springs Hospital on  February 23, 2012, with cholecystitis (inflamation and/or irritation of the gallbladder).  It was decided that her gallbladder would be removed.  The anesthesiologist placed a  central line  in the external jugular vein. She was scheduled to be discharged on February 29.  On that day, the nurse removed the central line after which Della suffered a “neurological event” (defendants call it a stroke; plaintiffs call it an embolism)  resulting in brain damage.  Della and her husband sued.  The Hospital maintains that Della had other conditions which made her at high risk for stroke  (she  had high blood pressure, was a heavy smoker, suffered from diabetes, high cholesterol, and chronic obstructive pulmonary disease).  Plaintiffs contend that the stroke was from an embolism due to the negligent removal of the central line.

After a bench trial (Tort Claims Act), the court found for the defendants.

On appeal, plaintiffs claim the court erred in allowing Dr. Jim Corder to testify about the standard of care for nurses performing a central line removal because he was “not designated, not qualified, and not tendered as a nursing expert.”

Plaintiffs also argue that “The trial judge erred in requiring Plaintiffs to prove their case by overwhelming proof rather than by a preponderance of the evidence” and that the trial court’s ruling for the defense was against the overwhelming weight of the evidence.

Sumralls’ brief

Singing River’s Brief

Sumralls’ reply brief

Watch the argument here.

Some states do not allow doctors to testify regarding the standard of care for nurses. As one law journal article puts it: Nursing is Not a Lesser Included Profession: Why Physicians Should not Be Allowed to Establish the Nursing Standard of Care, 16 Quinnipiac Health L.J. 43.   Where this holds true, a plaintiff typically must hire a nursing expert to testify as to the standard of care and a doctor to testify about proximate cause.  Noted Pennsylvania lawyer Howard Bashman won a victory for plaintiffs’ lawyers when he got the Pennsylvania Superior Court to rule that a nursing expert can also supply causation.  Not sure about the state of Mississippi law on these issues.  The Plaintiffs here do not seem to be arguing that a doctor can’t testify as to the standard of care for nurses, only that the designation of Dr. Corder did not reveal that he would testify on this subject.

5 thoughts on “Oral arg. – COA – Aug. 26, 2015

  1. MS law vague on the expert issue. Possibly a doctor could claim to work closely enough with nurses to address their SOC on some aspects, but seems a bad practice. Most docs I depose are clear they can’t address a nurse’s SOC. Always a good question to ask.

  2. A central line blood clot, even if it existed, and was proven to exist as a result of the central line, CANNOT cause a stroke.

    A stroke occurs on the arterial side of the circulation, and the only way a possible clot can traverse into the arterial circulation is if there is a patent foramen ovale, or “hole in the heart.”

    A doctor cannot and should not testify as to the “nursing standard of care.” What the doctor CAN testify to is causation. Nurses do not place central lines, and they do not generally remove them. Regardless, even if the nurse does remove the line, this has nothing whatsoever to do with whether there may or may not have been a clot.

  3. ok,

    just read Bob Smith’s brief, and it makes more sense. It is entirely possible that this lady did have an “air embolism” and NOT a “stroke.” Bob is pretty sharp and he knows the difference between the arterial system and the venous system. Apparently, the Judge here does not?

    On Wed, Aug 26, 2015 at 2:52 PM, Joseph Blackston wrote:

    > A central line blood clot, even if it existed, and was proven to exist as > a result of the central line, CANNOT cause a stroke. > > A stroke occurs on the arterial side of the circulation, and the only way > a possible clot can traverse into the arterial circulation is if there is a > patent foramen ovale, or “hole in the heart.” > > A doctor cannot and should not testify as to the “nursing standard of > care.” What the doctor CAN testify to is causation. Nurses do not place > central lines, and they do not generally remove them. Regardless, even if > the nurse does remove the line, this has nothing whatsoever to do with > whether there may or may not have been a clot. > > On Wed, Aug 26, 2015 at 10:40 AM, Jane’s Law Blog <

  4. My sister is a nurse. She watched the whole thing and was rather unimpressed by the care this woman received. She also wondered how it was doctors could testify as to the standard of care for nurses.

  5. Whom better to judge if nursing care is adequate than a physician? Why on earth hospitals are letting nursing staff place and remove central lines is curious. I wonder if it was a nurse anesthetist that removed the central line and that would be a whole different ball game.

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