Outline of Basic Legal Issues -

BASIC ISSUES IN NURSING LAW

I. CIVIL LIABILITY – CAUSES OF ACTION AGAINST NURSES

     A. Ordinary Negligence

          1. Elements

          2. Direct and Circumstantial Evidence

          3. Fact and Expert Witnesses

          4. Burdens of Proof

          5. Res Isps Loquitor

     B. Professional Negligence or “Malpractice”

          1. Distinction from Ordinary Negligence

          2. Standards of Care

               a) National vs local standards

               b) Sources of Standards

               c) Expert Testimony Requirement

               d) Nurse Expert Witnesses

          3. Vicarious Liability

          4. Defenses to Negligence and Malpractice

               a) Pleading and Waiver

               b) Statute of Limitations

               c) Good Samaritan Laws

               d) Sovereign Immunity

               e) Comparative Negligence

               f) Exhaustion of Administrative remedies

               g) Freres and Bivens Doctrine

               h) Leaving Against Medical Advice

     C. Product Liability

          1. Medical devices

          2. Pharmaceuticals

          3. Toxic Torts

     D. Intentional Torts

          1. Assault

          2. Battery

               a) Lack of Consent

               b) Sexual Misconduct with Patients

               c) Intentional harm

          3. False Imprisonment

               a) Physical restraint

               b) Chemical restraint

               c) Confinement in Radiological Equipment

          4. Invasion of Privacy

          5. Intentional Actions of Third Parties

     E. Quasi-Intentional Torts

          1. Defamation

               a) Libel

               b) Slander

               c) Defenses

          2. Privacy

          3. False light

          4. Disclosure of confidential information

     F. Breach of Contract

     G. Lack of Informed Consent

     H. Statutory Causes of Action

          1. EMTALA

          2. HIPAA

          3. Health Care Fraud and Abuse

          4. Patient Self-Determination Acts

     I. Tort Reform – Impact on Malpractice Law

II. KEY AREAS OF POTENTIAL LIABILITY FOR NURSES

     A. Observation/Communications and Monitoring

     B. Medication Errors

     C. Abandonment

     D. Delegation

     E. Supervision

     F. Patient safety  

     G. Physician Orders and Duty to Intervene

III. LICENSURE AND DISCIPLINARY PROCEEDINGS:

     A. Historical Background

     B. The Administrative Law Process

    C. Scope of Nursing Practice

          1. Nurse Practice Acts

          2. Mimimum Licensure Requirements

          3. Advanced Practice

          4. Continuing Education

          5. Standards of practice

               a) Protocols, standing orders and procedure manuals

               b) Professional associations

     D. Peer Review

          1. Purpose and process

          2. Safe Harbour Rules

     E. Disciplinary Process

          1. Role of Board of Nurse Licensure

          2. Grounds for disciplinary actions

          3. Disciplinary procedures

          4. Individual rights

          5. Potential outcomes

IV. CRIMINAL LIABILITY

     A. General Principles

     B. Criminal actions against nursing personnel

V. RESPONSIBILITY FOR PROFESSIONAL LIABILITY

     A. Liability Insurance

     B. Disciplinary Insurance

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Posted on: May 21, 2007

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