WEST PALM BEACH – The Florida Fourth District Court of Appeal recently reversed a jury’s verdict that found a physician was negligent in his supervision of an advanced practice nurse practitioner (ARNP) and ordered a new trial in the suit related to a patient’s death at a drug detoxification facility.
The appeals court, in its July 25 decision, also reversed was a post-verdict order that placed 100 percent of the liability on the physician.
The suit filed against Dr. Antonio F. Defilippo and South Florida Psychiatric Services Inc.claimed the alleged negligence resulted in a patient’s death at the facility although the physician had no knowledge of the patient’s admission to the facility until after the patient died.
The appeals court decision cited three errors at the trial in the 17th Judicial Circuit Court for Broward County
The first error included the prevention of Dr. Defilippo from testifying that he was not at the detox facility when the patient was admitted and was not notified of the patient’s existence until after the patient had died.
The second error claimed that the jury’s instruction regarding a section of the Nursing Practice Act of the Florida Statutes was “reasonably calculated to confuse or mislead the jury.” The third error was the request to “allocate 100 percent of the liability on the physician after the jury had found the physician 20 percent liable and the detox facility 80 percent liable.”
The appeals court stated that “based on the foregoing errors, we reverse and remand for a new trial.”
In addition to these three errors cited in the decision, Appeals Judge Jonathan Gerber cited an additional error, stating that “denying the physician’s motion for partial summary judgment, which argued that, as a physician, he owed no duty of care under section 464.012, because ARNPs are the subject of that statute."
Section 464.012 of the Florida Statutes, Gerber wrote, was part of the “Nurse Practice Act.” The act, the filing indicated, has a “sole legislative purpose” to regulate the actions of nurses and nurse practitioners within the state of Florida. The appeal decision stated that “it cannot be logically concluded … that physician’s behavior is the subject of section 464.012 ... because physicians’ behavior is not the subject of section 464.012."
The lawsuit was the result of a death of Michael J. Curtain, who checked himself into the detox facility late one evening. Curtain was assessed by the ARNP whose services, according to the filing, included “evaluating patients to determine whether they could be admitted into the facility or instead required hospital emergency room treatment.”
The ARNP admitted Curtain to the facility and planned to begin the detox process the next morning. When she left the facility at 11 p.m., she instructed the staff to do a bed check “every 15 minutes and take his vital signs every 30 minutes.”
Sometime in the early morning, the patient died. The medical examiner’s autopsy stated that the cause of death was “endocarditis, which is an acute bacterial infection of the inner lining of his heart chamber and valves.” The cause of the infection was determined to be from the patient’s intravenous drug use.
The ARNP did not contact the physician, who served as the facility’s medical director as an independent contractor. The ARNP testified in court that “in my clinical decision, he was OK to stay. And typically, (the physician) would depend on me to be able to see and give a proper and quality assessment, which I did. I could not have known (the patient) had bacterial endocarditis.” The filing also stated that before she left that evening, the ARNP stated the patient was “sitting upright, speaking, and his vital signs were improving.”
The patient’s estate later sued the physician, the ARNP and the detoxification facility, claiming “negligent supervision of the ARNP.”
According to the filing, the estate settled with the ARNP and the facility. The case against the physician moved to trial. In the trial, the jury found the physician was negligent in his supervision of the ARNP and that the negligence was the “legal cause” of the patient’s death. Further, the jury found that 20 percent of the liability should be allocated to the physician and 80 percent to the detox facility. The estate’s damages amounted to $1,312,000.
The post-verdict order had granted the estate’s request to allocate 100 percent of the liability on the physician.