Legal Lesson of the Month: The Dislodged IV Needle

Legal Lesson of the Month: The Dislodged IV Needle

Article Jul 11, 2018

EMS can be full of interesting and tricky legal scenarios. While you can’t have an attorney ride with you, it behooves providers to have at least some familiarity with the principles, precedents, and major issues of EMS law. To that end EMS World is pleased to offer the EMS Legal Lesson of the Month.

These cases are presented by prominent attorneys in the EMS field. This month’s comes from Larry Bennett, program chair for fire science and emergency management at the University of Cincinnati. Bennett’s departmeLawrence.bennett@uc.ednt publishes a monthly Fire & EMS and Safety Law newsletter; subscribe to that by e-mailing u or read the latest edition here. Find this case and more in his section on EMS cases

Case: Lee Roy Bember v. American Medical Response of Connecticut, Inc. 

Decided: April 2016

Verdict: A New Haven superior judge found AMR liable for negligence of its personnel who delivered dextrose through an improperly inserted IV. 

Link: http://ceas.uc.edu/content/dam/aero/docs/fire/IV.pdf

Facts: Plaintiff Lee Roy Bember’s girlfriend, Ashley Gill, called 9-1-1 because Bember was having a diabetic crisis. Paramedics Frank David and Greg Thornhill responded, took the plaintiff’s vital signs, and noted his GCS score was 6 and blood glucose 49 mg/dL. They attempted to initiate an IV while the plaintiff lay on his back on his bed. 

Unable to start the IV in Bember’s left arm, David reached across to begin it in the right. Satisfied with the needle insertion, he began administering 50% dextrose. As that began Gill observed that the IV needle did not appear to be fully inserted. As the dextrose entered the plaintiff’s forearm, he cried out in pain, and Gill observed that his arm became swollen. Dextrose can cause tissue necrosis and or death if it enters the “third space” of the forearm instead of the vein. David stopped the IV, but 12.5 grams of dextrose had already entered the plaintiff’s forearm. 

On arrival at the hospital, Bember was diagnosed with compartment syndrome as a result of the dextrose and underwent emergency fasciotomy. A second surgery and skin graft followed. 

Key quote: “The defendant breached the standard of care in that its employees failed to adequately secure the IV catheter after insertion so as to prevent dislodgement from the plaintiff’s vein; in that they failed to properly monitor the IV catheter after insertion into the plaintiff’s right forearm; in that they failed to pay proper attention while injecting the dextrose medication into the plaintiff’s right arm; in that they failed to properly restrain the plaintiff so as to prevent the IV catheter from becoming dislodged.”

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Legal lesson: Practice IV skills and be very observant of patients. 

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