Hospital Patient With Pneumonia Suffers Cardiac Arrest

Wendy Ketner, M.D.

Written by
— Updated on September 27, 2018

salineThis case takes place in Oklahoma and involves a patient who was admitted to the hospital after developing pneumonia. A laboratory test indicated the patient had a low blood-sodium level. A three percent intravenous saline solution was ordered for the patient. The three percent saline solution was administered intravenously to the patient by a nurse. Later that evening, a new nurse came on duty and did not check on the patient because she had to do paperwork. When the patient’s doctor came to check on him, he found the patient in cardiac arrest. The patient was resuscitated, but because his heart had stopped for between four and ten minutes, he sustained brain damage. He remained in a coma and died a month later. The patient’s family sued the hospital claiming that the nurse on duty had been negligent in failing to monitor the patient’s condition closely.

Question(s) For Expert Witness

  • What is the standard of care when administering IV saline solution to a patient?

Expert Witness Response

In most cases, a person’s normal body fluids are one percent saline. If a patient is admitted to a hospital with pneumonia and has a low blood-sodium level, an arterial blood gas test must be ordered by the hospital staff to determine the pneumonia’s effect on the patient’s blood-oxygen level. It would be a violation of the standard of care for the hospital staff to fail to administer such a test before administering a three percent saline solution. Since the nurse who administered the IV saline solution to the patient in this case did not measure the patient’s blood gas to determine how serious the pneumonia was, she had no way of knowing how dangerous it was to add sodium to the patient. The nurse did not meet the proper standard of care in this case because she did not properly evaluate the risk of giving the patient sodium. For the second nurse to have met the proper standard of care, she would have had to monitor the patient’s reaction to the three percent saline solution before his doctor arrived to check him.

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