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The patient was paraplegic. A home health agency was sending a nurse's aide and an LPN to his home because he had severe bedsores, although that was not the problem that resulted in him suing his home health agency.


The patient's penis and scrotum became red and swollen and there was blood in his urine. The aide reported it to the LPN and the LPN went to see him that day. He contacted the nephew and the patient's sister took him to the hospital the following day. He was given antibiotics and told to return in 10 days.


Two days later the nurse returned and saw the problem was unchanged or was becoming worse. He told the patient to go to the hospital but the nurse himself made no effort to transport the patient to the hospital.


Three days later the situation was unchanged and the same event occurred. The nurse told the patient to go to the hospital but did nothing to ensure that he went.


Two days later the nephew escorted the patient to the hospital. By now it had become necessary to debride necrotic tissue from the penis surgically.


The patient sued for the necrosis and claimed the surgery would not have been necessary with more prompt medical intervention. The jury sided with the home health agency. The Court of Appeal of Louisiana threw out the jury's verdict and awarded $250,000 (reduced by 50% for the patient's own comparative negligence).


Nurse's Role as Patient's Advocate

The court ruled that a nurse's role as advocate for the patient means a nurse must do more than advise a patient and let it go when the patient does not follow the nurse's advice. A nurse has to take action, the court ruled. The nurse should have contacted a family member and followed up to make sure the patient was taken to the hospital. Coleman v. Christian Home Health Care. 786 So. 2d 819 (La. App., 2001)


A nurse has the responsibility to act as advocate for the nurse's patient.


This means when a home health nurse knows the client is not following through on the nurse's advice to call a family member and go to the hospital, the nurse must take action and transport the client to the hospital.


The nurse's responsibility is especially acute with a disabled patient like this man who was paraplegic and lived alone.


Nevertheless, the patient is partially responsible for his own injuries.


He was paraplegic but he was not helpless.


He was catheterizing himself and was fully aware something was seriously wrong that demanded immediate medical attention.


He only had a physical disability. He had no cognitive impairment to prevent him from comprehending the nurse's instructions to call someone and go to the hospital.


The nurse was negligent. The patient was 50% comparatively negligent.


Court of Appeal of Louisiana, 2001.


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