Medical Malpractice

What Are the Elements of a Nursing Malpractice Claim?

January 20, 2016

Table Of Contents


When patients go to hospitals or have procedures performed, they often spend more time with nurses than doctors. The interactions with RNs save time and make doctors more efficient. But shifting responsibility to them potentially exposes patients to nursing malpractice.

Whether the nurse fails to keep doctors properly informed of the patient's condition or performs a procedure incorrectly, patients can suffer an injury from nursing negligence. Fortunately, a nursing malpractice lawyer can pursue claims for medical malpractice against nurses and their employers by proving duty, breach of duty, causation, and damages.

What Are Medical Malpractice Cases in Nursing?

All healthcare professionals, including nurses, owe patients a duty to provide reasonable care under the circumstances. Medical malpractice cases in nursing happen when a nurse fails to meet this professional standard of medical care, and as a result, a patient suffers injury or death. These cases can also give rise to claims for negligent supervision if another nurse had a duty to supervise the allegedly negligent nurse.

Common Examples of Malpractice Claims Against Nurses

Nursing malpractice claims against nurse practitioners and RNs can take many forms. The nursing staff has many responsibilities in the nurse-patient relationship. Examples of acts or omissions that can lead to medical malpractice claims against nurses include:

  • Failure to monitor patients for conditions like bedsores and urinary tract infections
  • Medication errors involving the wrong dose or medication
  • Mistakes while performing routine procedures entrusted to them, like drawing blood, catheterizing patients, and intubating patients
  • Poor documentation that leaves doctors and administrators with incorrect or missing information
  • Bad screening, where they fail to ask questions about a patient's symptoms, allergies, and medical history

In many cases, medical malpractice committed by a nurse often goes unnoticed until an adverse event, such as an allergic reaction or drug overdose, occurs. Unfortunately, by the time anyone notices anything, the patient may have already suffered serious harm.

Who Is Responsible for Nursing Malpractice?

When a nurse acts negligently, they bear liability for their actions. However, others can share in the liability through actions such as:

  • Fellow nurses saw someone do something harmful and failed to intervene or report the harm
  • Supervising nurses neglected to train and monitor the nurses working under them
  • Doctors gave incorrect or unclear instructions to nurses or failed to follow up with nurses after assigning a task
  • Hospitals hired nurses with poor track records and failed to supervise nurses to make sure they perform competently

The entities involved in your medical malpractice claim may start with nursing staff but run all the way up to the hospital administrators. As your medical malpractice lawyer investigates your case, you may find that many others were involved.

The Four Elements of Nursing Malpractice

Everyone in the medical field is supposed to provide care that meets the required standard of care. The standard may be very specific to nurses or it may be more general. In order to file a medical malpractice lawsuit against a nurse, there are four elements of medical malpractice that must be met. These requirements for nursing malpractice are the same as they are for any medical professional, including doctors and hospitals.  The four elements of nursing malpractice are:

1. Duty

There must be a duty owed to the patient.  For example, the patient is owed a safe environment, and a nurse has a duty to follow physicians' orders for the patient. These duties arise from the nurse-patient relationship. You must show that the nurse had a legal duty to provide care to you. For example, if you have a heart attack on a bus, nurses do not have a duty to leap to your aid and try to save you. But once they start administering CPR, they create the nurse-patient relationship and must provide care that matches what a competent nurse would provide.

2. Breach of Duty

The specific duty owed to the patient has been breached, meaning that the duty has not been met. In terms of the safe environment, perhaps a nurse forgets to put the bed rail up and the patient falls. The nurse's failure to maintain the patient's safe environment would constitute a breach of duty.

You will find a breach of duty of the duty owed wherever nurse competency was lacking. But tracing your injuries to a nurse's breach of duty may be difficult. If you contract an infection in a hospital, you might not know whether they failed to scrub their hands or a custodian failed to sanitize your room. Ultimately, it may not matter who was to blame because a hospital bears liability when any employee meets the four elements.

3. Damages

The breach of duty must have caused injuries that result in damages.  The injuries the patient suffered when falling out of bed are the damages that can be claimed.  If the patient was not injured, there are no damages. In other words, even if the nurse made a mistake, you can only sue if you suffered harm.

But bear in mind that you do not need to suffer some grievous injury to have damages. Any bodily injury, emotional distress, or discomfort you experienced qualifies as damages. So if you suffer bedsores when a nurse forgets to turn you, you have damage even though the bed sores healed. Conversely, if they neglect to change your dressing but someone else changes it before you suffer any adverse events, you do not have a legal claim.

4. Causation

This is generally the most difficult element to prove in a medical malpractice lawsuit. There must be a direct cause-and-effect link between the breach of duty and the injury to meet the fourth and final element of the four elements.  The breach of duty must have caused the injury. In the example, if the nurse had not left the bed railing down, the patient would not have fallen.  The nurse's breach of duty caused the injury.

At the same time, if a nurse's negligence sets off a chain of events, you can still prove causation. For example, suppose that a nurse fails to monitor a patient's vital signs. As a result, the doctor is unaware that the patient's blood pressure has dropped and orders the patient released. The patient falls down the stairs after passing out due to low blood pressure. The nurse's failure falls in the causal chain under medical malpractice law.

What Are the Consequences of Nursing Malpractice?

The four elements of nursing malpractice can cause physical, mental, and financial harm. Some consequences of nursing malpractice include:

Health Complications

Nursing malpractice can lead to adverse health events. Sometimes, these events are minor and temporary, like a bruise from a fall. But these events can also cause significant and permanent injuries like the loss of a limb.

Wrongful Death

Family members can pursue a wrongful death claim when a nurse's negligence kills a loved one. If you believe a relative died due to nursing malpractice, contact a wrongful death lawyer to discuss your claim.

Financial Loss

Injuries from nursing malpractice can require corrective medical treatment. They may also disable you from working. Your medical bills, lost wages, and out-of-pocket expenses constitute financial losses you can pursue in a nursing malpractice claim.

Emotional Distress

Nursing malpractice can cause emotional distress. If you suffered an injury, you might have anxiety about your health and finances. You also might become depressed if your injuries disabled you.

When you're injured by a nurse's breach of duty, you can pursue a medical malpractice case. Contact us to discuss your case with an experienced malpractice and personal injury attorney.

How to Protect Yourself Against Nurse Practitioners’ Malpractice

Patients can sometimes prevent nursing malpractice by:

Paying Attention

Sometimes, a nurse's negligence results from misunderstanding the doctor's orders. Pay attention to the doctor's instructions and guide the nurse so the orders are performed correctly.

Asking Questions

Ask questions to prompt the nurse to seek help. For example, you can ask questions if the nurse does something wrong, like:

  • Not having the correct medication
  • Failing to record your vital signs
  • Trying to lift you, risking patient falls

Nursing malpractice often happens due to carelessness rather than malice. Asking questions can keep the nurse on track.

How to Determine If You Have a Nursing Medical Malpractice Lawsuit

Sometimes, the signs of nursing malpractice are not obvious. A few signs you can look for include:

Adverse Drug Events

Some medication errors are unavoidable. But others happen due to nursing malpractice, including:

  • Failing to ask you about drug allergies
  • Administering the wrong dose
  • Administering the wrong medication

Errors can cause serious or fatal injuries.

Physical Injuries

Physical injuries can happen from:

  • Patient falls
  • Loose or unused bed rail
  • Bedsores
  • Neglecting or ignoring calls for assistance

Physical injuries can range from bruises to broken bones.


Infections might result from poor hygiene. They can also result from unsanitized instruments and equipment. Infections also happen when hospital staff fail to change dressings and watch for signs of infection.

Confusion or Inexperience

A nurse who is confused or inexperienced often suffers from a lack of training and supervision. Confusion might also occur when your doctor gives the nurses unclear instructions or, even worse, no instructions. If your nurse failed to do something or did it incompetently, you might have experienced nursing malpractice.

Average Settlement in Nursing Malpractice Claims

If you need to pursue medical malpractice litigation against a nurse or their employer, you can pursue compensation for your financial losses and non-economic damages. Fortunately, New York law does not cap the damages you can receive in a malpractice claim. Instead, the legal system allows you to pursue compensation for:

  • Medical costs
  • Lost wages
  • Diminished earning capacity
  • Pain
  • Mental anguish

Since these losses are unique to your particular situation, there is no average settlement. Instead, a fair settlement will vary depending on your injuries and how they affected your life.

What to Do If You Are a Victim of Nursing Malpractice

If you suspect nursing malpractice, you should seek both medical and legal assistance. A doctor can review your medical records and determine whether your nurse violated New York State's Nurse Practice Act, which sets the standards for nursing.

A medical malpractice lawyer New York practitioner can analyze the four elements of nursing malpractice and determine whether you received reasonable care under the circumstances.

Possible Causes of Malpractice in the Nurse-Patient Relationship

When you need health care services, you expect doctors and nurses to be at their best. But often, healthcare providers are compromised due to:

  • Overwork and fatigue
  • Lack of training
  • Poor supervision and communication
  • Substandard record-keeping

Nursing malpractice happens for many reasons. Often, it results from a combination of factors. But these factors are almost always preventable.

Hospitals that fail to hire enough staff might bear liability for the fatigue they experience from working too many shifts with too little rest. Doctors bear liability if they provide poor supervision and fail to give clear instructions. And senior nursing staff may be liable if they do not train others in the hospital's systems and procedures.

What Can Be Done to Avoid Nursing Malpractice?

Hospitals are in the best position to avoid nursing negligence. By implementing standards for nursing care and systems to prevent errors, such as medication errors, hospitals can improve patient safety. They can also avoid a nursing breach of duty by:

Creating Established Lines of Communication

Communication among doctors, nurses, and patients is critical to avoiding mistakes. A patient's condition should be known to everyone implementing the treatment plan. Communication systems and a collaborative and safe environment can reduce the risk of a nursing breach of duty.

Setting Expectations for Nurses

Nurses sometimes feel forgotten in the healthcare process. Make sure they understand their importance in delivering reasonable care regardless of the department where they work. At the same time, hospitals should set expectations for each nurse to minimize mistakes, provide reasonable care, and become patient advocates.

Jacob Fuchsberg Law Firm Is Ready to Fight for the Compensation You Deserve

Medical malpractice cases are often complex and time-consuming. As a result, you need a nursing malpractice attorney who can investigate your injuries, gather evidence from nurses and their employers, and fight for the compensation you deserve.

If you think you have been injured by a nurse because of malpractice, schedule a consultation with the Jacob Fuchsberg Law Firm to discuss your case with one of our New York medical malpractice attorneys. You can contact us online or by calling (212) 869-3500.