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Expert Testimony Regarding Meaning of Doctor’s Standing Order Relevant Only If Nurse Misunderstood or Found It Ambiguous


 A pregnant woman underwent a cesarean delivery of her baby. The antibiotic Cefotan was not administered at the time of clamping of the umbilical cord as required by the obstetrician’s standing order. The standing order stated, “For all C-sections: Have 2 grams of Cefotan prepared for infusion at the time of cord clamping.” The standard procedure was for the anesthesiologist to administer all drugs via IV. However, the nurse did not give the Cefotan to the anesthesiologist, the doctor did not give an oral order for the Cefotan to be administered, and the anesthesiologist did not mention the lack of Cefotan. An aggressive Streptococcus-A infection developed. The woman died due to complications from the infection.

 

The woman’s estate sued the obstetrician’s medical practice group for failing to administer the antibiotic Cefotan during the cesarean section. At trial, the court did not allow the plaintiff to present expert testimony on the meaning of the doctor's standing order regarding the antibiotic to show that the doctor's order was merely a “prepare” order. The nurse’s and doctor’s testimony regarding the meaning of the standing order indicated that they both understood the order to mean the same thing. The plaintiffs were not allowed to impeach the defendant’s expert witness with the deposition of another doctor. The plaintiff appealed. The court of appeals affirmed. The plaintiff appealed.

 

The Supreme Court of Kentucky affirmed holding that the trial court did not abuse its discretion when it disallowed expert testimony on the meaning of the doctor's standing order regarding the antibiotic. Proof regarding the meaning of the order was relevant only if the person to whom the order was directed, the nurse, misunderstood it or thought it was ambiguous. As the testimony of the doctor and the nurse indicated that they both understood the order to mean the same thing, there was no ambiguity in the order.

 

See: Tucker v. Women's Care Physicians of Louisville, P.S.C., 2012 WL 5274577 (Ky., October 25, 2012) (not designated for publication).

 

 

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