Ordinary Negligence or Medical Malpractice?
was a resident at Oak Woods Nursing Center.
She suffered from dementia and diabetes, had suffered several
strokes, and required 24-hour care that included assistance with
grooming, eating, toileting, and bathing. The patient's condition
impaired her judgment and reasoning ability and, in turn, caused
cerebral atrophy (loss of brain cells). Ms. Hemming had no control
over her movements in bed, and hence, was prone to sliding about
without sensing her position in bed. This lack of control was
addressed in the patient's plan of care in which the facility's medical
director authorized the use of various physical restraints. These
included bed rails to keep the patient from sliding out of the bed, and
a restraining vest that would keep her from moving her arms, thereby
impeding her ability to slide. The physician's orders also included
wedges or bumper pads that were placed on the outer edge of the
mattress to keep the patient from hurting herself by striking, or by
entangling herself in the rails. According to nursing home
regulations, the use of restraints of this sort must be authorized by a
physician to prevent overuse and excessive patient confinement.
Ms. Hemming died of asphyxiation after her neck got caught
between the raised bed rails and the mattress. The day before her
death, two nursing assistants had found the patient tangled in her
restraining vest, gown, and bed sheets. The employees untangled her,
repositioned her, and used wedges and pads so that she would not
slide into the gap between the mattress and the bed rail. Whether the
aides informed their supervisor about the risk remained unclear.
Denise Benton, as personal representative of Hemming's estate, sued
Oak Woods. After subsequent amendments to the initial complaint,
the case eventually came before the state's Supreme Court. In
claiming medical malpractice, Benton's complaint made four
specific allegations: (i) Oak Woods failed to ensure that Ms.
Hemming was provided an accident-free environment; (ii) Oak
Woods failed to train its staff to assess the dangers posed by bed rails
and the risk of potential asphyxiation; (iii) Oak Woods failed to
inspect the beds, bed frames, and mattress to ensure that the risk of
positional asphyxia did not exist; and (iv) Oak Woods failed to take
adequate corrective measures and protect Ms. Hemming after she
had been found entangled in her bedding on the day before her death
from asphyxiation. The complaint alleged that the facility had notice
of the risk of asphyxiation through the nursing assistants, but despite
this knowledge of the problem did nothing to rectify it.
1. The state's Supreme Court did not rule uniformly on the four
allegations contained in the lawsuit. One of them did not
constitute either malpractice or negligence. Provide explanations
and identify which allegation(s) constituted ordinary negligence,
which one(s) constituted medical malpractice, and which one was
2. Can any of these be held personally liable? (a) the two nursing
assistants, (b) the nurse supervisor, (c) the administrator. Provide