Piperato v. Lam, 2019 N.J. Super. Unpub. LEXIS 1813 (App. Div. Aug. 23, 2019)

Appellate Division rejects the trial court’s suggestion that the plaintiffs needed to present a single report addressing both deviation and causation as to the alleged negligence of the nurses.

On behalf of themselves and their minor son, the plaintiffs appealed the trial court’s dismissal of their medical malpractice action against several registered nurses and the hospital that employed them. The minor son injured his ankle on a trampoline. He was originally diagnosed with a sprained ankle, but his pain persisted, and he was taken to the ER for treatment on three different occasions. Each time, nurses failed to perform a proper assessment. Finally, the child’s leg turned purple and he was taken to another hospital where he was diagnosed with deep vein thrombosis and severe compartment syndrome. Following surgery, the child developed septic shock and went into respiratory failure, ultimately requiring amputation of his leg.

The plaintiffs obtained an expert report from a registered nurse, who opined that the defendant nurses deviated from the standards of nursing practice by failing to document the minor’s lower extremity pain and communicate that assessment to physicians. In a separate report, a board-certified physician in emergency medicine opined that the nurses’ assessments were deficient and were a contributing factor to the resulting amputation of the child’s leg. At the lower court level, the defendants successfully moved for summary judgment, with the trial court concluding that the plaintiffs’ “main report” failed to give any opinion regarding causation of the minor’s ultimate injury. The trial court denied the plaintiffs’ motion for reconsideration. On appeal, the court reversed summary judgment, rejecting the trial court’s suggestion that the plaintiffs needed to present a single report on deviation and causation.

This case demonstrates that it is typical in nursing malpractice claims for the nursing expert to render a medical opinion regarding deviations in nursing care, but often a physician is needed to provide an expert opinion on causation. It should be expected that courts in nursing negligence cases will “chain link” the various opinions into a complete opinion, so when read together, they can be understood as finding the nurses were negligent and a proximate cause of the injury. 


Case Law Alerts, 4th Quarter, October 2019

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