When patients leave hospitals without being seen, it can have serious consequences and result in subsequent harm due to delayed treatment.
Nursing negligence in the context of patients who leave a hospital without being seen is multifaceted as the provision of nursing care transpires in various contexts within the emergency department. Patients often interact with nurses at triage, in the waiting room and, once admitted to the appropriate department or unit, they may be assigned primary nurse or a charge nurse. Nursing care is further complicated by the handover or transfer of care during shift changes. The applicable standards of care are not always uniform and may differ depending on the context within which nursing care is provided.
In the framework of a lawsuit, plaintiffs have the onus of proving, on a balance of probabilities, that a nurse: (1) breached the standard of care; and (2) that “but for” the breach of standard of care the resulting injuries would not have occurred. In most circumstances, supportive expert evidence is required on the issue of liability.
Whether a breach of the standard of care occurred may be informed by whether nursing care was provided in accordance with the Canadian Triage and Acuity Scale (CTAS) and specific policies and procedures regarding Emergency Department protocols, Left Without Being Seen protocols and follow-up protocols. The factual circumstances of each case are unique and, therefore, also inform the standard of care. A patient’s medical history and mental health status may be crucial to the analysis of what the standard of care required in terms of assessment, monitoring and observation and, more importantly, the frequency at which a patient ought to have been assessed, monitored and observed.
Analyzing whether nursing negligence occurred is not always straightforward and requires an acute understanding of the applicable standards of care in different contexts of nursing care. At Bogoroch & Associates LLP, from the inception of litigation, our strategy is to obtain comprehensive productions and evidence through the examination for discovery process to substantiate alleged breaches of the standard of care.
There is no question that when patients suffer serious injuries after eloping from a hospital without being seen the civil justice system is a pathway they look to explore. However, while a civil lawsuit is commenced with the intention of recovering compensation, patients can also simultaneously pursue alternative avenues to achieve justice and accountability. A complaint with the College of Nurses of Ontario (CNO) will initiate an investigation into nursing conduct and nursing care. A complaint may result in disciplinary action as against a nurse. Regardless of the outcome of the CNO matter, any documents prepared in relation to a proceeding under the Regulated Health Professions Act are inadmissible in a civil proceeding.