Boston Accident Lawyer Blog

Medical negligence and medical malpractice usually involve mistakes in judgment on the part of a physician, nurse, or other health care provider. But an interesting source of medical negligence is on the rise in many American hospitals: It’s called “alarm fatigue”, and it most commonly affects nurses rather than doctors.

Think back to the last time you were on a patient ward in a hospital. Chances are, a great many of the patients were hooked up to some type of electronic patient monitoring system – whether for the purpose of monitoring heart rate, breathing, blood pressure or other vital signs. These machines are highly sensitive, and are designed to sound an alarm to the nursing station in the event of the slightest change in a patient's medical status. That sounds good – until you consider the practical reality that if a patient so much as leans too much on a tube, or unintentionally pulls a wire out of its input, an alarm will sound. Sometimes, if a patient sneezes and breathing is momentarily interrupted, an alarm will sound. Now combine this with the reality that on any given hospital patient ward, there are perhaps 50 or more patients at any given time. The result? Patient monitor alarms going off left and right. The practical reality is that a cacophony of alarm noises can result at nursing stations, and eventually, the alarms no longer produce the result they were designed to: An immediate human response to investigate any medical emergency. The Boston Globe reported on this new development recently (click on link for story.)

All of this poses an interesting legal question: Should nurses and hospitals be held legally liable for medical malpractice if medical harm or death results from a patient not being responded to appropriately, due to ‘alarm fatigue’? As a Dedham, Massachusetts personal injury lawyer, my professional opinion is thus: It depends. Nurses are human beings. They are responsible for the care of several different patients at any one time. If a hospital floor or patient ward is regularly experiencing a cacophony of alarms, many of which are non-emergent or not life threatening, this can produce a desensitizing effect among the nursing staff. To my knowledge as a Boston, Massachusetts medical malpractice lawyer, there are no accurate statistics yet available as to what percentage of patient monitor alarms are in fact false alarms, but if the actual number were high, it would be understandable, from a human behavior perspective, why some nurses would not respond as quickly as if the false alarms were very low. The unfortunate result is that, eventually, a patient in genuine medical distress is not going to be responded to appropriately – and a medical negligence suit is likely to follow. One Massachusetts medical negligence lawsuit based on ‘alarm fatigue’ has already been brought.

The legal question in such cases is not "Was the medical response too late to prevent the patient’s death or injury?", but rather, “How much of a delay in response occurred, after the alarm first sounded?” If the answer were merely 2, 3 or 4 minutes, that would be one situation. If the answer were a half-hour, 45 minutes, or an hour after the alarm first sounded, that’s quite another. These new cases, like all Massachusetts personal injury and negligence cases, are fact-driven. Reportedly, several hospitals have tried to tackle this problem – without great success, so far.

As to potential legal liability for hospital injuries or deaths that result from alarm fatigue, my first impression is that the manufacturers of these machines must find and develop a way to produce patient monitors that are effective at sensing truly threatening, emergent patient status changes, while not sounding off at the slightest change in patient status. By “slightest change in patient status”, I refer to the examples alluded to above: A patient sneezes, and an alarm goes off; a patent leans too much on an electronic lead or tube, and an alarm goes off. Surely, in the year 2011, the manufacturers of these machines can produce equipment that is both sensitive to alerting hospital staff to a true medical emergency, without producing a cacophony of alarm bells that desensitize the human beings they are directed at.

Almost everyone knows about the tragedies of drunk driving. What a lot of people don’t know about, is the subject of civil liability that can attach to drunk driving. When people do think of this subject, they commonly think of the damages that a victim of drunk driving might be able to receive from the insurance company that insured a car driven by the drunk driver. That’s very common in Massachusetts car accident cases, and it’s an area that our firm specializes in.

But what a great many people don’t know about is the liability that can attach to the business or other source that provided or served the alcohol to the drunk driver. Categorically, these sources are usually restaurants, bars & taverns, or non-commercial hosts of parties, receptions or similar events. Civil liability law permits individuals who are injured as the result of negligent service of alcohol to bring suit against any of these categories of potential defendants. When the defendant is a business such as a bar or restaurant, the liability is usually based on “Dram Shop Laws”, which are specific state statutes that impose liability on liquor license holders or their promotional partners (known legally as “licensees.”) Such statutes are designed to encourage responsible alcohol service, and to provide a mechanism for third parties to file suit for injuries or deaths that result from a liquor law violation. When the defendant is not a business such as a restaurant or bar, but is instead a homeowner who threw a party or function at which alcohol was served, and injuries resulted allegedly due to over-serving someone alcohol, the liability is known as “social host liability.” This liability stems from specific laws stating that social hosts (i.e., non-commercial hosts of a party or function, etc.) who provide alcohol to their guests can be held legally responsible for injuries or damages that may result to someone if alcohol has been provided irresponsibly to an attendee of the function.

In addition, suits for damages resulting from the over-service of alcohol can also be based on common negligence. This body of law defines “negligence” as the failure to act in a manner that a reasonable person would act under the same or similar circumstances. These types of lawsuits can be brought by innocent victims who are injured by an intoxicated person, and they can also be brought by the intoxicated person himself. Juries can award monetary damages to compensate victims for the damages they suffered due to the intoxicated person, and sometimes, they can issue punitive damages to further punish the defendant when particularly egregious evidence is presented. Awards can range from a few thousand to millions of dollars.

A case like this recently settled in Massachusetts, after a 37-year-old husband and father was killed while riding in a vehicle driven by his co-worker and friend. Both men were intoxicated, with the driver’s blood alcohol content (BAC) in excess of twice the legal limit. How did they get that drunk? Because they had attended a fund-raising event earlier in the day, hosted by a bar that had negligently continued to serve both men alcohol even though both of them were visibly drunk. The two men later left the bar, and the accident that killed the victim occurred less than a mile away from the fund-raiser. In what the bar apparently considered “responsible”, event attendees had begun drinking early in the day, with two bartenders serving drinks. In addition, as part of the fundraiser, a vodka manufacturer held a promotion at the bar, where the manufacturer’s employees would purchase drinks at an upstairs bar, then provide event attendees with free “shots” downstairs. Sounds real responsible, doesn’t it?

The plaintiff in this case, who was the executor of the estate of the man who was killed in the car driven by his friend, claimed that the bar was understaffed and therefore unable to effectively monitor the alcohol consumption of the event attendees, especially due the “shot girls” who were handing out free drinks purchased upstairs at the restaurant. Restaurants that are licensed to serve alcohol are required to attend a restaurant industry-sponsored course known as TIPS, which trains bartenders and wait staff on the responsible service of alcohol, and of how to effectively spot an intoxicated patron. The defendants in this case claimed they adhered to TIPS standards, and were not negligent in their service of alcohol in this case. Notwithstanding, the defendants decided to settle the case, for $3.1 million. Most of the funds were used to provide structured settlements for the victim’s two young children.

These kinds of alcohol liability cases can be awful in the facts they present. I say this as a Dedham, Massachusetts personal injury attorney who has seen more injuries and deaths due to this kind of negligence than I care to see. My firm knows how to investigate and litigate these cases very effectively. If you know of someone who was injured in connection with negligent service of alcohol, contact us for a free consultation. The more that negligent providers of alcohol are held legally responsible for these kinds of cases, the less they’ll happen.