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.