October 2010 Archives

For a variety of reasons (including urinary incontinence or urinary retention), nursing home residents may require the insertion and use of an indwelling urinary catheter (Foley catheter) that is placed into the bladder in order to collect urine.  These catheters may be required for short term or long term use.  Nursing home nurses are often called upon to catheterize residents by placing the catheter tube into the bladder through the urethra and inserting a small balloon in the bladder that keeps the catheter in place.    

Once inserted, the nursing home staff is responsible for ensuring that proper and necessary catheter care is provided to the resident to prevent complications including obstruction of the catheter and resulting infection.  The nursing home staff should therefore develop care plans in order to ensure that urine amount, urine color, urine odor, and urine clarity are appropriately monitored and documented in the resident's medical chart.

In our practice, we have seen situations where nursing home residents experience serious injuries, including death, as a result of improper urinary catheter insertion and/or inadequate urinary catheter care.  

Urinary catheter insertion misadventures, although rare, can result in devastating complications to the patient.  A fairly common mistake occurs when the nursing home nurse improperly inflates the catheter balloon inside the resident's urethra instead of the bladder.

A sample Maryland Circuit Court Complaint involving claims of negligence relating to traumatic catheter insertion follows:


Plaintiff, [insert name], by [his] undersigned attorneys, hereby files this Complaint against Defendants, [insert names] and in support thereof, states as follows:


1.   At all times material to this case, Plaintiff has been a citizen and resident of the State of Maryland.  
2. At all times material to this case, [insert names of Defendants] have been corporations engaging in the practice of medicine and rehabilitation services in Baltimore City, Maryland, and acting through actual and/or apparent agents, servants and/or employees.
3. The venue for this claim is proper in Baltimore City, Maryland.  The amount in controversy exceeds Thirty Thousand Dollars ($30,000.00).


4. At all times mentioned and relevant herein, [insert names of Defendants] have owned, managed and/or operated a nursing and rehabilitation center known as [insert name of nursing home] located at [insert address] and have held themselves and their agents, servants and employees out to the general public as experienced, competent and capable providers of medical and rehabilitation services, and in such capacity owed a duty to [insert name of Plaintiff] to render that degree of medical care and skill which is ordinarily rendered by those who devote special study and attention to the practice of medicine and rehabilitation services.
5. At all times mentioned and relevant herein, all of the individuals at [insert name of nursing home] who participated in the care provided to [insert name of Plaintiff] were acting on behalf of and within the scope of their employment and/or agency with [insert names of Defendants].  
6. On or about [insert date], [insert name of Plaintiff] was admitted to [insert name of nursing home] for short-term rehabilitation following a hospitalization at [insert name of hospital].  On or about [insert date], at [insert time] a nursing home nurse attempted to insert a Foley catheter into [insert name of Plaintiff].  The nurse apparently did inflate the balloon of the catheter, after which bloody fluid drained through the catheter.  Over the next hour, large amounts of blood continued to drain through the Foley catheter.  [Insert name of nurse] examined [insert name of Plaintiff] and attempted to irrigate the Foley catheter with no success and he was transferred to [insert name of hospital].     
7. Over the next several hours, [insert name of Plaintiff] continued to hemorrhage from the urinary tract.  Lab studies showed a precipitous drop in [insert name of Plaintiff]'s hematocrit and hemoglobin value.  [Insert name of Plaintiff] became severely hypotensive due to blood loss and was given multiple transfusions of red blood cells and pressors to maintain his blood pressure.  [Insert name of Plaintiff]'s condition continued to deteriorate, and he was ultimately intubated and transferred to the intensive care unit.  [Insert name of doctor], a consulting urologist, examined [insert name of Plaintiff] and recommended emergency cystoscopy surgery in order to stop the hemorrhage.
8. During the cystoscopy procedure, [insert name of Plaintiff] was aggressively resuscitated with 10 units of red blood cells, 4 units of fresh frozen plasma, and two liters of crystalloid. In his operative note, the surgeon noted that [insert name of Plaintiff] had suffered a traumatic Foley catheter placement.  
9. After addition hospitalization, [insert name of Plaintiff] was finally discharged home with a Foley catheter.
10. [Insert name of Plaintiff] continued to complain of an inability to void and severe abdominal and groin pain and required additional hospitalization to irrigate the Foley catheter and removed several large blood clots, after which bloody urine was drained from the catheter.  [Insert name] was admitted to [insert name of hospital] and placed on CBI, or continuous bladder irrigation.  He ultimately required removal of the Foley catheter, but afterwards developed intermittent urinary incontinence.    
11. [Insert name] has continued to suffer urinary tract complications and has required ongoing urology care and treatment.    

COUNT I (Professional Negligence)

12. The Plaintiffs incorporate all of the allegations contained in the above paragraphs as if those allegations are set forth in this Count.
13. Defendants, individually and through their actual and/or apparent agents, servants and/or employees, owed [insert name of Plaintiff] a duty to exercise reasonable care in their treatment of him.
14. Defendants, individually and through their actual and/or apparent agents, servants and/or employees, breached the above-described duty of care to [insert name of Plaintiff], thereby deviating from the applicable standards of care, and were otherwise negligent, careless and reckless in that they, among other things:
failed to obtain assistance from a qualified and experienced health care provider before attempting to insert a Foley catheter into [insert name of Plaintiff]'s bladder;
failed to use proper technique in performing the Foley catheterization on [insert name of Plaintiff];
failed to properly inflate the catheter balloon inside of [insert name of Plaintiff]'s bladder and instead inflated inside of his urethra; and 
were otherwise negligent and violated the applicable standards of care.
15. As a direct and proximate result of the above-described deviations from the applicable standards of care and breaches of duty by Defendants, [insert name of Plaintiff] was caused to sustain serious, painful and permanent injuries to his body, including great physical and mental pain and suffering.
16. As a further direct and proximate result of the above-described deviations from the applicable standards of care and breaches of duty by Defendants, [insert name of Plaintiff], among other things, was forced to undergo surgical procedures and medical treatment, and, as a result, was obliged to expend sums of money for medical, hospital and other care and treatment, among other injuries and damages.
17. Had Defendants followed the appropriate and applicable standards of care, [insert name of Plaintiff] would not have suffered the above-identified injuries and damages. 18. The injuries and damages herein complained of were directly and proximately caused by the negligence and want of care of Defendants, with no negligence on the part of [insert name of Plaintiff] contributing thereto.
WHEREFORE, Plaintiff respectfully requests that a judgment be entered against the Defendants for compensatory damages in excess of Thirty Thousand Dollars ($30,000.00) and any other relief to which this Court finds them entitled.

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Please feel free to contact the nursing home neglect lawyers at Dever & Feldstein, LLC at (888) 825-9119 for a free consultation if you believe that a family member or loved one has sustained serious injury or wrongful death as a result of traumatic urinary catheter insertion and/or improper urinary catheter care, bed sores (also known as pressure sores or decubitus ulcers), nursing home falls, dehydration/malnutrition, medication error/prescription mistake, elder abuse or elder neglect.
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This page is an archive of entries from October 2010 listed from newest to oldest.

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