The importance of having the right Expert Nurse


Skin Care: Court Accepts Physician, Rejects Nurse as Expert on Cause of Patient’s Bedsores.

After the patient’s passing, his wife sued the hospital for malpractice and wrongful death over six separate bedsores that started and progressed to deep tissue ulcers while the patient was in the hospital’s ICU being treated for pneumonia.

The hospital asked for a summary judgment of dismissal based on the written opinion of a physician that no departure from the recognized standard of care by the hospital’s nurses concerning his skin issues occurred during the patient’s hospitalization, and nothing the nurses did or failed to do led to the patient’s demise.

The family countered with an opinion from a Ph.D. level nurse who is not a nurse practitioner, that failure to reposition the patient caused the progression of his bedsores to deep tissue ulcers.

The hospital’s expert physician’s opinion is that treatment by hospital nursing personnel fully complied with the standard of care and no act or omission of theirs led to the patient’s skin breakdown. The patient’s family’s nursing expert’s opinion traced six of seven bed- sores to a failure to turn and reposition as needed in the hospital’s ICU.


The Court of Appeals of Tennessee ruled the family’s nursing expert may be an acceptable expert on nursing standards for handling a complex patient’s skin issues in a hospital ICU. However, the family’s nursing expert is not qualified to offer an opinion on a cause-and-effect relationship between alleged lapses in skincare and the development and progression of skin lesions and the effect of that progression in causing or hastening the patient’s demise. With no acceptable expert on their side on the issue of medical causation, the family has insufficient evidence for the Court to allow their case to go beyond the summary judgment stage to trial before a jury. Summary judgment was granted to the hospital. 

Lovelace v. Hospital, 2020 WL 260295 (Tenn. App., January 16, 2020).