Med-mal claim reinstated against Bloomington nurse practitioner

A ruling that favored a Bloomington nurse practitioner was reversed Thursday after the Indiana Court of Appeals found a question remained about whether she had provided health care to a patient just days before he suffered from cardiac arrest.

On Dec. 1, 2015 Peter Strickholm was prescribed a blood pressure medicine for his high levels by a nurse practitioner who had recently been established as his primary-care provider. One week later, Strickholm returned to have his blood pressure checked. Another nurse took the blood pressure test, rather than his NP, and sent the results to another physician in the office who noted improvement as well as unchanged levels. The physician suggested Strickholm be seen again in a few weeks and to increase his dosage if his blood pressure levels were still elevated.

When his NP reviewed and approved of the physician’s report on Dec. 11, she made no further testing or treatment recommendations. Strickholm suffered cardiac arrest days later, leaving him with cognitive impairment. His parents subsequently filed a medical malpractice claim against the NP, alleging she had breached the relevant standard of care in her treatment of Strickholm up to and through at least Dec. 8, causing him harm.

A trial court later granted the NP’s motion for summary judgment, finding she did not provide any medical care to Strickholm after Dec. 1, thus rendering the complaint late by three days. It concluded that the continuous-wrongdoing doctrine didn’t apply to the NP’s single act of prescribing Strickholm medication, and that she didn’t provide health care to him the day she signed his report because she did not physically see him in person.

An appellate panel reversed in Alfred Strickholm, et al. v. Anonymous Nurse Practitioner, 19A-MI-00696, finding as dispositive the issue of whether the NP’s act of reviewing and approving the record of Strickholm’s prior visit constituted the provision of health care.

“Anonymous NP characterizes her approval as merely ‘an administrative function to close the open note in Peter Strickholm’s medical record[,]’ and contends that the only response to Peter’s December 8, 2015, visit was made by the physician in the office that day and/or the LPN as a matter of law. We have little hesitation in concluding otherwise,” Judge Cale Bradford wrote for the appellate panel.

“Even if we assume that Anonymous NP did not see Peter after December 1, 2015, there is designated evidence that December 11, 2015, was the last opportunity she had to evaluate Peter’s latest test results and order further testing or further treatment,” the panel wrote.

It thus concluded that a genuine issue of material fact existed regarding whether the NP provided health care to Strickholm when she approved his report on Dec. 11. The appellate court further rejected the NP’s reliance on both Havens v. Ritchey, 582 N.E.2d 792 (Ind. 1991) and Szamocki v. Anonymous Dr. & Anonymous Grp., 70 N.E.3d 419, 424 (Ind. Ct. App. 2017), trans. denied, noting that each case was factually distinguishable from Strickholm’s case.

As a result, the appellate court ultimately reversed the trial court’s entry of summary judgement and remanded for trial on the question of timeliness.