South Florida Hospital News
Thursday August 13, 2020

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April 2013 - Volume 9 - Issue 10


Potential Legal Immunity for Nurses Working Under Physician Supervision

These days most hospitals employ their own nurses, whereas the physicians taking care of patients in the hospital are often independent contractors or community physicians who have privileges at the hospital. When patients sue their providers, the hospital is responsible for any negligence on the part of the nurses, but may not be held liable for the actions of defendant physicians.
When a nurse is acting under the orders of a supervising physician, case law suggests that the nurse (and, therefore, the employing facility) may be immune from liability where the actions of the nurse merely reflect the decisions of the physician in charge. In Siegel v. Husak, a patient sued his physician and an ARNP (Siegel) who was working under the physician’s supervision. The patient had reported an injury while exercising that started out with a “popping” sound when he lost control of his weights. When he presented to his doctor’s office, he was seen only by the ARNP, who diagnosed a sprain. The injury was later determined to be ruptured tendons, which ultimately required reconstructive surgery. The patient sued.
At trial, the jury awarded the patient nearly $2 million against the nurse practitioner. However, on appeal the Third District determined that a nurse practitioner may treat patients only under the supervision of a physician, and that the ARNP’s notes were sufficient to have led the physician to the correct diagnosis. Siegel had done everything correctly from a nursing standpoint. The court found that a nurse acting under the direction of a physician in matters involving medical skill and judgment is absolved from liability, absent independent negligence on the part of the nurse. Thus, the appeals court reversed and granted a defense verdict.
While Siegel took place in an office setting, the same reasoning has been applied to hospital settings in such cases as Drew v. Knowles (ICU nurses and respiratory therapists) and Buzan v. Mercy Hospital (operating room nurses). The important distinction to be made is whether the nurse’s alleged negligence pertains to a nursing decision or function, or simply the direction of a physician. In any event, whenever a hospital is sued for the actions of its employed nurses or respiratory therapists, it is important to closely analyze the claims against them in order to evaluate the merits of this potent defense.
Steven A. Osher, Fann & Petruccelli, P.A., can be reached at (954) 771-4118 or
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