Legal Aspects Of Health Care Administration 11th Edition by George Pozgar

Exercise 9

Facts
Kayser was admitted to a nursing home on July 14, 1992. On the evening of September 30, she was transferred to a hospital after ingesting an overdose of tolbutamide, a diabetic medication. She was diagnosed as having a hypoglycemic coma caused by the lowering of her blood sugar from ingestion of the medication. An IV device was inserted in the dorsum area of her right foot to treat the coma. Gangrene later developed in the same foot, which eventually required an above-the-knee amputation. As Kayser's guardian, Harder, Kayser's sister, brought a suit against the nursing home for harm caused to Kayser by an overdose of the wrong prescription administered to her while she was in the nursing home's care and custody. At the close of Harder's case, which followed a res ipsa loquitur pattern of proof, the trial court directed a verdict for the nursing home. The trial court ruled that Harder's evidence fell short of establishing a negligence claim because her proof failed to show all the requisite foundational elements for res ipsa loquitur.
Issue
Did the trial court err when it directed a verdict for the nursing home based on its ruling that Harder had not satisfied the requirements for a res ipsa loquitur submission?
Holding
By the evidence adduced at trial, Harder met the standards for submission of her claim based on the doctrine of res ipsa loquitur pattern of proof.
Reason
In light of the circumstances that surround the injurious event, it seems reasonably clear that Kayser's ingestion of a tolbutamide overdose would not have taken place in the absence of negligence by the nursing home's staff. The record shows that Kayser had not been prescribed any diabetes medication while a resident at the nursing home and that she had never been prescribed that type of hypoglycemic drug. It is uncontradicted that Kayser was at the nursing home when she ingested the prescribed medication. There is no direct evidence that anyone else supplied to her the harm-dealing dosage or that the substance in question was kept in her room (or elsewhere within her control). Neither is there indication that any other cause contributed to the coma. According to Ms. Dixon, a licensed practical nurse and a medication clerk at the nursing home is responsible for the administration of medication to its residents.
The administration of the wrong medication in an amount so excessive as to harm a resident is below the applicable standard of care.
Harder's evidence laid the requisite res ipsa loquitur foundation facts from which it could be inferred that the injury-from an overdose of the wrong prescription- was one that would not ordinarily occur in the course of controlled supervision and administration of prescribed medicine in the absence of negligence. Nothing in the record negates any of the critical elements for application of res ipsa loquitur. The responsibility for producing proof that would rebut the inferences favorable to Harder's legal position was thus shifted to the defendant.
Describe the elements the plaintiff's attorney had to establish under the doctrine of res ipsa loquitur.