LEGAL LIABILITIES IN

NURSING PRACTICE

NEGLIGENCE

Definition
It refers to the commission or omission of

an act, pursuant to a duty, that a

reasonably prudent person in the same or
similar circumstances would or would not
do, and acting or the non-acting of which
is the proximate cause of injury to another
person or his property.

Civil Code, Article 19

One shall act with justice, give every man

his due, observe honesty and good faith.

Civil Code, Article 20

Those who, in the performance of their

obligations through negligence cause any

injury to another, are liable for damages.

Common Acts of Negligence

Burns
Objects left inside the patients body
Falls of elderly
Falls of children
Failure to observe and take appropriate
action as needed

Specific Examples
Failure to report observations to attending

physicians
Failure to exercise the degree of diligence
which the circumstances of the particular
case demands
Mistaken identity
Wrong medicine, wrong concentration,
wrong route, wrong dose

Conditions for Res ipsa

loquitor
That the injury was of such nature that it

would normally occur unless there was a

negligent act on the part of someone
That the injury was caused by an agency
within control of the defendant
That the plaintiff himself did not engage in
any manner that would tend to bring about
the injury

MALPRACTICE

Definition
Implies the idea of improper or unskillful

care of a patient by a nurse

Denotes stepping beyond ones authority
with serious consequences
Is a term for negligence or carelessness of
professional personnel
Refers to a negligent act committed in the
course of professional performance (1962)

MEDICAL ORDERS,DRUGS,AND
MEDICATIONS.

RA 6675

Only validly registered

medical, dental and veterinary

practitioners, whether in
private institution, corporation
or in the government, are
authorized to prescribed
drugs.

RA 5921 (PHARMACY ACT)

All prescriptions must contain the following

information:
Name of the prescriber
Office address
professional registration number

Professional tax receipt number

Patients/clients name, age , sex
Date of prescription.

RA 6675
Requires that the drug be written in their

generic names.
Only when these orders are legal writing and bear

the doctors signature thus the nurse have the

legal right to follow them
The nurse must not execute an order if she is
reasonably certain it will result in harm to the
patient.

INTRAVENOUS THERAPY AND

LEGAL IMPLICATIONS
Philippine nursing act of 1991 section 28
in the administration of intravenous injections,

special training shall be required according to

protocol established.
Basis of nurses legal right to give IV injection.
Board of nursing resolution no. 8 states that any
registered nurse without such training and who
administers IV injections to patients should be
held liable, either criminally or administratively or
both.

TELEPHONE ORDERS
Only in an extreme emergency and when no

other resident or intern is available should a

nurse receive telephone orders.
The nurse should read back such order to the
physician to make certain the order has been
correctly written.
Such order should be sign by the physician on
his next visit within 24 hours.

MEDICAL RECORDS
Supplies rich material for medical and nursing

research
Serves as a legal protection for the hospital,
doctor, and nurse by reflecting the disease or
condition of the patient and his
management.
if it was not charted, it was not observed or
done.

CONTINUATION..
Nurses are expected to record fully,

accurately, legibly and promptly their

observations from admission to the time of
the patients discharge.
Nurses are legally and ethically bound to
protect the patients chart from unauthorized
person.

CHARTING DONE BY STUDENT

NURSES
When a nurse or clinical instructor counter

signs the charting of the nursing student,

he/she has personal knowledge of
information and that such is accurate and
authentic.
Anyone who countersigns without
verification commits herself to possible legal
risks.

Liabilities of nurses for

the work of nursing aides
Nurses should not delegate their functions to
nursing aides since the Philippine nursing act

specifies the scope of nursing practice of

professional nurses.
Nurses are enjoined to supervise their
subordinates and see to it that they perform only
those which they been taught to do and those
which they are capable of doing.

 Nursing aids are responsible for their

actions.
Nurses should not delegate their

functions to nursing aides.

Nursing aides perform selected nursing
activities under the direct supervision
of nurses.

LIABILITY FOR THE WORK OF

NURSING STUDENTS
RA 9173 nursing students do not perform

professional nursing duties.

Nursing students should be under supervision
of their clinical instructors.
In order that the errors committed by nursing
students will be avoided or minimized, the
following measures should be taken:
Nursing students should always be under

supervision of their clinical instructors.

 They should be given assignments that are

their level of training experience and

competency.
They should be advised to seek guidance if
they are performing a procedure for the
first time.
They should be oriented to the policies
where they are assigned.
Their performance should be assessed
frequently to determine their strength and
weaknesses.

TORT

Definition
A tort is a legal wrong, committed against

a person or property independent of a

contract which renders the person who
commits it liable for damages in a civil
action.

Examples
Assault and Battery.
Assault is the imminent threat of a harmful or

offensive bodily contact.

Battery is an intentional, unconsented touching
of another person.
False Imprisonment or Illegal Detention.
It means that the unjustifiable detention of a
person without legal warrant within boundaries
fixed by the defendant by an act or violation of
duty intended to result in such confinement.

 Defamation.
Slander is oral defamation of a

person by speaking unprivileged or

false words by which his reputation is
damaged.
Libel is defamation by written words,
cartoons or such representations that
cause a person to be avoided,
ridiculed, or held in contempt or to
tend to injure him in his work

CRIMES

Crime defined
It is an act committed or omitted in

violation of the law. It is composed of two

elements: (1) criminal act and (2)
evil/criminal intent

Conspiracy to commit a crime

A conspiracy to commit a crime exists

when two or more persons agree to

commit a felony and decide to do it.

Criminal Liability
nurse may incur criminal liability or subject

herself to criminal prosecution either by

committing a felony or by performing an act
which would be an offense against person or
property.

 Ignorance of the law is not an excuse

for failure to comply therewith.

Violators of the criminal law cannot
escape punishment on the ground of
ignorance of the law

Circumstances affecting
criminal liability
Justifying circumstances
Exempting circumstances

- an imbecile or insane person, unless the

latter has acted during a lucid interval.
-below 9 years old
-over 9 years of age and under fifteen
unless he/she acted with discernment

- causes an injury which is merely an

accident without fault or intention or causing
it
-acts under the compulsion of an
irresistible force
-acts under the impulse of an
uncontrollable fear of an equal or greater
injury

 Mitigating circumstances

Are those which do not constitute

justification or excuse of the
offense in question, but which in
fairness and mercy, may be
considered as extenuating degree
of moral culpability.

 Aggravating circumstances
Are those attending the commission of

crime and which increase the criminal

liability of the offender or make his guilt
or more severe.
Some of the ff circumstances:
When the offender takes advantages of his
public position.
When the crime is commited in place of
worship
When the act is committed with evident
premeditation or after an unlawful entry.

 Alternative circumstances

-are those which must be taken into

consideration as aggravating or mitigating
according to the nature and effects of the
crime and other conditions attending in
commission.
Should be taken consideration when the
offended party is the spouse, ascendant or
descendant, legitimate, natural or adopted or
relatives.

Points in order to avoid

criminal liability:
1. Be very familiar with the Philippine nursing
law.
2. Beware of laws that affecting nursing
practice
3. At the start of employment, get a copy of
your job description, the agencys rules,
regulations and policies.
4. Upgrade you skills and competence

5. Accept only such responsibility that is within

the scope of your employment and your job
description.
6. Do not delegate your responsibilities to
others.
7. Determine whether your subordinates are
competent in the work you are assigning
them.
8. Develop good interpersonal relationships
with your co-workers, whether they be your
supervisors, peers or subordinates.

9. Consult your superior for problems that

maybe too big for you to handle.
10. Verify orders that are not clear to you or
those that seem to be erroneous.
11. The doctors should be informed about the
patients conditions
12. Keep in mind the values and necessity of
keeping accurate and adequate records
13. Patients are entitled to an informed
consent.

Examples
Nursing:

liabilities of

Liability for injury to patient

Liability for sponge left in the patients

abdomen
Liability for a safety pin left in patients

abdomen
Liability for defective equipment
Liability for death for patient who jump from
window of his room

 Liability for negligence of surgical nurse

Liability for rapture of surgical wound.
Liability for burns for suffered by

patient
Liability for burns from hot water bags
Liability for negligence of nurse
employees
Liability fro death of infant resulting
from injection of digitalis
Liability of nurse performing
administrative work

Principals
Are those who take a direct part in the

execution of the act; who directly force or

induce others to commit; or who cooperate in
the commission of the offense by another act
without which it would not have been
accomplished.

Accomplices
Are those persons who, not being principals,

cooperate in the execution in the offense by

previous or simultaneous act.

Accessories
Are those who, having knowledge of the

commission of the crime, either as principals

or accomplices, take part in the subsequent
to its commission by profiting themselves or
assisting the offender to profit from the
effects of the crime.

Criminal Actions
Deal with acts or offenses against

public welfare.

Misdemeanor
Is a general name for a criminal

offense which does not in law amount

to felony.

Felony
Is a public offense for which a

convicted person is liable to be

sentenced to death or to be
imprisoned in a penitentiary or prison.
Is committed with deceit and fault.

Criminal negligence
Reckless imprudence when a person does

an act or fails to do it voluntarily but without

malice, from which material damage results
immediately.
Simple imprudence means that the person or
nurse did not use precaution and damage was
not immediate or the impending danger was
not evident or manifest.

Criminal intent
Is the state of mind of a person at the

time the criminal act is committed.

Two elements of deliberate intent:
freedom and intelligence