This case involves a patient in Vermont with a known skin allergy to adhesive tapes who also possessed an extremely delicate skin condition. On the date of the incident in question, the patient presented for a routine orthopedic surgery. His records clearly indicated that he had an allergy to adhesives, and the patient was also wearing a medical alert bracelet that made note of this allergy. Despite this information, the nurses working on behalf of the anesthesiologist arrived to start IV fluids and used adhesive tape on the patient. The patient immediately advised them against using the tape, but nursing staff dismissed his concerns and proceeded to apply the tape regardless. At the conclusion of the surgery, the anesthesiologist treating the patient removed the tape very quickly, which, combined with the patient’s allergy and skin condition, allegedly inflicted a significant open wound. The would would later become infected, and eventually healed with significant scarring.
Question(s) For Expert Witness
- 1. Have you ever treated a patient with a skin condition similar to what's been noted above?
- 2. If so, what additional steps must be taken to ensure the safety of this patient - and the avoidance of adhesives?
- 3. Have you ever had a patient develop this complication?
Expert Witness Response E-014500
In 25 years as a Certified Registered Nurse Anesthetist, I have encountered innumerable patients who list adhesives as an allergy. Patient concerns are always at the forefront of my and my colleagues’ practice. This is a difficult situation in that anything, whether it be tape of any kind, or other dressing securing devices, have some adhesive on them, but to varying degrees. It is our practice to utilize paper tape for such patients who have such delicate, fragile skin. If there is further concern for loss of IV access, I will use a gauze wrap to cover the IV site as well to hopefully give more security to the site. I have not had a patient, for whom I have delivered anesthesia care, develop the complications your patient here developed.
Expert Witness Response E-014573
I have cared for many patients with tape allergies or sensitivities in the past. It is not uncommon to see such patients, and the standard for their care is fairly common knowledge. When caring for these patients, the nurse should query the patient about his or her allergies, review the chart carefully for the same, note allergies recorded on allergy arm bands, and note on any signs posted on or near his/her bed. I have never had a patient develop this outcome by following these standard procedures.