This case involves a 28-year-old male patient who had been undergoing mental health treatment every 6 months for 6 years. During this timeframe, the patient was seen and solely treated by a nurse practitioner. The nurse practitioner saw the patient in sessions which lasted less than 10 minutes at a time. The nurse practitioner diagnosed the patient with bipolar disorder, along with a variety of other mental health disorders, and prescribed the patient Clonazepam, Escitalopram, Lamotrigine, and Trazodone. The nurse practitioner never consulted with physicians at the affiliated mental health center. The patient was eventually referred to another psychiatrist who informed him that he had been misdiagnosed with bipolar disorder and had been inappropriately prescribed medications during his treatment. An expert family medicine nurse practitioner with experience working in a mental health capacity was sought to opine on the standard of care.
Question(s) For Expert Witness
1. Do you routinely treat patients in a mental health setting, like the one described above?
2. How long have you been practicing in this capacity?
3. What is the duty of the nurse practitioner in this type of case?
Expert Witness Response E-053622
I am a board-certified family nurse practitioner, and I maintain a clinical practice. I have been practicing as a board certified family nurse practitioner in family practice and addictions medicine since 1999. I teach on the role of the NP in practice as well as the current clinical guidelines across the lifespan and diagnoses. I currently evaluate and treat patients with mental health diagnoses. As an assistant professor and core faculty member at a top tier, doctoral-level family nurse practitioner program, I have lectured across the lifespan, including mental health assessment, treatment, and follow-up in children and adults. I have published several peer-reviewed articles on vulnerable populations and presented at national conferences on mental health issues. The duty of the NP is to follow the practice guidelines for the patient's associated symptoms according to the American Psychiatric Association. This includes using the recommended screening tools and appropriate diagnostic tests to formulate a valid diagnosis. Through the NP's practice agreement, the collaborating physician should have been consulted if there were any questions about the definitive diagnosis or if the patient's case became complicated.
About the author
Wendy Ketner, M.D.
Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.
Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.
Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.
