This case involves a 73-year-old male who was to undergo polysomnography under the suspicion of sleep apnea. He went for an evaluation by a nurse practitioner and was instructed to return for an overnight stay. The patient stated he had complaints of night vision problems, glaucoma, and muscle fatigue. Due to the time of day he was supposed to report for the overnight stay, the nurse practitioner instructed the patient that he was to enter the facility through the side entrance since the front entrance would be closed. When the patient arrived, there was minimal lighting available and he had to take the stairs to get to the side entrance. He subsequently fell on the steps and sustained a severe head injury. It was revealed that the sleep study center has previously made accommodations for patients like this so that they could enter the front entrance as they are at higher risk for this type of incident.
Question(s) For Expert Witness
- 1. Do you see patients in a sleep study center?
- 2. In an elderly patient with vision and gate issues, would it be prudent to make special accommodations to make sure they could enter the sleep center safely?
- 3. Please explain why you are qualified to review this matter.
Expert Witness Response E-011217
I have had more than 20 years worth of expertise in the field. I frequently lecture on this subject and have published peer review journals as well as book chapters on these types of cases.
Expert Witness Response E-053830
I think it would have been highly necessary for the sleep center to make appropriate accommodations for this patient. I am board certified in sleep medicine and have experience with patients in a sleep center. In addition, I teach nursing students and nurse practitioner students about the care of all patients. As a reviewer of major medical/surgical nursing textbooks, I am very familiar and up-to-date with the care of an elderly patient. I am also currently interpreting sleep studies and in charge of Quality Improvement.