Was a nurse's painful IV start before a GI endoscopic procedure the result of negligence and the cause of permanent nerve damage to a patient's hand? That's a matter for a jury to decide, the Alabama Supreme Court has ruled.

The case stems from a 20-minute upper and lower endoscopic GI exam related to ulcerative colitis that was performed on Shelvia Graves in 2000. Ms. Graves alleges that a difficult and painful IV start performed by a nurse at Brookwood Medical Center in Birmingham caused permanent nerve damage. The nurse who started the infusion first tried the left arm, then the left hand and finally the back of the right hand. As soon as the infusion started, Ms. Graves "began experiencing severe pain in her right hand and [it] caused her to start crying," according to court documents.

When Ms. Graves complained to the physician who began infusing anesthetics through the IV, he told her "they were already behind in the procedure and that she would just have to endure it." Just after the GI exam, Ms. Graves looked at her hand and noticed that it was swollen "like a boxing glove," according to court documents. Ms. Graves had surgery on her hand twice and has not regained complete use of her hand. The attorney representing Ms. Graves did not return a request for comment for this article.

As a result of her injury, Ms. Graves sued the hospital in the 10th Judicial Circuit Court, Jefferson County, in July 2002. In court, the hospital argued that the evidence and expert testimony that the plaintiff presented did not adequately establish that the nurse's IV insertion was the probable cause of Ms. Graves' injury, as required by the Alabama Medical Liability Act.

Indeed, there could be other causes of the injury, attorneys for the hospital argued. Aside from ulcerative colitis, Ms. Graves also had iron deficiency anemia, which required her to have frequent vitamin shots and occasional blood transfusions. The pre-op nursing documentation said that Ms. Graves already had a swollen hand, a cut on a finger and bruises on her arms. The trial court judge agreed with the hospital's arguments and dismissed the case in April 2008.

Ms. Graves appealed to the state Supreme Court in August 2008. In its opinion issued in December 2009, the court ruled that based on the evidence and expert testimony, "Graves demonstrated the existence of a genuine issue as to medical causation and that the trial court's summary judgment against her on this basis therefore was in error." Brookwood asked for a rehearing, which the court denied in March 2010.

George E. Newton II, attorney for Brookwood Medical Center, says the hospital has no comment on the Supreme Court's decision. The case, which has been in court for 8 years, will resume in the trial court early next year, said Mr. Newton.

Kent Steinriede

More breaking news