Hospital Understaffing: How the Risk of Birth Injuries and Other Medical Malpractice Increases

Technological advances in medicine have been simply amazing. Robotic devices now allow tremendous precision and control in surgical procedures. Wearable medical devices enable remote monitoring of blood oxygen, heart rhythm, and other vital signs. Regenerative medicine is actively being used to repair damaged tissue and organs. Neurostimulation devices are now used to treat a range of conditions, from epilepsy and Parkinson’s disease to sleep apnea.

But care provided by human staff members is still a vital part of the healthcare system, and human abilities have not changed. Hospitals and other facilities are increasingly expecting their staff to accomplish more in less time. The result is not an occasional “busy day” but rather chronic understaffing that increases the risk of patient harm. It is important to understand the link between understaffing and medical malpractice and how facilities can be held liable.

At Ragain & Clark, we’ve been securing compensation for victims of medical malpractice for decades, so we know the range of problems that can result from understaffing. Being aware of those problems can help protect you in some cases, but often, even when patients and their families do everything right, medical negligence causes irreparable harm. We believe no family should suffer simply because a hospital was more interested in cutting costs than protecting patients.

The Ways Understaffing Frequently Leads to Malpractice

It is not hard to imagine how inadequate staffing can cause care to suffer in a hospital or other medical facility. However, in law, it is important to be specific and present arguments that directly link an irresponsible action to the victim’s injuries. Here are some of the most common ways understaffing can lead to a finding that injuries were caused by actionable medical malpractice.

• Significant delays in response times. During an emergency situation such as a heart attack, a patient’s prognosis depends on prompt assessment and intervention. When a hospital lacks adequate staffing, patients may not receive appropriate care until it is too late.
• Fatigue leading to mistakes. When a facility lacks adequate staff to meet patient needs, the staff are overworked, chronically tired, and stressed. The exhaustion is likely to lead to mistakes such as giving a patient the wrong dose of medicine or mixing up patient charts or regimens.
• Inadequate monitoring. Patients in certain situations require constant monitoring because a change in condition will necessitate immediate intervention. Women in labor, for instance, need to have their vital signs monitored, as well as the baby’s heart rate and oxygen levels. When staff are responsible for too many patients, they cannot provide adequate oversight and may not recognize and respond to problems.

Studies have revealed direct correlations with patient mortality. For instance, one study showed that for every 5% increase in the proportion of understaffed hospital shifts, there was a 1% increase in mortality. Another study showed that nursing staff shortages were linked to significantly higher in-hospital mortality, higher readmission rates, and longer hospital stays. Researchers noted that these findings were consistent with numerous other studies.

Injuries Commonly Caused by Improper Staffing

The problems generally referred to as “understaffing” can encompass several types of improper staffing issues. Issues could be triggered by a failure to hire sufficient overall staff, particularly nursing staff. This leads to staff being overworked and can result in high turnover rates, leaving staff with institutional knowledge in short supply.

Problems can also stem from improper scheduling of existing staff, such as refusing to schedule the appropriate number of skilled nursing staff for particular shifts to keep costs low.

Regardless of the reason, when a hospital is not appropriately staffed, patients are more likely to suffer from injuries such as:

• Post-surgical infections and other complications
• Birth injuries
• Falls as unassisted patients attempt to use the restroom
• Delays or mistakes in giving medication
• Pressure ulcers, which can lead to severe infections
• Misdiagnosis of dangerous conditions, including sepsis, pneumonia, and heart failure

It is tragic when a patient suffers an untimely death or disabling injuries because hospital staff were too busy to notice a problem or unable to provide standard treatment for the condition.

Birth Injuries are a Particular Concern

Lack of appropriate staff at hospitals is a particular concern for young families because of the risk of birth injuries. The labor and childbirth process places both baby and mother in a highly vulnerable state where a few seconds of delay or inattention can make a tremendous difference in health. One recent study of staffing shortages in maternity units revealed an 11% increase in “harmful incidents” due to understaffing, while another study concluded that “staffing shortages play a key role in unsafe maternity care” after reviewing cases where labor was considered “low risk” and yet problems required a transfer to more intensive medical units. Over 30% of the babies studied died either during labor or within a week after birth.

Without adequate levels of staffing, fetal heart rate and other vital signs are often not monitored properly. Problems also arise even when monitoring is appropriate because the response is often delayed too long. Without intervention to increase oxygen levels, babies can suffer birth injuries such as hypoxic-ischemic encephalopathy or cerebral palsy. When deliveries are rushed or poorly supervised, babies are more likely to suffer from brachial plexus injuries leading to Erb’s palsy, shoulder dystocia injuries, and intracranial hemorrhages.

Hospitals that are understaffed frequently lack nursing staff to monitor conditions and lack experienced physicians to supervise residents. Inexperienced staff are often not equipped to recognize or respond to emergency situations that are unfortunately common during childbirth.

The Hospital’s Legal Responsibility

Medical negligence can occur at many different levels. The problem can lie with the conduct of a single individual, a group of people, or an entire organization.

Many medical malpractice cases focus on how a single doctor or nurse failed to provide care that complies with acceptable standards. But medical facilities have obligations too, and they can also be held liable for medical negligence not because of an employee’s failings but because of their negligent policies. When leaders establish policies or foster environments that fail to provide safe, appropriate care for patients, the institutions they run should be held liable for corporate negligence.

As with malpractice cases involving an individual practitioner, cases centered on corporate negligence require diligent research and considerable effort to establish liability. It is necessary to show what the standard of care should have been, what it actually was in the instance at issue, and how the deviation from the standard caused injuries.

In the case of understaffing, it is necessary to examine staffing plans from the hospital involved in the case as well as similarly situated facilities. Analysis of shift rosters and regulatory requirements is also part of the investigation.

Seeking Justice: Experience Matters

Medical malpractice cases of any type are challenging to undertake. After all, no hospital is going to willingly admit that one of their staff members acted negligently, and they won’t make it easy to prove how the care provided deviated from medically acceptable standards.

But the cases become even more complex when the issues center on institutional policies and practices. It may be necessary to bring in experts on staffing ratios for specific facilities who can link the injuries to the hospital’s negligent practices. Uncovering evidence of staffing shortages or overworked staff can be challenging. 

To succeed in recovering full compensation for the harm suffered due to this type of medical negligence, it is necessary to prepare a solid case that will withstand judicial scrutiny and cross-examination by defense counsel in court. Many cases settle before the trial date, but only when the patient’s attorney is prepared to win in court. It is important to work with a legal team experienced in litigation to use discovery tools and tactics to the greatest effect in uncovering evidence to prove causation.

If You Suspect Understaffing or Other Medical Negligence Caused Injuries, Talk to Ragain & Clark

The extensive investigation necessary to succeed in a medical malpractice case does not happen overnight. It takes time, and that is one reason it is crucial to talk to an experienced attorney as soon as you suspect that injuries in a situation may have been caused by failure to follow appropriate medical practices.

When a “business decision” prevents a hospital or other medical facility from having adequate staff on hand to care for its patients, it is important to call attention to it and hold the facility accountable for its short-sighted and irresponsible decision. A medical malpractice action could not only provide resources to meet the family’s future needs but also lead to changes that prevent this type of tragedy from occurring to others. 

If you believe that lack of adequate staffing or other preventable errors lead to injuries to yourself or a loved one, contact the team at Ragain & Clark to learn about how we may be able to help you achieve justice and fair compensation. Just call us at 406-651-8888 or contact us online to get started.