Page 7 - Part 2 Collaborating with Advanced Practice Providers - An Overview of State Rules

SVMIC Collaborating with Advanced Practice Providers

which the patient care team physician practiced with the nurse

practitioner under such a practice agreement.
1

One of the primary allegations in a negligent supervision claim is the
absence of a written protocol. Take a look at the following case (names

have been changed).

CASE STUDY

Betty Smith, a nurse practitioner employed at ABC Dermatology, saw

a patient, Melinda Jones. At the time, Mrs. Jones was 77 years old, a
diabetic and on dialysis. Mrs. Jones had a shunt in her left arm. Mrs.

Jones presented for examination of suspicious spots on her arms and
legs. These lesions were diagnosed as precancerous. As a result, Mrs.

Jones received Cryotherapy by NP Smith, on these spots, including the
left arm, which bore a shunt. Post-procedure, NP Smith prescribed

Hylatopic Plus Cream for Mrs. Jones to apply to the dry areas of her

body, not to the wounds left by freezing. The treatment on the right arm
healed normally, but the treatment to the left arm did not heal and

began to ulcerate. Mrs. Jones’ husband alleged he attempted to

contact ABC’s office but received no return call. ABC Dermatology’s
records show that Mrs. Jones missed several follow-up appointments.

It turns out that, Mrs. Jones and her husband applied the cream to the
wounds, rather than to the dry spots. Due to the same, Mrs. Jones’

wounds progressively began to get worse. The wounds grew in size
after not healing. Mrs. Jones continued her treatment with her primary

care physician, an emergency room, and a wound care center. The
wounds continued to deteriorate until three months later, when Mrs.

Jones returned to ABC Dermatology. At this time, the wounds were

1 http://lis.virginia.gov/cgi-bin/legp604.exe?181+ful+HB793ER

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