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Failure to Monitor

Articles & Publications

March 31, 2023

Healthcare providers owe patients a duty of care which includes the duty to monitor symptoms, behavior, treatment, or progress, as appropriate. A failure to monitor a patient can lead to catastrophic consequences - the new mother who suffers a stroke when her blood pressure goes unchecked and untreated, the baby born with cerebral palsy because the delivery team did not monitor fetal blood oxygen levels, or the high risk post-operative patient who suffers a pulmonary embolism (P.E.) when medical staff failed to monitor the patient’s movement, leg elevation, or use of compression stockings. If a medical provider fails to properly monitor a patient, the provider may be liable to the patient or family for the harm that they cause. A healthcare provider’s failure to monitor is one of many types of medical malpractice claims.

When does a medical provider have a duty to monitor a patient?

Patient monitoring may be required in many different settings - inpatient or outpatient, during surgery or childbirth, pre-op and post-op - and can be a short or long term obligation. While monitoring vital signs during a minor surgical procedure may be short term, for example, monitoring the progression of a low risk prostate tumor may last for years. The duty to monitor a patient may fall on nursing staff, a primary care provider, an anesthesiologist, a C.R.N.A., a midwife, resident, or any other healthcare professional, depending on the circumstances.

Medical providers may have a duty to monitor various medical conditions, or patient signs and symptoms, such as:

  • Vital signs - body temperature, pulse rate, respiration rate, blood pressure
  • Proper administration of medication
  • Adverse reactions
  • Fluid intake and output
  • Nutrition
  • Mobility
  • Disease progression
  • Psychiatric issues
  • Responses to treatment
  • Changes in condition

What are examples of a failure to monitor in medical malpractice?

In our practice, we see patients who have been injured by the negligence of healthcare providers every day. Situations in which a patient should be monitored by a medical professional, and that failure to monitor could cause harm to the patient for which the medical professional is liable, include:

Inpatient monitoring

The doctors, nurses, and other hospital staff, have patient monitoring obligations which will differ depending on the reason for the patient’s admission. They may need to monitor a patient’s fluid intake/output, levels of pain medication, the titration of an I.V., or changes in the patient’s mobility. They should always be monitoring vital signs. Medical equipment is often used in monitoring, but if not properly maintained or used, that may lead to a failure in monitoring. Sometimes a medical professional does not set up the equipment properly or ignores an equipment alarm, and the patient is harmed. Injuries from a failure to monitor a patient in the hospital could include overdosing, wound infections, stroke, suicide, and many, many other tragic outcomes.

Patients are also not properly monitored if they are discharged too soon from the hospital, or without proper follow up instructions that ensure a continuity of care. You can find out more about medical negligence due to a failure to follow up here.

During surgery

When a patient is under a general or regional anesthetic, qualified anesthesia personnel should be present at all times to monitor the patient. The patient’s oxygenation, ventilation, circulation, and temperature should be continually evaluated. The team will use medical equipment to monitor the patient. This equipment must be properly maintained, and there are guidelines for the settings (including alarms and warning lights.) 

Post-operative care

Following surgery, a patient may need to be monitored for signs of infection, bleeding, air in the abdomen, pulmonary embolism (P.E.), postoperative ileus (P.O.I.), or other complications. The nurses in the recovery room or hospital ward, or the surgeon or nurse practitioner in the follow-up clinic, may be responsible for this, and may be held liable if they fail to provide proper monitoring.

Receiving non-surgical treatment

A patient who is receiving treatment or medication, whether inpatient or outpatient, may need to be monitored for adverse reactions or lack of improvement. This may require anything from continuous monitoring of vital signs, such as during a chemotherapy infusion, to monthly primary care physician (P.C.P.) or cardiologist appointments to monitor blood pressure medication. 

Prenatal care

A pregnant mother should see her doctor or obstetrical clinicians for proper prenatal care. As the due date approaches, the prenatal appointments typically become more frequent as the ob/gyn more closely monitors the mother and baby for complications. The doctor will be monitoring an expectant mother’s blood pressure, the baby’s weight, baby positioning, placental positioning, and other factors. If the doctor misses a warning sign, and the mother or baby suffers harm as a result, the doctor could be liable.

Labor and delivery

Birth injuries are sadly the reason behind many failure to monitor cases. A birthing mother and baby should be monitored throughout the birth to ensure that labor is progressing safely. Irregularities in a baby’s heart rate or blood oxygen levels could indicate the need for an emergency cesarean section or other action to ensure that the baby is not harmed. If a medical professional is not monitoring the birth properly, the baby may suffer cerebral palsy or another birth injury. You can read more about birth injuries to a mother or baby here.

Psychiatric admission

In some psychiatric admissions, the patient may require monitoring because of a risk of self-harm or harming other patients. In these situations, it is not just the patient’s medication and vital signs that must be monitored but also their mental wellness and physical environment. A hospital or its staff could be legally and financially liable for the harm a patient causes to himself or herself, other patients, or staff members.

What harm can be caused by a failure to monitor a patient?

A patient who is not appropriately monitored by their medical team may suffer long term physical or mental issues, and financial costs. We have handled cases where patients have faced injuries such as:

  • Stroke
  • Cardiac arrest
  • Wound infection
  • Sepsis
  • Cerebral palsy
  • Birth injuries
  • Pulmonary embolism
  • Brain injury
  • Paralysis 
  • Permanent disability or disfigurement
  • Disease progression
  • Prolonged treatments
  • Death

What compensation can I expect for a failure to monitor?

When there has been a negligent failure to monitor, the patient or their surviving family members may be able to claim compensation from negligent medical providers for the harm caused. Compensation should cover economic damages that were caused by the failure, such as additional medical expenses (past and future), lost wages and benefits (past and future), and home and vehicle modifications, as well as non-economic damages. Non-economic damages cover a patient’s non-monetary harm as a result of the negligence, such as physical pain, emotional trauma, disfigurement, loss of enjoyment of life, or a spouse’s loss of companionship and consortium. Non-economic damages are not proven by receipts or invoices but by how much your attorney understands the effect of the medical malpractice on you, and how well they can explain that to a jury.

Why choose Morris James to represent you?

The medical malpractice attorneys at Morris James have spent years working with medical experts, insurers, healthcare professionals, and injured victims to settle and fight cases of medical malpractice, including failure to monitor claims. We began our practice defending healthcare providers, and we know the strategies that they use to defend claims. Now, we use our experience to fight for injured victims, and get them maximum compensation for their losses and suffering. 

At Morris James, our attorneys have been protecting our clients’ legal rights since we opened our doors in 1932. If you or a loved one has been injured because of a healthcare professional’s failure to monitor, contact us online or call 302.888.6857 for a free, no obligation consultation.


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