Legal Review & Commentary

Newborn loses finger after being burned by a plastic diaper: $1.35 million Texas settlement

By Jan J. Gorrie, Esq., and Blake Delaney, Summer Associate
Buchanan Ingersoll PC, Tampa, FL

News: Following its birth, a newborn was taken to the hospital’s neonatal intensive care unit (NICU). While attempting to take the infant’s blood gases, the unit nurse used a plastic diaper that had been dipped in very hot water to warm the area. The hot water severely burned the newborn’s hand. Three of the infant’s fingers had to be amputated. Prior to trial, the case settled for $1.35 million.

Background: Shortly after being born, the newborn was taken to the NICU because of breathing difficulties. The unit nurse attempted to take the infant’s blood gases, but because the unit was not equipped with temperature-controlled heat warmers, she used a plastic baby diaper soaked in hot water to warm the area. The water was much too hot and the newborn sustained severe burns to the first, second, third and fifth fingers of his right hand. The injuries required debridement of dead tissue, partial amputation of three of the four injured fingers, and resulted in permanent scarring of the hand.

The mother brought suit against the hospital on behalf of her son, claiming the nurse was negligent and the hospital violated the standard of care. Prior to trial, the action settled for $1.35 million.

What this means to you: Any source of heat must be used with caution when being applied to the skin.

"This is especially true of the delicate skin of the newborn. A compounding factor is that the infant cannot communicate the specific source of his discomfort. Crying can be attributed to any number of reasons, or even no particular reason," notes Cheryl Whiteman, RN, MSN, HCRM, clinical risk manager for BayCare Health System in Clearwater, FL.

In the absence of a temperature-controlled warmer, the nurse was trying to be resourceful in obtaining the needed blood gases of this infant experiencing respiratory difficulty.

"However in using available resources, the nurse apparently did not consider that newborn skin would not be as resilient to heat as hers would be. At the very least, the nurse should have utilized a simple thermometer to ascertain the temperature of the water being applied to the infant’s skin. Further compounding the potential injury was the nurse’s choice to use a plastic baby diaper," cautions Whiteman, "for the diaper helped to maintain the temperature of the water used, thus prolonging the contact of very warm or hot water to the infant’s skin.

"The application of heat to any body surface must be done judiciously. This is particularly true in the newborn and neonate, young children, the elderly, and the debilitated — patients with more tender skin. The temperature of the medium being applied should be measured to prevent burning. Any medium that heats an area of the body must be considered, including liquids and lamps or lights. Consideration should be given to equipment that includes a light source that will also generate heat," she adds.

"While budgetary constraints and limited resources are an ongoing issue in health care, the price of a temperature controlled warmer is probably insignificant compared to the cost of this claim," concludes Whiteman.

Reference

• Potter County (TX) District Court, Case No. 87699-E.