This month we look at a case of first impression from Minnesota. A “case of first impression” means that the case addresses issues that the courts of that state had not examined before, making it particularly interesting. 

The case arose out of an interaction between employees of 2 different Minnesota health systems. The patient, 54-year-old Mrs W, arrived at her local health clinic on a Friday morning, complaining of abdominal pain, fever, chills, and other symptoms. She was seen by Ms S, the nurse practitioner working at the clinic that day. Ms S ordered tests to determine the nature of Mrs W’s illness. Test results showed that Mrs W had unusually high levels of white blood cells, as well as other abnormalities. The test results led Ms S to believe that the patient was suffering from an infection and needed to be hospitalized. 

Ms S prepared a note for Mrs W’s employer, stating that Mrs W was “unable to attend work due to illness and hospitalization.” Then she called the other health system to arrange Mrs W’s admission to the hospital.

Because the health system that ran the clinic did not have a hospital in that town, it was standard practice for clinicians in the clinic to seek hospitalizations of their patients at the hospital run by the other heath system. The way this would typically take place is that the healthcare practitioner at the clinic would call the hospital, be assigned to one of the on-call hospitalists, present the case to the hospitalist, and then the patient would either be admitted or the hospital physician would suggest another plan. 

Ms S called the hospital and was assigned to Dr D, the hospitalist on call that day. The conversation between the clinicians lasted approximately 10 minutes. Later, when asked to recall what was said, there was disagreement between the two. Ms S said she shared the abnormal test results and Mrs W’s symptoms. Dr D said that Ms S shared only some of the test results. Ms S said that she specifically requested that the patient be hospitalized. Dr D claimed that Ms S only asked whether the patient should be hospitalized.