Nursing Lawsuit Cases: Errors, Verdicts, and Defenses

Nursing lawsuit cases are civil malpractice claims, and in rare instances criminal prosecutions, brought when a nurse’s failure to meet the professional standard of care causes a patient harm. The average total incurred cost per nursing malpractice claim has reached $236,749, with large verdicts and settlements running into the millions and, in a handful of high-profile matters, tens of millions.¹ The sections below walk through what a plaintiff has to prove, which errors show up most often, who pays, what claims are worth, and the defenses and deadlines that shape the outcome.

What a Plaintiff Has to Prove

A nursing malpractice claim is a species of medical malpractice, and it rises or falls on the same four elements.²

Duty. A nurse-patient relationship existed, which created a legal obligation to provide care, maintain a safe environment, and follow physician orders.
Breach. The nurse failed to act the way a reasonably qualified professional would have under the same circumstances, measured against the standard of care that a competent nurse with similar training would provide.³
Causation. That breach directly caused the injury, and the injury would not have happened without it.⁴
Damages. The patient suffered actual, compensable harm: physical injury, emotional distress, extra medical costs, or lost income.

The standard of care is no longer tied to geography. Whether the nurse works in a rural clinic or an urban trauma center, the benchmark is a national one established at trial through expert testimony from both sides.³ Some states layer additional specifics on top: in New York, for example, benchmarks for nursing care come from the state’s Nurse Practice Act.²

Errors That Drive Nursing Lawsuits

A handful of error categories account for most claims. Treatment and care failures alone make up 56.2% of professional liability claims against nurses, according to the NSO/CNA claim report.⁵

Medication Errors

These involve giving the wrong drug, the wrong dose, or a drug to which the patient is known to be allergic. Look-alike drug names, overridden dispensing-cabinet safeguards, and poor communication between providers all contribute.⁶ Published nursing home results include a $5.5 million verdict for a medication error.⁷

Failure to Monitor and Failure to Rescue

Nurses are usually the first to see a patient deteriorate, and missing those signs is one of the costliest errors. In a Texas appellate case, an expert report established that the nursing standard required vital-sign assessments at least every 30 minutes after an acute change in status; nursing staff missed more than two hours of deterioration in a patient with atrial fibrillation before cardiac arrest.⁸ In another matter that settled for $250,000, a nurse failed to assess a post-surgical knee replacement patient, failed to supervise the LPN caring for her, and failed to notify the physician of changes; the patient died from anoxic encephalopathy.⁹

Patient Falls

Falls are a leading cause of preventable injury in hospitals, especially among older patients and those taking medications that cause dizziness. Inadequate staffing, high proportions of new staff, and environmental hazards all raise the risk.⁶ Published nursing home outcomes include a $1 million verdict for a hip fracture after a fall and a $1 million settlement for a fall that caused a fatal subdural hematoma.⁷

Documentation and EHR Errors

Incomplete or inaccurate charting undermines the defense if a case reaches trial. Copy-and-paste errors in electronic health records, alert fatigue that leads providers to override valid warnings, and template-driven assessments that leave important fields blank all create exposure.¹⁰

Scope-of-Practice Violations

These claims allege a nurse performed tasks outside licensed authority, such as prescribing without proper authorization or doing a procedure that certification did not cover. Lawsuits citing scope-of-practice violations grew from 0.5% of closed nurse practitioner claims in 2012 to 4.2% by 2017, with average paid indemnity of $146,250 for those claims.¹¹

Who Gets Sued

When a nursing error injures a patient, the complaint typically names both the individual nurse and the employer. Under the doctrine of respondeat superior, a hospital or healthcare facility is vicariously liable for the negligent acts of employees committed within the scope of their employment, even if the hospital itself did nothing wrong.¹² The test is whether the employer had the right to control the details and manner of the nurse’s work.

Hospitals can also face direct claims for their own failures: negligent hiring, inadequate training, or failing to enforce safety policies.¹² That matters because it lets plaintiffs reach the institution’s deeper pockets and systemic failures. Even independent contractors can create hospital liability under the doctrine of ostensible agency if the facility held the worker out as an employee and a patient reasonably believed the person was hospital staff.

Liability can also extend past the nurse who made the error. Fellow nurses who fail to intervene, supervisors who neglect monitoring, and physicians who give unclear orders or fail to follow up can all be named.²

How Often Nurses Get Sued and What Claims Cost

The NSO/CNA Nurse Professional Liability Claim Report, now in its fifth edition and covering claims from 2020 to 2024, offers the clearest picture. Average total incurred cost per claim reached $236,749, a 12.5% jump from the prior period. Claims resolving above $750,000 rose to 7.9% of the total, up from 5%.¹

Exposure varies sharply by setting. Home healthcare nurses account for 21.7% of all claims with an average cost of $301,031, a 39.3% increase.⁵ Obstetric nursing claims have declined in volume but carry the highest severity at $543,305 per claim. Emergency and urgent care nursing saw claim severity rise by more than $100,000 in the most recent period.¹

For nurse practitioners, average total incurred cost reached $332,137 as of 2022.¹³ A study published in the Annals of Emergency Medicine reviewed 144 malpractice cases involving nurse practitioners and physician assistants from 1985 to 2020 and found that failure to diagnose was the most common allegation, appearing in 92 cases. When negligence was found at trial, the mean award was $3,216,538; settlements averaged $1,607,716.¹⁴

Notable Verdicts and Settlements

Published outcomes give a sense of the financial stakes. A Bronx jury in 2014 awarded $172 million against New York City in the case of Tiffany Applewhite, who suffered brain damage at age 12 after a home nurse administered a steroid injection that triggered anaphylactic shock. The nurse and her employer, Accuhealth Inc., were separate defendants; Accuhealth went bankrupt and the nurse settled out of court. The $172 million verdict targeted the city’s paramedics for their response, but the case originated with the nursing error. The city said it would appeal.¹⁵

A $5.5 million settlement resolved a case in which a nurse midwife and labor nurse at St. Luke’s Hospital in New Bedford, Massachusetts, failed to respond to fetal heart monitor readings showing distress during a 20-hour labor in 1997. The baby was born with the umbilical cord wrapped around her neck, sustained permanent brain damage, and was left unable to walk, talk, or live independently.¹⁶

Nursing home and assisted living cases produce large verdicts as well, including a $14.7 million wrongful death verdict out of Miami, a $12.8 million verdict for bedsores leading to amputation in California, and a $12.5 million bedsore verdict in Tampa, reported as the largest verdict against a Florida assisted living facility.⁷

When a Nursing Error Becomes a Criminal Case

Criminal prosecution of nurses for medical errors is rare but not unprecedented, and the two most prominent examples both involved medication mistakes.

RaDonda Vaught

On December 24, 2017, Vaught, a registered nurse at Vanderbilt University Medical Center, was working as a “help-all” nurse in the Neuro ICU when she tried to retrieve the sedative Versed (midazolam) from an automated dispensing cabinet for a patient awaiting a PET scan. When the system did not return a result for “Versed,” she triggered an override and selected vecuronium, a paralyzing agent, overlooking multiple warnings. The patient, 75-year-old Charlene Murphey, died from a severe anoxic brain injury.¹⁷ Vaught reported the error to the physician and was fired.

Vanderbilt’s handling of the aftermath drew intense scrutiny. The hospital did not report the death to the Tennessee Department of Health, did not file a required sentinel event report, and a VUMC physician told the Davidson County Medical Examiner that the death was due to natural causes. The medical examiner later said an investigation and autopsy would have been conducted had the true circumstances been disclosed.¹⁸ Staff were instructed not to document the medication error in the patient’s record. The error remained concealed for roughly ten months until an anonymous report to CMS prompted a federal investigation.¹⁷ CMS issued a 56-page report in November 2018 documenting Vanderbilt’s failures, including inadequate monitoring policies and the absence of pharmacist approval or dual-nurse verification for dispensing vecuronium. No administrators faced repercussions and no criminal charges were brought against the institution.¹⁹

A Nashville grand jury indicted Vaught in February 2019 on charges of reckless homicide and impaired adult abuse. In March 2022, a jury convicted her of the lesser charges of criminally negligent homicide and gross neglect of an impaired adult. On May 13, 2022, Davidson County Criminal Court Judge Jennifer Smith sentenced her to three years of supervised probation with judicial diversion, which allows first-time offenders to have charges dropped and records expunged on successful completion.²⁰ Vaught completed probation in May 2025 and her record is slated for expungement.²¹ The Tennessee Board of Nursing revoked her license in July 2021. On March 20, 2025, the Tennessee Court of Appeals affirmed the revocation, finding she had waived certain defenses by not raising them during the initial administrative proceedings.²²

The conviction drew a forceful response from the profession. The American Nurses Association called it a “dangerous precedent” that could have a “chilling effect on reporting and process improvement.”²³ The Ohio Nurses Association warned it would “further demoralize the nursing profession” and “contribute to the nurse staffing crisis.”²⁴ Multiple medical and toxicology organizations issued a joint statement in May 2022 opposing the criminalization of medical errors.²⁵

Julie Thao

In 2006, Julie Thao, a veteran obstetric nurse at St. Mary’s Hospital in Madison, Wisconsin, was charged with one felony count of neglect of a patient causing great bodily harm after she intravenously administered an epidural medication (bupivacaine and fentanyl) instead of the ordered penicillin to a patient named Jasmine Gant, who died. The Board of Nursing found Thao had failed to fasten the patient’s identification wristband, scan the required barcodes, and read the drug label, which clearly identified the bag as epidural medication. Her license was suspended for nine months and then reinstated with restrictions, including limits on work hours and mandatory continuing education on medication error prevention.²⁶ The Institute for Safe Medication Practices, the Wisconsin Nurses Association, and the ANA opposed the prosecution, arguing that criminal charges for unintentional errors ignored the systemic problems that contribute to such mistakes.²⁷

Common Defenses

The most fundamental defense is that the nurse met the standard of care, meaning the actions taken were consistent with what a competent professional would have done under the same circumstances. Expert witnesses on both sides define that standard for the jury.³ Other common defenses include:

Lack of causation. The defense argues the alleged error did not actually cause the injury, pointing to underlying conditions or other factors.
Comparative or contributory negligence. The defense presents evidence that the patient’s own conduct, such as failing to follow discharge instructions or take prescribed medications, contributed to the harm. In some jurisdictions this reduces the award; in others it can eliminate it.
Informed consent. The defense argues the patient was fully advised of the risks and consented to the treatment that allegedly caused harm.
Statute of limitations. The defense moves to dismiss if the case was filed after the legal deadline expired.

Contributory negligence evidence can be strategically powerful even when it does not appear on the verdict form. Defense attorneys have described cases where evidence of a patient’s own failures shifted the jury’s overall perception enough that it found the plaintiff had not proven causation at all.

Deadlines to File

Every state imposes a filing deadline, and they vary. Pennsylvania allows two years from the date of injury.²⁸ California allows three years from injury or one year from discovery, whichever comes first. Washington State allows the later of three years from the act or one year from discovery of the injury, with an absolute eight-year outer limit.²⁹ Florida imposes a two-year statute of limitations with a four-year statute of repose and requires plaintiffs to conduct a presuit investigation and provide formal notice to each prospective defendant before filing.³⁰

Most states toll the limitations period for minors, so the clock does not start until the child reaches the age of majority. Tolling is also commonly available in cases involving fraud, intentional concealment, or discovery of a foreign body left inside a patient.²⁹

Board Discipline Runs Alongside the Lawsuit

A civil lawsuit or criminal charge against a nurse usually runs parallel to an investigation by the state board of nursing. Those administrative proceedings are independent of civil litigation, operate under a public safety mandate, and are not subject to statutes of limitations. If the board finds a violation of the state’s Nurse Practice Act, sanctions can range from fines and mandatory education to practice restrictions, license suspension, or permanent revocation. In urgent situations where continued practice poses a danger of immediate and serious harm, a board can issue a summary suspension before completing its investigation.³¹ Boards can also discipline a nurse based on actions taken in another state, which prevents a nurse from evading consequences by relocating.

Adverse licensing actions remain relatively uncommon. In 2021, the National Practitioner Data Bank recorded 18,145 adverse actions against nursing licenses, affecting less than 1% of nurses nationally. The most common allegations in board complaints involve professional conduct (32.5%), scope-of-practice violations (24.8%), documentation errors (9.7%), and treatment and care failures (9.3%).³²

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