Bureau of Health Care Services v. Gerard Anthony Eichbauer Rn Crna
332714
| Mich. Ct. App. | May 11, 2017Background
- Gerard Eichbauer, an R.N. and C.R.N.A., returned to work at Henry Ford Health System after medical leave; audits found ~30 discrepancies in narcotics administration/waste records.
- A drug test was positive for Vicodin (with prescription) and Valium (no prescription); HFHS terminated Eichbauer.
- Bureau of Health Care Services (petitioner) summarily suspended his nursing license and filed an administrative complaint alleging violations of the Public Health Code (general duty and incompetence).
- ALJ dissolved the summary suspension (insufficient evidence of danger to public health) and later proposed dismissal on the merits for lack of proved breach of standard of care.
- The Board of Nursing Disciplinary Subcommittee (DSC) disagreed, finding repeated failures to document wasting of controlled substances violated the general duty and standard of care; DSC placed Eichbauer on probation, required continuing education, and fined him $250.
- On appeal, the Court of Appeals reviewed whether the DSC’s decision was supported by competent, material, and substantial evidence and whether evidentiary limits on cross-examination were proper.
Issues
| Issue | Plaintiff's Argument (Bureau) | Defendant's Argument (Eichbauer) | Held |
|---|---|---|---|
| Whether petitioner proved breach of standard of care for documentation/wasting of controlled substances | DSC: Repeated failures to accurately document wasting violated general duty and standard of care for nurse anesthetists | Eichbauer: Petitioner failed to establish standard of care (relying on HFHS policy), no proof of missing drugs, and common practice showed widespread minor errors | Held: Sufficient competent, material, substantial evidence supported DSC that Eichbauer breached general duty and standard of care |
| Whether the expert’s standard-of-care testimony impermissibly relied on internal hospital policy | Petitioner: Expert testified standard requires documenting administration and waste; not limited to HFHS form | Eichbauer: Johnson relied on HFHS internal policy and didn’t show local community standard | Held: Johnson’s testimony described a general standard (document waste and witness signature); not limited to HFHS policy, and he was qualified to testify about local standard |
| Whether ALJ improperly limited cross-examination of petitioner’s expert | Petitioner: Limitation was appropriate because counsel pursued irrelevant line implying requirement to use HFHS pharmacy form | Eichbauer: Cross-examination into basis of expert’s opinion was restricted, denying full inquiry | Held: Limitation was proper; questions about HFHS policy specifics were irrelevant to the general standard at issue |
| Whether absence of evidence that drugs were diverted defeats finding of misconduct | Petitioner: Fate of unaccounted drugs is irrelevant to duty to document waste | Eichbauer: No drugs reported missing undermines violation allegation | Held: Court agreed the ultimate fate of drugs is irrelevant; failure to document waste itself breaches the duty |
Key Cases Cited
- Dep’t of Community Health v Risch, 274 Mich App 365 (review of administrative agency requires findings be supported by competent, material, substantial evidence)
- Dowerk v Oxford Twp, 233 Mich App 62 (definition of substantial evidence)
- VanZandt v State Employees’ Retirement Sys, 266 Mich App 579 (review considers whole record, not just supporting portions)
- Zdrojewski v Murphy, 254 Mich App 50 (internal institutional policies cannot alone establish legal duty in negligence claims)
- Wiley v Henry Ford Cottage Hosp, 257 Mich App 488 (nursing standard measured by local professional practice; expert testimony required)
- Bahr v Harper-Grace Hosps, 448 Mich 135 (expert with comparable practice experience can testify to local standard)