re: SB 435 would allow advanced practice nurses to not work under a physician

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If you don't mind me asking, were they cases of bad luck

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First was a compartment syndrome. Went to the ER after waking up with ankle pain. NP did uric acid and Xray, charted a good exam, and DX the guy with gout (middle aged black guy). Told to F/U with PCP in 2 days. Guy follows up, PCP (MD) doesn't do much, puts guy on different NSAID. 1 week later guy comes back with foot drop. PCP does US that shows popliteal abscess. Transferred to Ortho for emergent surgery due to compartment syndrome. Review panel clears ED Doc (as they should, MD just signed pain need Rx) and F/U doc. Says although this was a unique presentation, NP should have picked up on it. Put was symptomatic for 3 hours before seeing NP. Attorney says CBC was standard of care, and would have pointed to abscess.

Second was a guy that presented with chest pain and productive cough to a UC. NP Rx'd levaquin for bronchitis (which I would not have done, but the guy smoked and had and of recurrent bronchitis). 3 days later presents with STEMI due to dissection. Attorney says it's from Levaquin which had a black box warning for bronchitis (which was released after the incident happened). We found in favor of the NP, but admitted it wasn't a great idea to jump to a quinolone at first. They guy had a history of non-compliance and had a recent negative cardiac workup.