All the details in our Health Safety stories come from publicly available Final Orders, Consent Orders, Orders of Suspension and other documents from the Virginia Department of Health Professionals. For more information, see the Editor’s note below the story.
NEW MARKET – A 76-year-old woman came in to Life Care Center in New Market on February 5, 2020. She had been in the hospital for several weeks before, suffering from lower extremity edema and cellulitis.
During her admission, nurses and physical therapists immediately noticed signs of neurological compromise in the patient. She had muscle weakness, poor lower extremity motor control, diminished sensation of her lower extremities and feet, numbness, and tingling in her lower extremities after briefly standing.
A Life Care physical therapist told Advanced Practice Registered Nurse Amanda Renee Welch her symptoms were not consistent with cellulitis. Welch was licensed to practice on June 4, 2019, the preceding year. Her license is registered in Staunton.
When Welch inspected the patient on Feb. 10, she found her reflexes were intact. She did not ask the patient to stand or walk, but wrote the patient was “using her hand to pick up her leg to reposition on the wheelchair” because of “inability to use her legs.”
She thought the patient's symptoms were “questionable” and possibility a psychological issue.
By Feb. 17, the patient could not sense when she was voiding her bladder or bowels.
By Feb. 24, she was experiencing back pain, diminished strength, and reduced muscle control.
On Feb. 28, she had an MRI. This was when Welch found the patient could not walk and had severe degenerative changes. She “may be in need of surgical interventions” and needed to be seen by a neurospecialist “ASAP.”
Welch told an investigator with the Department of Health Professions she “recognized that a neurosurgeon needed to be consulted and become involved in [the patient's] care sooner than later.”
The patient did not go to the hospital for another eight days.
A neurosurgeon diagnosed the patient with incomplete paraplegia, then performed surgery on March 12. Her condition only slightly improved.
The Virginia Committee of the joint boards of Nursing and Medicine met to review Welch's case in April this year. Welch came to the proceeding in person with a legal representative.
The board put Welch on probation on May 3, requiring her to comply with all laws and regulations for five years lest her license be revoked.
Probation terms include:
- Welch will be on probation at least until she completes six months of active practice as an advanced registered nurse.
- She can only work in a structured practice employment setting pre-approved by the committee of joint boards and under the supervision of a physician approved by the committee.
- Bimonthly self reports to the committee. The physician will also provide reports every other month.
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To file a formal complaint against a health professional, click here . For links to the public information informing this story, see below.
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EDITOR’S NOTE: When citizens are a danger to the public safety, law enforcement arrests them and charges them with crimes; they have the opportunity to face a jury of their peers; if convicted, they serve time and/or probation that can often ensnare them in the system for years.
When a medical professional is an alleged danger to the public safety, the Virginia Department of Health Professionals handles all facets of the inquiry, including the investigation and penalties. And sometimes, even when a medical professional is found liable of doing harm to patients, they may face a reprimand, pay a fine and continue to practice, without missing a day of work and with little chance for the public to see what they’ve done.
The Health Safety stories in this series tell the facts of cases where medical professionals endanger our public health safety. They also bring you into the world of the medical board’s consent orders and public final orders, so you can see exactly how the VDHP’s self-policing system works.
Lyra Bordelon (she/her) is the public transparency and justice reporter at The News Leader. Do you have a story tip or feedback? It’s welcome through email to lbordelon@gannett.com . Subscribe to us at newsleader.com .
This article originally appeared on Staunton News Leader: Nurse questions neurological symptoms, mistakes them for psychological issues
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