Ethan Belcher Negligence Case Study

Case
Summary

In 2009, Ethan Belcher a first grader at
Kelly Elementary School in Wichita, Kansas was excused from class to use the
restroom.  While using the urinal, his
pants came in contact with an undiluted general-purpose disinfectant solution
that had puddled onto the floor. 
According to court documents, after returning to class, the student
began “complaining of burning and stinging” near his left hip area, (The
Wichita Eagle, 2018).  The student was
sent to the nurse and returned to class with an ice pack.  The teacher became concerned as the student’s
condition worsened and he was carried to the nurse’s office for further
examination.  It was then discovered the
student had a five inch by four-inch wound on his left hip area.  Ethan was taken to the hospital where doctors
later determined the student had suffered a third-degree chemical burn.  Ethan had to undergo several surgeries and
major skin grafting while spending a month in the burn unit.  His mother filed a lawsuit alleging the
Wichita School District was negligent in ensuring her son’s safety at school.   A settlement was reached out of court in
February 2014.

Application to Readings

HISTORY OF SCHOOL NURSING   

      School nursing
dates back over a hundred years and the basic need to provide a safe and
sanitary environment in which to attend school and learn was the focus.  A safe, healthy environment continues to be one
of the main components of a successful school health program today.  Over 90% of all children spend their days
inside school buildings making them vulnerable to array of environmental
hazards (healthyschools.org, 2018).  Some
potential sources of exposure in schools include biological and chemical
hazards, air, food and water contaminants (Schwab, 2005).  These exposures during childhood can have a
lifetime impact due to student’s developing organs, body size and
vulnerability.  All children are at risk
of developing future health and learning difficulties due solely to the
environment of their school (healthyschools.org, 2018).  Students must be able to learn in an
environment free of hazardous contaminants posing health risks to them.  Currently, the Environmental Protection
Agency (EPA) regulates chemicals found in school buildings and every chemical
used in schools must have a Material Safety Data Sheet (MDSD) that describes
chemical properties, storage, disposal, potential hazards, as well as
protective equipment and spill handling procedures (EPA.gov, 2018).   Many schools have started adopting green
cleaning programs by selecting alternative products to help minimize health
risks.  States play a critical role in
the implementation of a healthy school environment by setting guidelines to encourage
school districts to formulate the best plan possible to ensure all student’s
health and safety. 

SOURCE AND CLASSIFICATION OF LAWS

     The lawsuit filed by Ethan’s mother on behalf of her son, against
Wichita School District was a case law or law of judicial decision.  Although this lawsuit was settled out of
court it was determined a civil action lawsuit alleging negligence on part of
the Wichita School District and co-defendant, former school nurse, Cynthia Ann
Thomas.  The tort action of negligence does
not require any intent but results from a breach of legal duty (Schwab, 2005).  Ethan’s mother argued the school system was
negligent in ensuring her son’s safety at school.  First, for allowing hazardous chemicals to spill
on the floor, second, for failing to train custodians in the proper handling
and storage of chemical agents and finally, that the school nurse failed to
examine and identify the student’s injuries as well as initiate the proper care
and treatment of a chemical burn.  

NEGLIGENCE

     Ethan Belcher’s mother, Martha Smith, filed a lawsuit alleging
negligence against Wichita School District in permitting hazardous chemicals to
collect on the bathroom floor where students could be harmed and failing to properly
train employees on safe use and storage of chemical agents (The Wichita Eagle,
2018).  The undiluted cleaning solution,
which is normally diluted 2 to 3 ounces per gallon of water, soaked into the
student’s clothing causing a third-degree burn wound.  The lawsuit also names the school nurse as
co-defendant in the case stating she failed to assess the student’s injuries as
well as failed to identify and treat the chemical burn.  According to court documents, during the
initial health room visit the school nurse gave the student an ice pack but
never assessed the area causing discomfort.  It was later determined at the hospital the
wounds likely worsened and increased in size due to the delay in treatment at
school.   “Liability in a negligence action
does not require intent on the part of the defendant but proof that the
defendant’s conduct did not conform with a standard of care” (Schwab,
2005).  It appears the school district
and school nurse were negligent in ensuring Ethan’s safety and health while at
school.  If this case had gone to court
the four elements of negligence would have had to be proven with more than 50%
of the evidence indicating the school district and school nurse were at fault
in causing injury to the student.  The
school had a duty to keep a healthy
environment free and safe of hazards and the school nurse had a duty to assess the student’s health
concern/complaint.  Since the school
nurse failed to assess the needs of the student she then was unable to execute
the duty owed which establishes a breach
of duty.  This leads to a proximate cause.  The school nurse failed to assess for
injuries, and take action resulting in further harm to the student.  The student sustained an injury or damages in the case proving all four
elements of negligence were present (Schwab, 2005). 

STANDARDS OF PRACTICE

Assessment

    All school nurses have a duty to assess our students who are in our
care and collect all information needed to make a sound judgement in the
treatment or outcome of a student’s health situation (ANA, 2015).  In relation to this case, the student
appeared to have a complaint of burning and stinging that was not thoroughly
assessed.  According to court documents,
the nurse gave the student an ice pack and he returned to class. 

Diagnosis

   As school nurses we are required to analyze information in our
assessment to determine a potential problem (ANA, 2015).   Due to the limited assessment the school
nurse conducted, she was unable to formulate a proper diagnosis or health issue
in a timely manner.  The student’s health
continued to decline which resulted in an emergency. 

Outcomes Identification

     To identify an expected outcome for a plan, the school nurse must be
able to accurately assess and diagnosis the health situation (ANA, 2015).  In this case the school nurse’s assessment
and diagnosis failed to deliver a favorable outcome due to a poor initial
assessment.  This resulted in not being
able to develop an expected outcome or facilitate care in an efficient manner.  The student suffered a third-degree burn and
an extensive recovery.

STANDARDS OF PROFESSIONAL PERFORMANCE

Environmental Health

     The environmental health of Kelly Elementary School in relation to
this case was unsafe.  Schools use
chemicals in a variety of ways daily.  The
appropriate storage and proper management of chemicals must be maintained to
help ensure the environmental health and safety of students.  It only takes one incident to break a
community’s trust.  Toxic chemicals are
associated with several serious health problems and in this case a young boy
developed a third-degree burn with permanent scarring.  The school nurse can assist in promoting a
safe and healthy work environment by advocating for safer products to reduce
environmental risks (ANA, 2015).

Conclusion

      This legal case
shows the serious health hazards which can result from an unsafe
environment.  All schools use chemicals
daily in a variety of ways from cleaning agents to classroom chemistry labs,
elementary to high school level.  It is
imperative schools have a safe and effective chemical management program.  Improper use of chemicals can impact our
student’s health and safety as well as cost schools financial stress and
possible school closure or legal issues. 
Improving chemical management through proper training of staff, regular
inventory assessment to dispose of chemicals that are outdated or unauthorized,
and appropriate storage with accurate labeling can help the environmental
health of schools (EPA.gov, 2018).   An
area I feel strongly is incorporating green cleaning products into
environmental health programs.  Many
school districts have begun to adopt green cleaning programs and
practices.  “Green cleaning” products
reduce the harmful effects on health and the environment by using safe effective
alternatives that are environmentally friendly. 
 The school nurse has the
knowledge and understanding of environmental health issues and is in a pivotal
position to advocate for a successful sustainable healthy school environment (NASN,
2018).   A healthy school environment can create
lasting benefits to students and staff!

References

• American Nurses Association, (2015). Nursing: Scope and Standards of Practice (3^rd Edition Silver Spring, MD: ANA (pages 4-5).
• Environmental Law Institute, (2018). Retrieved from: https://www.eli.org/buildings/green-cleaning-schools
• Environmental Protection Agency, (2018). Retrieved from https://www.epa.gov/schools/role-states-fostering-environmental-health-programs-k-12-school
• Healthy Schools Network, (2018). Retrieved from https://www.healthyschools.org/coalition.html
• National Association of School Nurses, (2018). Retrieved from https://www.nasn.org/advocacy/professional-practice-documents/position-statements/ps-environmental-health
• Schwab, N.C. & Gelfman, M.H.B. (2005). Legal Issues in School Health A resource for School Administrators, School Attorneys, School Nurses. Lincoln, NB: Authors Choice Press.
• The Wichita Eagle (2018). Retrieved from https://www.kansas.com/news/article1132426.html