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Nurses’ written accounts or documentations are critical for planning and evaluation of medical interventions and patient care. Providing false documentations could lead to incorrect treatment decisions compromising patient safety. This negligence can lead to a case being filed against an RN/LVN and your license could be in danger if not defended by an experienced nurse attorney.

At the time of the initial incident, he was employed as an LVN at a hospital in Edinburg, Texas, and had been in that position for five (5) months.

On or about August 1, 2020, while employed as an LVN at a hospital in Edinburg, Texas, LVN documented inaccurate information in the medical record of a patient. LVN documented in error an incident where the resident pushed another resident. Instead of correcting the error, LVN documented an additional entry stating the incident report error was due to LVN’s poor concentration and sleepless nights. LVN’s conduct resulted in an inaccurate medical record.

Another incident happened on or about August 9, 2020, while employed as an LVN at a hospital in Edinburg, Texas, LVN documented a respiratory assessment in the medical record of a resident stating that the resident was using his chest muscles to breathe and was gasping for air at 7pm; no interventions were performed. The resident was found around 8:45pm unresponsive and was pronounced deceased. LVN’s conduct resulted in a delay in treatment for the resident that was needed to prevent further complications and may have contributed to the resident’s subsequent demise.

In response, LVN states that when he was instructed to correct the error, he added an entry that he believed his earlier report was accurate, but if it was considered incomplete it was due to interruptions in his regular sleep cycle imposed by the requirements of his job. Furthermore, LVN states that he incorrectly documented that the resident was “gasping for air” when in reality the resident was merely “breathing deeply.” LVN states that he agrees that interventions would have been necessary and appropriate if the resident had indeed been gasping for air at 7pm, but that was not the case. LVN states that he regrets the documentation error and understands how bad it makes him and the facility look.

The above actions constitute grounds for disciplinary action in accordance with Section 301.452(b)(10)&(13), Texas Occupations Code, and is a violation of 22 TEX. ADMIN. CODE §217.11(1)(A),(1)(B),(1)(C),(1)(D),(1)(M)&(2)(A) and 22 TEX. ADMIN. CODE §217.12.(1)(A),(1)(B),(1)(C)&(4).

A case was ultimately filed against him before the Texas Board of Nursing (BON). The said allegation was fatal to the LVN’s capability to perform the essential functions and duties. Sad to say, the nursing defense attorney who handled his case was not able to properly defend his interests and rights before the Board. The Texas Board of Nursing (BON) found him guilty of the offense alleged in the complaint and decided to place his LVN license under disciplinary action.

If you also received a letter from the Texas Board of Nursing regarding a case or complaint filed against you, you should hire a nurse attorney immediately before it’s too late. Texas Nurse Attorney Yong J. An is one of those dedicated nurse attorneys who helped represent more than 300 nurse cases for the past 16 years. You may contact him 24/7 at (832) 428-5679 for more information or if you want to schedule a private consultation.