Ms. G worked as a nurse at an outpatient surgical facility. In this role, she had the opportunity to work with numerous physicians. One of her favorites was Dr. K, an ophthalmologist.

Unlike some of the other doctors, Dr. K was friendly and dealt with Ms. G as a colleague, treating surgical procedures as teaching opportunities. Ms. G appreciated this, and found working with Dr. K interesting and informative.

One day, Ms. G’s supervisor told her that Dr. K had requested that she assist during surgery. The patient, Mrs. M, was having a small mass on her eyelid removed. Prior to the procedure, Dr. K took Ms. G aside to speak with her.

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“It’s a very routine procedure,” Dr. K said, “but I wanted to warn you that the patient can be a bit prickly. She seems to be very suspicious and a bit of a complainer. I’ve been treating her for years, but she sought five second opinions before agreeing to this. I never had a patient who asked so many questions. I just want you to be aware.”

Ms. G told the physician that she understood. The clinicians then went into the patient’s room and began preparing for the procedure. Mrs. M had signed all the consent forms and was introduced to Ms. G.

The procedure went well, and the mass was successfully removed from Mrs. M’s eyelid. However, the patient began reciting a litany of complaints almost as soon as surgery began. She loudly complained about the temperature of the room (too cold), the anesthetic injection (too painful), and the temperature of the ECG pads (also too cold). And when Ms. G started to inflate the automatic BP cuff, the patient began shrieking.

“Ouch!” Mrs. M yelled. “That hurts! Take it off!”

At that point, the cuff deflated but began inflating a minute later. Mrs. M continued to complain about the pain, demanding that Ms. G remove the cuff immediately. Ms. G looked at Dr. K, who shrugged. Ms. G left the cuff in place, but after the third inflation — and the third outburst from Mrs. M — the physician nodded at Ms. G and she removed the cuff. The rest of the procedure took place without BP monitoring.

After Mrs. M went home, the two clinicians shook their heads and made a few comments to each other, assuming they had seen (and heard) the last of the patient for a while.

Following the operation, Mrs. M went to another surgeon who performed a pronator teres release and discovered damage to her right arm. The blood vessels in her arm had hemorrhaged, and blood had collected around her median nerve, causing severe and permanent injury. Mrs. M retained a plaintiff’s attorney and filed a malpractice lawsuit against Dr. K, Ms. G and the surgical facility.