Posted in: Medical Malpractice | Feb 21,2025

Nurse practitioners (NPs) and physician assistants (PAs) are essential healthcare professionals in modern medical care, but growing responsibilities can increase legal and ethical obligations and impact patients’ conditions or quality of life. When nurses and assistants negligently fail to provide care meeting established standards, patients can suffer the consequences of medical malpractice. Under medical negligence law, victims and their malpractice attorneys can hold NPs and PAs accountable for errors, omissions, or actions that cause harm.

Understanding the scope of practice for NPs and PAs and the legal and regulatory frameworks that govern them can help build and strengthen your medical malpractice case. Being able to identify responsible parties with evidence of their actions or inactions gives your medical malpractice lawyers the necessary information for a thorough investigation.

 

The Scope of Practice for Nurse Practitioners and Physician Assistants

Nurse practitioners and physician assistants train to handle a wide range of healthcare responsibilities and medical tasks, including diagnosing illnesses, developing treatment plans, ordering diagnostic tests, and prescribing medications. However, specific state and federal laws carefully regulate the full extent of their authority and independence to ensure patient safety under the care of NPs and PAs.

 

Indiana’s Reduced Practice Model for NPs

Indiana operates under a Reduced Practice model for nurse practitioners, which means they cannot practice independently. Instead, NPs must collaborate with a supervising physician to provide care. This legal framework restricts an NP’s ability to independently diagnose or prescribe medication without physician oversight.

In practical terms, NPs in Indiana can:

• Diagnose and treat common conditions like infections or chronic diseases under a collaborative agreement.
• Prescribe medications, including controlled substances, with limits outlined in their agreement.
• Provide preventive care, such as conducting wellness exams or administering vaccinations.

However, some tasks fall outside an NP’s scope of practice in an effort to mitigate opportunities for negligence, such as:

• Performing complex surgical procedures.
• Diagnosing rare or highly specialized medical conditions without physician input.
• Prescribing certain high-risk medications, such as opioids, without approval from their supervising physician.

For example, while an NP may manage a diabetic patient’s routine care, they need physician consultation to address severe complications like diabetic ketoacidosis. This collaboration ensures patients in high-risk scenarios receive expert care. If cooperation and communication break down—such as when an NP fails to seek timely input from their supervising physician—errors like misdiagnosis or delayed treatment can occur.

 

Supervisory Requirements for PAs

Physician assistants must also operate under a structured system of supervision. PAs have training to assess patients, order tests, and develop treatment plans, but they must do so under the oversight of a licensed physician.

Indiana law governing physician assistants includes mandates such as:

• A supervising physician must periodically review a certain percentage of a PA’s patient charts.
• PAs must work within an agreed-upon scope of practice as outlined in their supervisory agreement.

Following state regulations and their supervisory agreements, healthcare facilities permit PAs to independently perform various tasks, including:

• Conduct routine physical exams or perform basic procedures like suturing.
• Assist in surgeries under a physician’s direct supervision.
• Prescribe medications, including controlled substances, when authorized by their supervising physician.

However, PAs are not permitted to:

• Make independent medical decisions beyond their agreed-upon responsibilities.
• Perform complex or specialized medical procedures without physician approval.
• Serve in a supervisory role overseeing other healthcare providers.

For instance, a PA managing a patient with acute chest pain may order initial diagnostic tests, such as an EKG, but they would need to consult their supervising physician to confirm a diagnosis of a heart attack and initiate advanced treatment. If this consultation does not happen—or the physician fails to properly oversee the PA’s care—the patient could suffer serious harm.

 

Montross Miller: Advocates for Victims of Medical Negligence

Navigating the complexities of medical negligence law and medical malpractice cases can be difficult for victims and their families, especially when multiple parties—such as nurse practitioners, physician assistants, and supervising physicians—may share responsibility. That’s where Montross Miller steps in.

If you believe you or a loved one are a victim of negligence due to a nurse or assistant performing tasks outside their specified scopes of practice, taking specific steps can make a significant difference and help experienced attorneys build your case:

• Request copies of your medical records: These documents can provide critical details about your diagnosis, treatments, and the roles of specific providers.
• Journal appointment details: Record the names of the providers involved, what was discussed during your visits, and any treatments or medications prescribed.
• Tracking errors or concerns: If you experience an adverse outcome, document the symptoms, complications, or any observed gaps in care, treatment, and recovery.

Gathering this information helps build a strong foundation for your case and gives our team crucial details necessary to hold negligent parties accountable.

For more than 40 years, Montross Miller has been a trusted ally for those harmed by medical malpractice. Our experienced attorneys, including a licensed physician, are uniquely equipped to meticulously investigate and handle cases involving NPs, PAs, and the healthcare providers and facilities that oversee their work.

If you or a loved one has suffered harm due to the negligence or medical malpractice of a nurse practitioner, physician assistant, or supervising physician, contact Montross Miller today for a confidential consultation. We’re here to hear your story, answer your questions, and guide you through every step of the legal process.