Can I Use Another Student's EpiPen to Save a Child's Life?

Carolyn Buppert, NP, JD

Disclosures

May 01, 2013

To submit a legal/professional nursing question for future consideration, write to the editor at syox@medscape.net (include "Ask the Expert" in subject line).

Question

What are the legal ramifications if a nurse who acted in good faith to save a child's life used another child's epinephrine autoinjector to do it?

Response from Carolyn Buppert, NP, JD
Attorney, Law Office of Carolyn Buppert P.C., Bethesda, Maryland

The School Nurse's Dilemma

The school nurse who asked this question of Medscape provided the following background information for the question:

"Children with food allergies are at risk for anaphylaxis and can die within minutes of exposure. Anaphylaxis can be treated with an injection of epinephrine. Although epinephrine is safe and easy to administer with an epinephrine autoinjector (one brand is the EpiPen®, Mylan Specialty, LP; Basking Ridge, New Jersey), it is a prescription drug.

States are beginning to pass laws that require schools to stock epinephrine autoinjectors for children who may have an anaphylactic reaction at school. Ohio Revised Code 3313.713 says that prescribed medication cannot be administered to a student until a written authorization from the parent and prescriber requesting that the medication be administered.

As a nurse working in the schools, I am not worried about the children who have EpiPens. I have a means to help those children when and if an allergic reaction occurs. I am worried about the students in whom we have no knowledge of an allergy, and therefore have no emergency medication available. Time is paramount in waiting for emergency medical services to arrive with lifesaving medication.

As a healthcare professional, I would find it unconscionable to let a child die in my presence when I have the means to save that student, even though the EpiPen at my disposal was not prescribed for that child. What are the legal ramifications if a nurse who acted in good faith to save a child's life used another child's EpiPen to do it? Does the law permit any leeway that covers a situation like this? I don't think I could tell the parents of a dead child that I could have saved their child, but I didn't because I didn't have the proper form on file. This is a situation that all nurses working in schools face every day, and all hope that they never have to make that decision."

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