Sacramento Medical Malpractice Lawyer Blog

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

G. Home Remodel or Replacement Costs

One important item which Dr. Barchuk recommended, but Ms. Albee was unable to price, was the cost of either updating the Bates’ home to accommodate her disabilities or selling the current home and buying a home that is ADA compliant in bathrooms, hallways, kitchen, bedrooms, and entries and exits. For purposes of this letter, I will estimate the cost of either choice to be $135,500.

H. Loss of Consortium: Andy Bates

Andy Bates is entitled to his own claim for general damages for loss of consortium. He is not limited by his wife’s MICRA cap of $250,000 (see Atkins v. Strayhorn (1990) 223 Cal.App.3d 1380, 1394-1396). Under MICRA he has a separate MICRA cap of $250,000. Under EADACPA he has no cap. For purposes of this letter, his claim for loss of consortium under either cause of action will be $250,000.

III. SUMMARY OF DAMAGES
Claimants have the following damage claims pursuant to their First and Second Causes of Action:

1. Cost of Life Care Plan $12,123,769.64
2. Andy Bates’ Loss of Income $ 228,080.00
3. MICRA General Damages $ 250,000.00
4. EADACPA General Damages $ 625,000.00
5. EADACPA Attorney Fees and Costs $ 312,000.00
6. Home Remodel or Replace $ 135,500.00
7. Andy Bates’ Loss of Consortium $ 250,000.00

TOTAL $13,924,349.64

Continue reading "Carmichael Hospital Patient Files Medical Malpractice Claim, Part 5 of 5." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

C. Andy Bates: Loss of Income

Andy Bates is married to Susan Bates. He is currently employed as a shift leader at Denny’s Restaurant in Roseville. He works 35-40 hours per week earning $9.00 per hour. His average salary is, therefore, $333.00 per week, or $1,398.60 per month, or $16,783.20 per year.

In 2003, the Sacramento Superior Court appointed Andy and Susan as permanent legal guardians of two boys born to Susan’s brother, who were not getting proper parental care. The children were James (age 4 at the time) and Sean (age 9 months at the time). Shortly thereafter, Susan’s nephew also relinquished his parental rights to his daughter, Carli (age 5 at the time) and she was also placed with Susan and Andy. As a result, since 2003, all three children have been taken into Susan’s and Andy’s home and raised as their own children, with Andy serving as father and Susan as mother.

Prior to her paralysis Susan actively participated in caring for her family. She had an early morning job so she was off in the afternoon. She shopped for her family and cooked dinner. She cleaned the home and did the laundry and cared for the three children when they came home from school (Andy worked in the evenings) and put them to bed. She also shared the yard work.

Susan’s paralysis and care needs have placed a severe strain on the family. As a result, she has been unable to care for James, Sean and Carli. She has been unable to cook and clean as she did before.

Set forth in item B, above, are funds to hire an attendant to take care of Susan’s needs. This attendant is not, however, expected to care for the three children or perform household chores for the family.

Continue reading "Patient Suffers Paralysis At Citrus Heights Hospital, Part 4 of 5" »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

The patient will continue to require urological supplies, skin supplies, as well as bowel supplies which are delineated in the Life Care Plan.

The patient continues to require 24/7 attendant care. Her skilled needs are as follows:

1. Catheter changes
2. Wound care
3. Blood draws
4. IV antibiotic administration
5. PICC line maintenance and flushing

It is not anticipated, in view of the patient’s multiple medical problems, that she would be able to tolerate any sort of competitive employment in the future.

The patient is in need of an ADA compliant home supplied with air conditioning secondary to heat intolerance from his spinal cord injury.

The details of the above mentioned recommendations are included in the Life Care Plan Worksheet which will be reviewed with Tracy Albee, R.N., Life Care Planner.

It should be noted that as the patient ages with her spinal cord injury she will require more and more assistance and will become more and more dependent on others for her activities of daily living, self-care, grooming and hygiene, as well as mobility.

The patient should also enroll in a smoking cessation program as soon as possible.

Prior to the patient’s cervical myelopathy she was independent in all of her basic activities of daily living, self-care, grooming and hygiene and was described as a very active individual, hard working, taking pride in her family life.

Continue reading "Sacramento-area Woman Suffers Spinal Cord Injury In Hospital, Part 3 of 5" »

C. Third Cause of Action: Loss of Consortium

Andy Bates, husband of Susan Bates, makes a claim for loss of consortium following his wife’s total incapacity.

II. DAMAGES

A. Alex Barchuk, M.D.

In order to assess Ms. Bates’ need for ongoing medical and attendant care under both her First and Second Causes of Action, that is, for both (1) her paralysis/neurogenic bowel and bladder and (2) her stage IV sacral decubitis ulcer/colostomy bag, claimant was assessed at her
residence by Alex Barchuk, M.D., on August 29, 2007.

Dr. Barchuk is Board Certified in Physical Medicine and Rehabilitation. He is the Director of the Spinal Cord and Trauma Rehabilitation Program, Kentfield Rehabilitation Specialty Hospital, Kentfield, California.

Dr. Barchuk prepared a report and a DVD setting forth his findings and conclusions. Dr. Barchuk’s DVD is available for review. (The DVD contains a PowerPoint presentation that also includes a number of video clips of interviews with Mr. and Ms. Bates. Once loaded in the computer the presentation can be initiated by using your computer mouse in one of two ways. You can either scroll down to each subsequent page and then use the left click to initiate the video - - by left clicking on the video itself - - on that page, or you can left click on each image or page to advance to the next set of images or video.) Dr. Barchuk’s report and Life Care Plan Worksheet are referenced herein.

Dr. Barchuk states the following in his report beginning at page 18:

The patient is a 45-year-old married woman with history of acute cervical myelopathy status post C4 to C6 laminectomy with decompression evaluated at his home on 8/29/08. At that time a history was obtained from the patient as well as her husband and a physical examination was performed.

Continue reading "Roseville Couple Files Claim For Medical Malpractice , Part 2 of 5" »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

RE: Susan and Andy Bates

I. BRIEF SUMMARY OF CLAIMS
Ms. Bates’ claims involve two distinct separate injuries occurring at two different times. Her claims are brought under two separate legal theories and causes of action. Her first Cause of Action is for medical malpractice. Her Second Cause of Action is brought pursuant to The Elder Abuse and Dependent Adult Civil Protection Act (EADACPA), found at Welfare and Institutions Code §15600 et seq. As a result, she is entitled to and seeks two different financial recoveries.

In addition, Andy Bates makes a claim under the Third Cause of Action for loss of consortium.

A. First Cause of Action: Medical Malpractice

Ms. Bates’ First Cause of Action focuses on the care and treatment she received during the period she was hospitalized at United Hospital in Carmichael from December 26, 2005 through January 13, 2006. As a result of that hospitalization, Ms. Bates now has the following injuries:

1. Paralysis,
2. Neurogenic bladder,
3. Neurogenic bowel,
4. Chronic neuropathic pain.

This claim is subject to MICRA.

B. Second Cause of Action: Dependent Adult/Elder Abuse

Ms. Bates’ Second Cause of Action is brought pursuant to Welfare and Institutions Code §15600 et seq., the Elder Abuse and Dependent Adult Civil Protection Act (EADACPA). This claim focuses on United’s neglect of claimant, Susan Bates, after she was hospitalized for the above described paralysis and is distinct in time and injury from her paralysis claim. It occurred at ABC Hospital in Citrus Heights after January 13, 2007, and resulted in the following injuries:

1. Stage II sacral decubitus ulcer arising when Ms. Bates was an in-patient at United. This ulcer progressed as described in #2 below.

2. Stage IV sacral decubitus ulcer.

3. Placement of permanent colostomy bag required by the Stage IV sacral decubitus ulcer.

Continue reading "Sacramento-area Hospitals Sued for Malpractice, Part 1 of 5" »

I. BACKGROUND

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

WILLIAM SMITH cannot walk, run, stand, or drive. He does not have the use of his legs. He cannot use his left hand or arm. Two years ago, at the age of 62, Mr. SMITH was an active man. He loved to work in his yard and enjoyed traveling. Now he cannot do the things he loves. He is confined to a wheelchair. He has C5 incomplete quadriplegia. He has neurogenic bowels and bladder and must wear a Foley catheter twenty-four hours a day. He has to rely on someone else to help him cook his meals, cut his food, change his clothes, clean his back wound, and drive him to medical appointments and the store. He needs some one to be at home with him in case he falls because he cannot pick himself up. What happened to Mr. SMITH?

II. DEFENDANTS

There are currently four defendants in this case:

A. DR. X, M.D.:

Dr. X is a dermatologist practicing in Roseville. He treated Mr. Smith for many years. For two years preceeding March 23, 2002, he treated Mr. Smith for an open wound on his back that would become the focus of this litigation.

B. ABC HOSPITAL:

ABC HOSPITAL is a hospital operating in Roseville, California. Mr. Smith sought treatment on March 23, 2002, at ABC HOSPITAL for excruciating back pain secondary to the open back wound Dr. X had been treating. When Mr. Smith entered the hospital on March 23, 2002 he was ambulatory.

Continue reading "Sacramento-area Hospital Sued For Malpractice, Part 1 of 23." »

C. Dr. Y, M.D.:

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

Dr. Y. is an internist/general practitioner practicing in Roseville, California. Dr. Y was Mr. Smith’s attending physician from March 23, 2002 until March 25, 2002. He failed his medical boards and is not Board Certified.

D. Dr. Z., M.D.:

Dr. Z. is a physician specializing in the control of infectious diseases. He was following William Smith from March 23, 2002, the date of his admittance, until March 25, 2002, when Mr. Smith was found to be quadriplegic.

III. HISTORY

A. Medical:

Prior to March 23, 2002, Mr. Smith was in generally good health. He had undergone a radical prostatectomy for carcinoma of the prostate in December 2001, from which he had made a full recovery. In 1991, he underwent a vertebral laminectomy of the lumbar spine (L2-3) after which he developed a staph infection of the lumbar spine with a diagnosis of osteomyelitis. Dr. X was treating him at the time and placed him on a few weeks of IV antibiotic therapy. He made a full recovery. Mr. Smith’s history is positive for hypertension, skin cancers, Guillian-Garnes syndrome, and cholecystectomy.

B. Employment:

Mr. Smith was employed as a plant supervisor for many years. At the time of the incident he was temporarily not working while he recuperated from his prostatectomy.

Continue reading "Sacramento Man Sues For Medical Malpractice, Part 2 of 23." »

C. Miscellaneous:

Mr. Smith is divorced. He has four living children. Twenty years ago, in 1984, he suffered a criminal felony conviction for violation of penal code section 288a(b)2, lewd or lascivious acts involving children.

IV. THE WOUND THAT WOULD NOT HEAL

A. Dr. X., M.D.:

Dr. X’s records state that he began treating William Smith on September 16, 1999, for excision of a skin cancer on Mr. Smith’s upper back. The cancer was excised by Dr. X. on October 5, 1999.

On October 12, 1999, Mrs. Smith called Dr. X’s office stating “excision site looks infected.” On October 13, 1999, Dr. X's nurse recorded “site is red and painful. I think it's infected, patient states.”

Dr. X’s records are poor with little documentation. He rarely recorded his observations and rarely recorded performing physical exams.

The report of an infection on Mr. Smith’s upper back wound would prove prophetic of the lower back infection which is the subject of this lawsuit.

Later that year (his records are minimal); Dr. X. performed an excision on a basal cell skin carcinoma on Mr. Smith’s lower back. This is the wound that would not heal. It is the subject of this lawsuit.

Continue reading "Sacramento Man Files Claim For Malpractice, Part 3 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

On February 3, 2000, Dr. W. finished his radiation treatments of Mr. Smith’s lower back skin lesion. He returned Mr. Smith to the care of Dr. X..

On February 23, 2001, Mr. Smith returned to Dr. W. for a follow-up visit. Dr. W. noted in part to his report to Dr. X.:

“The patient states he is doing well except he has a chronic sore over the low back. The patient will return to see Dr. X. regarding this in the near future. He will return to see Dr. X. as scheduled.”

The contents of Dr. X's reports are referenced herein. The balance of Dr. W.’s records are referenced herein.

Under Dr. X.’s care the wound never healed. It became extremely painful. Dr. X. described it as an ulcer. Dr. X’s nurse recorded on December 21, 2001: “complains back hasn’t healed up since radiation.” The contents of these records are referenced herein.

Dr. X. used a number of drugs on Mr. Smith including various ointments, and Neurontin.

The pain from the back wound grew worse. William Smith’s family members described the wound as “infected, red, and foul smelling.”

When the pain grew unbearable, Dr. X. injected the open wound with 3 ml of Kenalog, a powerful steroid, on March 11, 2003.

Injecting an infected wound with a steroid has been described as “like throwing gasoline on a fire.”

Continue reading "Roseville Hospital Sued For Malpractice, Part 4 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

On March 18, 2003, Mr. Smith called Dr. X. “wanting to know if it was possible to come in today for more shots because he is in a lot of pain.”

Family members were sure Dr. X. was making William Smith worse. They begged him to change doctors. He responded that he still trusted Dr. X..

His back wound was now so painful that he could hardly drive his car.

On March 19, 2002, Mr. Smith again saw Dr. X.. Dr. X’s nurse recorded that he was complaining of “severe pain.” Dr. X. prescribed Vicodin as needed for pain. He again injected plaintiff's open wound with an additional 1 ml of Kenalog. Dr. Bock also had Mr. Fideldy on oral steroids. A copy of the record is referenced herein.

On March 21, 2002, Mr. Smith went back to Dr. X’s office with complaints of pain from the open back wound. Dr. X. increased his Vicodin and Neurontin. This would be Mr. Smith’s last visit to Dr. X..

When he returned home from Dr. X’s office on March 21, 2002, his ex-wife had to pull him from the car. He lay in a fetal position for 24 hours.

In the early morning hours of March 23, 2002, Mr. Smith's ex-wife, Ms. Greene, could not stand to see him suffer anymore. She insisted on calling an ambulance. Plaintiff agreed. At 4:47 a.m., she placed a call for an ambulance.

Continue reading "Medical Malpractice Leaves Sacramento Patient Quadriplegic, Part 5 of 23." »

B. ABC Hospital:

Immediately upon arrival the emergency room the doctor noted a large “draining wound” on his back. Unlike Dr. X., the medical staff at ABC Hospital immediately realized that the back wound may be infected. Unlike Dr. X., the emergency room doctor started plaintiff on Ancef, an IV antibiotic. He was admitted to the hospital. Unlike Dr. X., a culture was ordered. Mr. Smith was neurologically intact. An assessment of his back wound was performed by a nurse. She noted the following:

“DATE 3/23/02

WOUND NUMBER I
STAGE III
COLOR Red
DRAINAGE Yellowish
ODOR Yes”

Dr. Y. was filling in for Mr. Smith’s regular doctor, Dr. V., M.D. Because of Dr. V’s absence, Dr. Y. became Mr. Smith’s attending physician.

Unlike Dr. X., Dr. V. felt the wound might be infected. He stated in his history and physical: “We will empirically treat with antibiotics. We will talk to Dr. U. to rule out osteomyelitis or skin cancer infiltrating the subcutaneous tissue with MRI scan of the back.”

Dr. Y. was concerned that an infection could spread to Mr. Smith’s blood stream, causing sepsis.

On March 24, 2002, Dr. Y. visited Mr. Smith. He noted that Mr. Smith could move all four extremities but had difficulty lifting his legs. In his deposition, Dr. Y. said he thought this was secondary to pain but it is not noted in his records. At that time Dr. Y. received results from the blood culture. Mr. Smith had sepsis. It was gram positive, meaning it was either strep or staph.

Continue reading "Paralyzed Man Sues Doctors, Part 6 of 23." »

D. Nurse Robert Black:

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

On March 25, 2002, at approximately 7:00 a.m., Nurse Brown was replaced by Robert Black, RN. When he did his assessment of the patient at 0810 he noted:

“Does not move legs. Very weak movement to arms.”
.
This was in sharp contrast to Nurse Brown’s assessment at 2400 hours of:

“Full ROM [range of motion]”

In his deposition taken on June 16, 2004, Nurse Black testified as follows on page 17 line 8 through page 18 line 12:

“Q. In fact, you’re trained to call the doctor if there’s a significant change in condition, right?
A. That I am, yes.

Q. Okay. Now if you can compare the assessment done on the night [shift] to the assessment you did on the day [shift] at 0810, was there a change of condition?
A. That’s correct, there are.

Q. In fact, it was a significant change of condition.
[objection omitted]
THE WITNESS: I’m having trouble - - oh, okay. On the neuro, yes, it is. She writes that moves extremities, which would mean that he moved all of his extremities.

MR. COLLINS:
Q. And you wrote he couldn’t move his lower - - in other words, your assessment was he couldn’t move his lower extremities?
A. That’s correct.

Q. And that’s a very significant change in condition.
[objection omitted]
MR. COLLINS:

Q. Am I correct, sir, that’s a very significant change?
A. Based on what is written here it certainly is, yes.

Q. It looks like an onset of paralysis, true?
A. Yes.”

Page 20, lines 1 through 5:
“MR. COLLINS:

Q. Well, sir, let me just ask a question which really doesn’t require that foundation. Did you ever contact a physician regarding Mr. Smith’s apparent onset of paralysis?
A. Not to my recollection.”

Continue reading "Sacramento-area Hospital Sued For Malpractice, 7 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

Finally, at 1604 hours (4:04 p.m.) Dr. T., M.D., happened to drop by Mr. Smith's room. Mr. Smith’s sister was present in the room. She told the doctor that William was losing feeling in hands. Dr. T. seemed shocked. He quickly did a neurological assessment confirming Mr. Smith’s paralysis.

Dr. T. called for a STAT MRI of Mr. Smith’s cervical and thoracic spine to rule out “epidural abscess.” He called neurosurgery for a consult.

Something was finally begun, but it would prove to be too late to prevent a catastrophic paralysis.

An urgent neurosurgical consult was performed by Dr. S., M.D. He recorded: “the neurological exam reveals that the patient has complete paralysis below the biceps level.” It was also discovered that Mr. Smith’s infection was MRSA.

Dr. S. noted:

“IMPRESSION: This is a patient who is septic with MRSA and has an hitherto undetermined period of paralysis that is, on exam, complete at the C6-7 level. The MRI findings are suspicious for disc space infection at C6-7 which would be seeding of this disc space hematogenously via the sepsis.

PLAN AND DISCUSSION
Since the patient’s neurological deficit is complete, his likelihood of making any sensible or functional recovery with any procedure at this point is low. However, without any procedure, the patient is for certain likely to remain in a state of complete paralysis. Since the duration of the completeness of the deficit is difficult to determine, and the possibility that the completeness may be recent exists, it is reasonable to propose a relatively ‘small’ procedure in an attempt to drain the infection. With this in mind, I reviewed the patient’s MRI scan with the patient’s family and recommended an anterior cervical discectomy at C5-6 and C6-7 without fusion. I would include 5-6 in the procedure since there is some spondylotic bar compressing the spinal canal in this region. I emphasized to the family that the likelihood of a substantial recovery with such a procedure would be low; however, this should be considered a last ditch heroic effort employing an operative procedure that is relatively short in duration and does not involve extensive dissection.”

Continue reading "Physicians In Roseville Hospital Sued For Malpractice, Part 8 of 23." »

V. CURRENT STATUS

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

Mr. Smith was recently assessed by Alex Barchuk, M.D., a Board Certified Physiatrist specializing in the long-term care of patients with serious spinal cord injuries. Dr. Barchuk is currently the Director of Trauma Rehabilitation, Spinal Cord Injury & Wound Clinic at Kentfield Rehabilitation Hospital in Kentfield, California.

Dr. Barchuk’s report states in part:

“DISCUSSION:
The patient is a 65-year-old divorced white gentleman, C5 ASIA Class C/D quadriplegic secondary to a cervical epidural abscess at C5 through C7, status post a decompression.

As a result of his quadriplegia he now has multiple medical issues including a neurogenic bowel, neurogenic bladder as well as weakness in his upper extremities, left greater than right decreased range of motion in his left shoulder and left hand, weakness in his trunk as well as lower extremities as well as sensory loss.

In view of his multiple medical issues he will require continuous medical follow up as well as therapeutic follow up provided by physical as well as occupational therapy to maintain his current functional status.

Continue reading "Claim for Medical Malpractice by Sacramento Man, Part 9 of 23." »

VII. ECONOMIC IMPACT REPORT

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

Robert Johnson, a Forensic Economist and President of Robert W. Johnson & Associates, has prepared an Economic Impact Report calculating the present cash value of Mr. Smith’s economic losses and future medical expenses. The report stated in part:

Total Expected Value Total Present Value
Expected Income $587,566 $579,542
Medical Expenses $2,286,027 $2,428,274
TOTALS: $2,873,593 $3,007,816

VIII. DAMAGES
General Damages $250,000.00
Wage Loss $579,542.00
Medical Expenses $2,428,274.00
TOTAL ECONOMIC DAMAGES: $3,257,816.00

IX. LIABILITY OF DR. X., M.D.

A. Dr. X’s treatment of William Smith's back wound was below the standard of care.

1. FAILURE TO CONSIDER OR TEST FOR INFECTION:

The wound did not heal for more than two years under Dr. X’s inadequate care. During this time, Dr. X. failed to consider infection as a possible cause of the chronic ulcer or his severe back pain even though this possibility was immediately recognized by Mr. Smith’s family. Ms. Greene, plaintiff's ex-wife, and both of his sisters (Susan and Mary Smith) described the wound’s appearance on March 17, 2002 while he was under Dr. X’s care as follows:

Continue reading "Paralyzed Man Sues For Medical Malpractice, Part 10 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

Susan Smith:
“MC: On that occasion [3/17/02] did you happen to see the wound on William’s back?
SS: Yes.

MC: How did you come to look at it?
SS: Because our aunt was so upset so she said come and look at, he never wanted us to look at it, and we all went over there and looked at it. Unbelievable.

MC: What did you see, how would you describe it?
SS: It was gross, it was just unbelievable. It was all red and swollen and smelled.

MC: Have you had children?
SS: I have four daughters.

MC: So you’ve seen an infected wound before?
SS: Yes.

MC: Was that wound infected when you saw it?
SS: Yes.

MC: Clearly infected?
SS: Yes.

MC: No doubt in your mind?
SS: Yes, because it was red all around it.

MC: You were just shocked at the way the wound looked?
SS: Yes.

MC: You couldn’t believe that the wound was that bad?
SS: No.

MC: After Dr. X. had been taking care of it for two years?
SS: Right.”

Mary Smith:
“MC: On 3/17/2002, you gathered at William’s house, the whole family?
MS: Yes.

MC: On that occasion on 3/17/02, did you look at the sore on William’s lower back?
MS: Yes we did.

MC: Had you ever seen that sore before?
MS: No. . . . He was in a lot of pain, so we just insisted on looking at it.

MC: So, on 3/17/2002, you took a look at it?
MS: Yes.

MC: Can you tell us what you saw?
MS: Red all around it, there were red streaks, his whole back was red.

MC: Was there a smell?
MS: Yes, terrible smell.

MC: When you looked at that sore, did it look infected to you?
MS: Yes.

MC: And that’s because of why?
MS: Because of all the redness and swelling and smell.”

Continue reading "Physicians Sued By Sacramento Patient, Part 11 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

From the outset, Dr. X. knew that Dr. W’s radiation treatment might result in an infected wound. Dr. X. testified on page 43, lines 11 through 19:

“Q. But my question to you, sir, you knew when you sent him down to see Dr. W. that what Dr. W. was going to do carried with it a risk of infection of that area?
A. Correct, but no greater risk than any other treatment of skin cancer.

Q. Whether or not it’s greater or lesser, you knew there was a risk of infection?
A. That’s correct.”

In fact, Dr. X. testified that with 90 percent of his patients he has to consider infection:

Page 45, lines 11 through 16:

“A. On almost 90 percent of what we see there’s always a potential for a pathway for infection to start.
Q. So 90 percent of the things you see you’ve got to be considering infection?
A. We’re always aware of the possibility. I’m always aware of the possibility of infection.”

In his testimony, Dr. X. sets forth his personal standard of care: “I’m always aware of the possibility of infection.” He failed to follow his own standard of care when treating William Smith’s open back wound.

Incredibly, Dr. X. does not feel he should be criticized for failing to consider that this chronic and increasingly painful wound might be infected. This is a true even though he conceded plaintiff’s worsening pain would be a sign of infection.

Page 96, lines 7 through 17:

“Q. Infection had not been ruled out, true?
A. Infection had not been ruled out, but one would expect if infection were an element in here that there would be over time, that things would get worse.

Q. Okay. Would the pain get worse?
A. It’s conceivable pain would get worse. It would be one potential change with infection.

Q. Pain getting worse, it would be saying to you well, maybe the cause is infection, right?
A. Infection would be one of the things that I would consider.”

Continue reading "Sacramento-area Hospital Sued By Patient, Part 12 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

2. FAILURE TO REFER TO A SPECIALIST:

After having tried to close the open wound for six months, or perhaps even a year, the standard of care would require Dr. X. to send Mr. Smith to a wound specialist or a plastic surgeon. As the months and years went by, Dr. X. failed to refer Mr. Smith to an appropriate wound specialist or plastic surgeon.

It was critical to plainitff’s health that the open wound be closed by plastic surgery if necessary. This is because the skin acts as a barrier to infection. When the skin is broken, bacteria can enter. Dr. X. testified on page 44, lines 8 through 11:

“Q. So when the skin is broken, there’s always a risk of infection?
A. There’s a risk of infection when the skin is broken.”

3. STEROID INJECTION: “THE WRONG THING TO DO”

In the hospital Mr. Smith was confirmed with an MRSA infection in his wound. Dr. X. had injected this infected wound with Kenalog, a powerful steroid, on March 11 and March 19, 2002. Dr. X. testified on page 71, lines 14 through page 72 line 25:

“Q. Right. And would you agree that injecting an infected wound with a steroid such as Kenalog would be the wrong thing to do?
A. I would agree that injecting an infected wound with Kenalog would be the wrong thing to do.

Q. Why would it be the wrong thing to do?
A. Kenalog can interfere with the healing process and with the immune process.

Q. And tell me what you mean by that.
A. It can - - Kenalog can slow down the growth of fibroblasts which make new tissue and can slow down the growth of and thin the epidermis, the skin, and it can also slow down the - - reduce the effectiveness of the body’s inflammatory cells.

Q. So injecting an infected wound with Kenalog makes it harder for the body to fight the infection?
A. It could.

Continue reading "Sacramento Hospital Patient Left Quadriplegic, Part 13 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

X. LIABILITY OF ABC HOSPITAL

The nursing staff at ABC HOSPITAL failed to summon the appropriate care for William Smith as he descended into quadriplegia on their ward and under their care.

A. STANDARD OF CARE: CALL A DOCTOR

ABC Hospital's nurses admit they are trained to call a doctor when they note a significant change in condition:

Nurse Paul White on page 41, line 24 through page 42, line 4:

“Q. What have you been trained - - have you ever had any training on what to do if a patient was ambulatory and then suddenly became paralyzed?
A Yes.

Q. What did your training tell you to do?
A. We have to notify the doctor.”

Nurse Black on page 17, lines 3 through 10:

“MR. COLLINS: Q. Sir, do you recognize the phrase “change of condition.”
A. Yes, I do. Of course, there’s a big change in condition and smaller changes in condition, but yes, I do.

Q. In fact, you’re trained to call the doctor if there’s a significant change in condition, right?
A. That I am, yes.”

Nurse Black admitted the change in condition of plaintiff on March 25, 2002, looked like the onset of paralysis:

Page 17, line 11 through page 18, line 12:

“Q. Okay. Now if you can compare the assessment done on the night to the assessment you did on the day at 0810, was there a change of condition?
A. That’s correct, there are.

Q. In fact, it was a significant change of condition.
[objection omitted]
THE WITNESS: I’m having trouble - - oh, okay. On the neuro, yes, it is. She writes that he moves extremities, which would mean that he moved all of his extremities.

Continue reading "Medical Malpractice At Roseville Hospital, Part 14 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

B. WAS A DOCTOR CALLED?
Nurse Brown (11 p.m. to 7 a.m. shift) claims she called Dr. Y. and told him the patient could not longer move his legs. She does not document that she gave Dr. Y. this critical information.

Nurse White states the nurses are trained to document that they notified the doctor of the change in condition:

Page 42, lines 6 through 16:

“A. We have to do a, you know, like a documentation of our observations.
Q. So in the medical records you’d document the fact that he could no longer move the legs?
A. Yeah.

Q. And you’d document that you notified the doctor?
A. On what case?

Q. You’ve been trained - -
A. Yeah, yeah, based on our training, yes, we’d do that.”

The written policy of ABC Hospital regarding contacting physicians states in part:

“ATTACHEMENT A
6. Be concise and organized in your presentation of appropriate information: state clearly why you are calling; what the problem is; get to the point.”

The policy goes on to state:

“IMPORTANT NOTES
1. All of the above should be carefully timed and documented.
2. Do not hesitate to get help from other sourced and higher authority such as: other physicians known to be within the facility; section, department and executive staff chiefs.”

Continue reading "Sacramento-area Hospital Negligence and Malpractice, Part 15 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

Page 20, line 15 through page 21, line 8:

“MR. COLLINS: Q. Okay. So you noted that he couldn’t move his legs, and then you went about your duties on 4 West that day?
A. Yes sir.

Q. Did you tell the - - who was your supervisor?
A. The day shift supervisor position was shared. It was Sara Davies and Bobbi Edwards, who is now Bobbi English, and then the overall supervisor is Heather Jones.

Q. I’m sorry. Who is the day shift supervisor?
A. Sara Davies and Bobbi - - her name was Bobbi English (sic) at the time. She’s been remarried. It’s Bobbi English.

Q. Did you contact any of those people to tell them what was going on with Mr. Smith?
A. No, I did not.

Q. And you’ve been trained to do neuro assessments, true?
A. Yes, I have.”

Page 24, lines 6 through 18:
“Q. Okay. This form records the interventions that you do to assist the patient, right?
A. Yes.

Q. What does that mean, ‘interventions’?
A. It means to act within a process to - - for instance, to stop pain, to help with breathing if they’re having difficulty breathing.

Continue reading "Roseville Physicians' Malpractice Subject of Lawsuit, Part 16 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

C. NOTHING WAS DONE:
Nothing was done to help William Smith from 1:00 a.m. to 4:30 p.m. Nurse Brown tries to argue she called Dr. Y. and notified him of the patient’s status. Dr. Y. denies this. Nurse Brown failed to document she even told a doctor of his change of condition, a violation of the hospital’s policy and standard of care.

Even if Nurse Brown (an LVN) called Dr. Y. and he only said “start a Foley” she should have told her RN or charge nurse.

Allowing plaintiff’s paralysis to go untreated for fifteen and a half hours is a violation of the hospital’s standard of care. As Nurse Black testified on page 25, lines 15 through 16:

“The sooner you intervene in a process like that the better chance the patient has to recover.”

XI. LIABILITY OF DR. Y., M.D.
Dr. Y’s liability stems chiefly from the fact that Nurse Brown testified she told him of Mr. Smith’s paralysis and he did nothing except order a Foley catheter.

Nurse Brown's deposition, page 37, lines 7 through 15:

“BY MR. COLLINS: Q. Did you specifically call Dr. Y. to tell him of the change in condition from generalized weakness but could ambulate with assistance to can’t move his legs, can’t ambulate?
A. Yes.

Q. Okay. What - - and you told him that?
A. Yes.

Q. And what did he say to you?
A. Just put Foley catheter.”

Continue reading "Sacramento Man Left Paralyzed By Doctors, Part 17 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

In his deposition (not yet transcribed) Dr. Y. admitted urgent intervention was needed as soon as it was noted William Smith could not move his legs. He stated that had he known the patient could not move his legs at 1:00 a.m. on March 25, 2002, he would have immediately gotten out of bed, come to the hospital, and called for a neurosurgical consult. He said he would do all this in order to try and stop or reverse the paralysis.

If the jury believes Nurse Brown, they will find Dr. Y’s lack of intervention to be below the standard of care, by his own admission of what he should have done. The deposition transcripts of Nurses Black, Brown, and White are referenced herein.

XII. LIABILITY OF DR. Z.,, M.D.
Dr. Z. is an infectious disease expert. He was called to see William Smith on March 23, 2002. His consult is referenced herein.

Dr. Z’s liability is based on his failure to act appropriately to investigate, identify, and stop an infection that later rendered Mr. Smith quadriplegic.

In his deposition taken February 17, 2004, Dr. Z. admitted on page 28, line 22 through page 29, line 10:

“Q. But you also thought there might be a secondary infection, true?
A. Yeah. I thought there might be an infection there as well.

Q. What was the basis for your belief that there might be an infection?
A. Well, whole area of his low back where the skin was, it looked kind of inflamed.

Continue reading "Man Paralyzed At Roseville Hospital, Part 18 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

Page 30, lines 12 through 14:

“MR. COLLINS: Q. You said Dr. Y. was concerned about osteomyelitis under that area, right?
A. Under that infected wound.”

Page 43, lines 8 through 12:

“MR. COLLINS: Q. I’ll do it this way. Sir, you’ve been trained – you’ve had training on how to – what to do on a physical exam to rule in or out osteomyelitis, right?
A. Yes.”

Page 50, lines 2 through 15:

“Q. Did you perform a percussive exam of Mr. Smith’s back?
A. No.

Q. Or spine?
A. No.

Q. Have you been trained that that is one of the tools to diagnose
osteomyelitis?
A. If you’re thinking about it.

Q. So you have been trained that’s one of the tools, true?
A. If you think this might be some infection, yes, you can percuss there, yes.

Q. But you didn’t do it?
A. I didn’t think there was any need for it.”

Continue reading "Roseville Hospital Patient Paralyzed, Part 19 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

Q. Was there any contraindication to giving William Smith, on March 23,
2002, vancomycin?
A. If after seeing this patient and his history and physical and his background and his medical condition, if I thought that he should also be on vancomycin, there is no contraindication.”

Page 97 lines 5 through 8:

“Q. On March 24th, 2002, you did not do a percussive exam on Mr. Smith, true?
A. I did not do it because I did not think there was any need for it.”

Page 117 lines 13 through 16:

“Q. You had him on Ancef, and Ancef had no therapeutic value whatsoever for this patient it turns out?
A. On the 26th when you find out he’s MRSA, yes.”

In summary, Dr. Z’s care of Mr. Smith was below the standard of care in the following areas:

1. Dr. Z. knew that he was being asked by Dr. Y. to evaluate whether Mr. Smith had osteomyelitis (infection in the spine). In fact Dr. Z. had previously treated Mr. Smith for osteomyelitis in 1991.

Continue reading "Quadriplegic Patient Sues Sacramento-area Hospital, Part 20 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

XIII. PRIOR DEMANDS FOR SETTLEMENT
A. DR. X., M.D.:
Dr. X. has a policy limit of $1,000,000. On July 28, 2003, plaintiff served on Dr. X. an offer under CCP section 998, in the sum of $1,000,000.00. There has been no response.

B. ABC HOSPITAL:
ABC Hospital is insured by XYZ Insurance, Ltd., with a policy limit of $107,000,000, for each annual occurrence. On May 28, 2004, plaintiff served ABC Hospital with an offer under CCP section 998 in the sum of $1,250,000. There has been no response.

C. DR. Z., M.D.:
Dr. Z. is insured by Socal Mutual Insurance Company with a policy limit of $2,000,000 per incident. On March 1, 2004, plaintiff served Dr. Z. with an offer under CCP section 998 in the sum of $195,000. It was rejected.

D. DR. Y., M.D.:
On July , 2004, plaintiff served Dr. Y. with an offer under CCP section 998. There has been no response.

IVX. OTHER JURY VERDICTS
The following jury verdict may be of some assistance:

Fox v. Ramano Roe, M.D and Simi Valley (1998)

Continue reading "Roseville Hospital Sued For Millions, Part 21 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.) XV. LIFE CHANGE Since being diagnosed as a quadriplegic, Mr. Smith's entire life has changed. In his deposition on page 184, lines 10 through page 189, line 4, Mr. Smith testified how dramatically his life has changed: “A. My life has changed. I lost control of my bowel movement. I have accidents two or three times a month. I lost use of my legs and my left hand. I can’t work because as a plant supervisor there are no other job at this time. I worked a lot. I spent a lot of money on my backyard building a fish pond and building water falls, put a lot of trees in, a lot of bushes in so I could take care of them when I retired and I can’t do that now and that’s what I planned on doing when I retired, but now most of it is lost. I can’t drive so I need to have somebody to help me every time I go somewhere. When I get up, I have a hard time dressing myself. I need to do that while I’m still in bed to get my pants on. I have trouble getting in my wheelchair on my own. I can do so, but I wouldn’t want to do it without somebody being there. My bathroom, I need extra room and I had to lower everything down in my bathroom so I could shave and clean myself and shower. The toilet, I need bars on there and I have had a hard time getting off and on. I need to stimulate my bowel movement every morning in order to have a movement, which we already talked about. If I take stool softeners, which I’m supposed to do, I have more accidents and that’s probably one of the worst things that happened to me in this whole thing, I think, is my own personal - - is having a bowel accident. I have to, you know, and it’s just - - I go to pieces when that happens. I have a three-inch hole in my back that needs to be changed three times a day. I put down two, two or three times a day. Someone has to - - my son has to do it now. I take a lot of pain pills, the Vicodin, because of my pain in my back and my legs hurt a lot. I wake up during the night hurting a lot and have a lot of leg spasms. I feel a lot better now since I came back from Palo Alto, though, this time. I have a better attitude. I’m trying to work towards trying to have a better attitude making myself - - before I went to Palo Alto, I was - - laid in be all the time and I didn’t do nothing besides lay in bed and feel sorry for myself. I’m trying to change that. Just dressing, I need to rest afterwards. It’s a shame here, I try to dress myself, then I have to rest, you know, because I get tired. Taking a shower I get tired which don’t sound like it makes sense, but I get so tired. Just sitting in a chair sometimes I get so tired and so sick, I have to lay down. If I lay down a couple hours I feel I can get back up like today I went pretty good.

Continue reading "Sacramento Man's Life Changed Due To Medical Malpractice, Part 22 of 23." »

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)

I planned on traveling a lot when I retire. And along with my backyard, I planned on traveling and now I have to make special plans. I don’t know what I’m going to do about traveling. I know I have checked into airlines. I can’t travel with the wheelchair. I just don’t have the desire like I did before. I hope I can get that desire back. I want to travel and do things.
I spend a lot of my time in my room doing nothing where I used to keep busy. I was never, you know, kids think I was a workaholic. I couldn’t sit down more than 10, 15 minutes. I’d never watch TV, because I would always get up and do things out in my backyard. Now I just seem to sit all the time.
I’m trying to change that somewhat, but I’ll never get back to where, I guess, where I was where - - I was always getting up and working in my yard. I love my yard and I wanted to plan on doing that.
I have to - - I put down pee in a bag here, but it’s to urinate in a bag. I have a Foley in my thing so I have to keep it clean and have to change it, the Foley every two weeks or every two months at lease. I have to irrigate it and have to learn a lot about how to take care of it where I didn’t have to, of course, before.
I can’t keep my room clean. I have to have somebody come over, usually my sister comes over and helps me. My son helps me a lot, but we’re trying to get a better relationship with my son and we haven’t done a lot together, but we’re trying to get a better relationship.
My sister helps me clean the room. My niece comes over and helps me. I can’t make my own bed. If I want to change sheets, I can’t get around the bed to make my - - make my own. Sweeping the floor puts a lot of strain on me because I can’t pick up the stuff after I get done sweeping it. I did drink a lot of water to keep my Foley from plugging up.”

Page 189, line 11 through page 190, line 25:

“I need someone to fix my meals. Again, I can probably microwave, yeah, I can make a TV dinner or something, I guess.
Take care and change my back daily. On my back two or three times a day, it has to be done. They want three times a day. They did want two, now it’s three times a day. It’s very difficult to get my son to do that, but he’s doing it now and I think for the first time he really understands it has to be done.
He has to pick me up when I fall and I have done that more than I like to think about. It’s very embarrassing to have to fall, and not only embarrassing, it hurts. And I can’t get myself up off the floor. They tried showing me in therapy how to get up and they can’t - - it took three of them, therapists, to help me get up off the floor. It hasn’t worked out what they’re trying to do.
I’m a big guy and really too fat maybe, but I just have a hard time getting up. If there was a fire in my house I don’t know if I could get out of the house or not without help. I think maybe I could, I hope I can. But I get real nervous if things happen like have a bowel movement, I have an accident in bed. I get so mad I just don’t even care if I get out of bed, but if I have a fire, I don’t know what would happen.
I don’t know if I could stand the strain of getting out of the - - into my wheelchair and then out the door or not. I would be scared at - - my house is old and any house could burn down. I had a couple kids burn down - - burn themselves - - the house down several years ago next door over and I’ll never forget that.
I need someone to clean my yard. The house where I used to take care of, I used to do all that. Now I can’t do that, so I need somebody to help me constantly. It’s a shame.
I need somebody to take me to the doctor. My son takes me to the hospital five times in one month. Takes me to the food store. I can’t do that by myself. Anyplace I got to go, I have got to have somebody help me.”

XIII. SETTLEMENT
Plaintiff will consider settlement with individual defendants. (END.)

For more information you are welcome to contact Sacramento personal injury lawyer, Moseley Collins.