The of Medical Malpractice - Case Study Example

Running head: Medical Malpractice Case Law MEDICAL MALPRACTICE CASE LAW - AN ANALYSIS of the _________________________________ Student ID No.: _____ Program: _________________________________________ (course or educational curriculum) Specialization: ____________________________________________ Faculty Mentor/Professor: Name of school ___________________________________________ Abstract There have been volumes of court cases involving medical malpractice. While some acts being charged are usually not intentional, the degree of imprudence has to be always assessed if the same amounts to negligence and may thus be adjudged whether excusable or not. This is the main point that will be addressed in the present paper as reflected in the chosen case. Medical Malpractice Case Law - An Analysis The selected case The litigation ruling under review pertains to the case of SHEILA WEBB versus TULANE MEDICAL CENTER HOSPITAL AND ABE ANDES, M.D. which underwent a full-blown trial. The decision of the trial court was raised on appeal to the COURT OF APPEAL OF LOUISIANA, FOURTH CIRCUIT. The identity of the plaintiff and of the defendants and the jurisdictional matters The plaintiff, Sheila Webb, instituted the action in connection with the death of her son, Rodney Comeaux, the alleged victim of the medical malpractice. The main ground of the suit she filed was the negligence of the attending medical doctors and of the hospital appurtenant to the duty of the latter to closely monitor the said patient through its nursing staff. Rodney Comeaux died at the hospital on July 21, 1988. The defendants, on the other hand, were (a) the Tulane Medical Center Hospital where Rodney Comeaux was entered for confinement and diagnosis, and (b) a certain Dr. Abe Andes, a doctor of medicine supposedly specializing in hematology, who attended to the patient, decedent Rodney Comeaux. The civil complaint was filed with the Civil District Court for the Parish of Orleans which had original jurisdiction over the matter pursuant to the Rules for Louisiana District Courts. (TITLE II RULES FOR CIVIL PROCEEDINGS IN DISTRICT COURTS (EXCEPT FOR FAMILY AND DOMESTIC RELATIONS AND JUVENILE PROCEEDINGS. RULES FOR LOUISIANA DISTRICT COURTS. [internet]). After the decision was handed down by the trial court, the matters at issue were raised on appeal to the COURT OF APPEAL OF LOUISIANA, FOURTH CIRCUIT, which had appellate jurisdiction over the suit in accordance with the applicable procedures.(Rule 1-2. Title and Scope of Rules. UNIFORM RULES LOUISIANA COURTS OF APPEALS. THE STATE OF LOUISIANA COURT OF APPEAL FOURTH CIRCUIT. [internet]) The facts of the case Rodney Comeaux was full of complicated health problems since when he was young. Diagnosed with Sickle Cell Anemia at an early age of six months, Rodney was never in perfect health. Sickle Cell Anemia (or SCA for short) is a genetic abnormality in blood which is incurable. He had continuously suffered from pneumonia bouts and the anemia predicaments. During the month of June in 1988, Rodney, aged twenty three by then, complained of chest pains and stomach discomforts. He was brought to defendant Tulane Medical Center for admission. Dr. Abe Andes, the medical director of the hospital, attended to him. Released from the medical confinement on July 6, 1988, Rodney was prescribed an oral antibiotic called Keflex. He was advised to come back for an appointment with Dr. Andes on July 12 of that same year, specifically at two thirty in the afternoon of that date. Dr. Andes wrote down his findings as pulmonary infarction versus pneumonia. Before Dr. Andes, Rodney Comeaux was being treated at the SCA clinic by a certain Dr. Frempong, the the director of the said clinic. It was only in 1986 that Dr. Andes took over from Dr. Frempong. Hours before the designated visit on July 12, 1988, Rodney showed up at the SCA clinic where he complained of chest pain and request to meet Dr. Andes. The latter was then preoccupied attending to other patients who had prior appointments. It was therefore that Rodney Comeaux was not able to see Dr. Andes at that moment. Rodney left and proceeded to the office of her mother, Ms. Shiela Webb. Ms. Webb was then the Deputy Director of Health for the City of New Orleans and working with one Dr. Brobson Lutz, an internal medicine doctor at the Charity Hospital. Dr. Lutz rushed Rodney to the emergency room of the Tulane Medical Center at about past noon. This time the patient complained of having difficulty in breathing and that his chest was hurting. It was found out that he was suffering from multiple pulmonary infarctions in his lungs. He was brought to a room in the hospital. At four o'clock in the afternoon, Dr. Andes checked Comeaux in his hospital room and advised the need for transfusion of Packed Red Blood Cell or PRBC. Rodney refused the transfusion due to concerns of HIV hazards. On July 13, 1988, or the day following, Rodney had fever which steadily worsened. Dr. John Hill, a pulmonologist in the hospital, observed that Rodney was expelling out yellow matters. Dr. Hill gave instruction for tests and X-ray examinations. Dr. Andes opined that the antibiotics were not very effective to ease the chest pain and mitigate the fever. The patient finally agreed to a blood transfusion. That was already late in the afternoon of that day, that is, July 13, 1988. A little while later, he suffered cardiopulmonary arrest caused by what is called aspiration vomitus, an occasion when one inhales his or her own vomit. (Alternative Names. Aspiration pneumonia. HealthScout. [internet]). Despite all the medical processes and remedies initiated and applied on Rodney, he died on July 21, 1988 after becoming comatose on July 14, 1988. The suit began with a panel for medical review which found that there was no negligence on the part or Dr. Andes or of Tulane Medical Center. The trial court issued a decision in the case in which Dr. Andes was freed of any accountability. However, the hospital was found to have at fault for nursing negligence. The dispute was thus brought on appeal. The duty of care required of the defendants unto the plaintiff The duty of care required of the attending medical doctor and of the hospital where the patient is confined must be one not only that which pertains to the duty of a well-minded or sensible person toward others and the public under a given set of circumstances and situations. (Duty Of Care. Legal resources in plain English. Legal-Explanations.com. [internet]). Instead, life and limb being at stake, the degree of care must be more than what is ordinary. Otherwise, the aggrieved party is entitled to some remedies in a court action. The standard of care which was breached In the instant case, and for the particular aspects where nursing duties were concerned, it was reasonably determined that there was one standard of care which required extra and religious attention. That pertained to the obligations on the part of the nursing staff of the medical center to monitor the condition and the other circumstances of Rodney Comeaux. According to the trial court, the hospital, through its nurses, committed a breach of that requisite and necessary standard. On appeal, however, the appellate court agreed that there was that required extra care. However, the higher tribunal ruled that such obligation was not neglected and that even if there was constant monitoring, the victim did not have a chance to survive under the then prevailing conditions. It was as if to say that there was no connection between the alleged failure to monitor and the eventual death. The award for damages The trial court resolved that Dr. Andes was not guilty of any negligence while it made the finding that the Tulane Medical Center was at fault in view of the lapses in the monitoring by the nursing staff over the patient. However, the portion of the decision of the trial court regarding the liability of the hospital was set aside by the appellate court. Resultant of that, there was no award for civil damages at all. In effect, there would have been monetary award for the injuries allegedly suffered by the plaintiff albeit partly out of the total claim. This ruling was abandoned by the appellate court. The defenses put up by the defendants On the part of Dr. Andes, his main defense was that he attended diligently to the medical needs of Rodney. On top of that, he insisted on the claim that the transfusion of Packed Red Blood Cell (PRBC) was the most applicable and appropriate remedy at that time. That defense was countered by the plaintiff who contrarily argued that simple transfusion was the wrong prescription and that it would have been partial exchange. The trial court did not agree with the plaintiff and instead relied on expert opinions as testified to in court and submitted in evidence which suggested that the transfusion of PRBC was the appropriate treatment for the deceased. The appellate court sustained that ruling of the trial court. Hence, Dr. Andes was again freed of any liability upon appeal. For the medical center, it countered that there was no proof that the standard of care was breached by the nursing staff and that there was no causation between the alleged breach and the death of the patient. The trial court found for the plaintiff. However, this finding was reversed by the appellate court. The remedies available to the plaintiff The remedies available to the plaintiff were to seek for moral damages for wounded feelings, serious anxiety, and sleepless nights over the thoughts and agony of having her son died and all similar injuries which can all be quantified monetarily. The plaintiff could also sue for punitive damages, also known as exemplary damages, which are intended to serve as a sample to society in order to deter similar misdeeds or omissions in the future. (punitive damages. THE FREE DICTIONARY BY FARLEX. [internet]). Necessarily, she could have also claimed for reimbursement of her expenses incidental to the filing of the case in court and such other necessary costs in the course of the legal proceedings. The omission and commission of acts which caused the damage or injury The allegations of the plaintiff regarding omitted and committed acts which caused the death of her son were that, firstly, Dr. Andes was negligent when he diagnosed pulmonary infarction when the diagnosis should have been acute chest syndrome. Accordingly, what could have been applied as treatment was partial exchange and not simple transfusion which was recommended and caused to be executed by Dr. Andes. Secondly, Ms. Sheila Webb argued that there was inadequate monitoring on the part of the nursing staff of the hospital during the crucial moments of her son's confinement. The rules of law applied by the court Aside from the general common law on tort, the appellate court cited some jurisprudence one of which was the case of Gordon v. Willis Knighton Medical Center which the plaintiff in the present case tried to rely on. However, the appellate court ruled that the instances were different. In Gordon, the woman patient was totally left unattended inside the hospital room without any monitoring. She was only able to receive medical attention when her son discovered her to be alone. In the case at bar, Sheila Webb was not able to convincingly prove any parallel. As a matter of fact, witnesses, all medical doctors, testified that Rodney was monitored adequately all throughout during his treatment and that detailed observations of his condition were conducted and recorded in the files of the hospital. The applicable law in the case of defendant Dr. Abe Andes does not have to be further elaborated here because the ruling of the trial court regarding the utmost diligence which he exercised in attending to plaintiff's son was affirmed by the appellate court. As a matter of fact, Dr. Andes meticulously presented proof and evidence as to how he prudently and diligently applied whatever was necessary for Rodney to survive. The decisions The ruling of the trial court found the hospital liable for the alleged lapses in the monitoring of its nursing staff. It exonerated Dr. Abe Andes. On appeal, it was found that both the hospital and Dr. Andes were not liable for any negligence. One judge, however, dissented from the majority opinion. He was Robert L. Lobrano. He opined that both the hospital and Dr. Andes were accountable, saying that the trial court erred in appreciating the fact that the refusal of the deceased for a blood transfusion due to fear of an HIV risk contributed only very partly to his demise. The opinion of this paper It is concluded that the appellate court was correct in affirming the exoneration of Dr. Andes. However, it is strongly opined that the higher tribunal should have also affirmed the portion of the decision of the trial court regarding the failure of the respondent hospital in adequately monitoring the patient. It was very apparent that had the thorough watch been observed, the nurses could have taken care of the vomiting which led to Rodney inhaling his own vomit, later on resulting to his comatose condition and subsequent death. References Alternative Names. Aspiration pneumonia. HealthScout. [internet] Accessed March 8, 2010. Available at: ) Duty Of Care. Legal resources in plain English. Legal-Explanations.com. [internet] Accessed March 8, 2010. Available at: punitive damages. THE FREE DICTIONARY BY FARLEX. [internet]. Accessed March 8, 2010. Available at: Rule 1-2. Title and Scope of Rules. UNIFORM RULES LOUISIANA COURTS OF APPEALS. THE STATE OF LOUISIANA COURT OF APPEAL FOURTH CIRCUIT. [internet] Accessed March 8, 2010. Available at: ) TITLE II RULES FOR CIVIL PROCEEDINGS IN DISTRICT COURTS (EXCEPT FOR FAMILY AND DOMESTIC RELATIONS AND JUVENILE PROCEEDINGS. RULES FOR LOUISIANA DISTRICT COURTS. [internet] Accessed March 8, 2010. Available at: Read More