Facts

On July 28, 2005, Johnny Moyer, age 48,went to the emergency room at Gardena Memorial Hospital with complaints of shortness of breath. Upon arrival, he was diagnosed with acute exacerbation of chronic obstructive pulmonary disease, hypercapnia, respiratory failure, anxiety depression disorder, hypertension and obesity. It was his second admission in many years. Moyer was an admitted smoker.

On Aug. 6, 2005, a gastroenterology consultation by Dr. Timothy Simmons, M.D. showed that the patient had chronic obstructive pulmonary disease with hypercapnia, respiratory failure requiring endotracheal tube placement, hypoxemia, anoxic encephalopathy, swallowing dysfunction, glucose intolerance, electrolyte imbalance, and protein calorie malnutrition.

On Aug. 8, a tracheostomy was completed on the patient. Also on Aug. 8, an esopagogastroduodenoscopy with a percutaneous endoscopic gastrostomy was performed by Dr. Simmons.

Dr. George Thompson, M.D. assumed the patient's care on Aug. 11.

Johnny Moyer was in the hospital for 24 days. Dr. Thompson was bedside with Moyer every day of admission. He was in and out of ICM during that time.

On Aug. 19, the patient was not showing any signs of improvement, and Dr. Thompson's impression of the patient at that time was severe sepsis, renal failure, hyperkalemia, respiratory failure and respiratory acidosis. The patient was started on dialysis.

On Aug. 20, the patient became asystolic. A Code Blue was called and patient failed to respond to resuscitative measures. The patient expired at approximately 11:50 a.m. The coroner determined the cause of death to be peritonitis brought on by a leaking g-tube.

PLAINTIFFS' CONTENTIONS:
The plaintiffs, decedent's wife and son, contended that both Dr. Simmons and Dr. Thompson failed to diagnose the onset of peritonitis, which they contend was the cause of death.

Dr. Pena, the County Deputy Coroner, testified that the cause of death was peritonitis causing sepsis that lead to multisystem organ failures including renal and cardiovascular failure. He opined that COPD was the secondary cause of death.

Dr. Thompson took over the care and treatment of Moyer on August 11, 2005 as his admitting physician went on vacation.

Dr. Boylen and Dr. Cole both agreed with Dr. Pena that the cause of death was peritonitis.

There were no entries in the medical records that lower abdominal exams were ever performed by Dr. Thompson. When he finally recognized that the lower abdominal was distended, he ordered a radiographic study that would have diagnosed peritonitis, however, he canceled that order within hours. He testified in his deposition that he did not recall why he canceled this study, however, at trial he testified that he consulted with a radiologist and they concluded that Moyer's condition was such that he could not be transported to the radiology department. He also testified that Gardena Hospital did not have a portable x-ray.

Dr. Cole testified that if the peritonitis had been diagnosed on August 17, 2005, Moyer was still a candidate for surgical intervention and the abdomen could have been drained, and sepsis and the multi-organ failure avoided.

Dr. Cole opined that Moyer's life expectancy was at least five years if he continued to smoke after discharge and ten years if he quit smoking.

DEFENDANT'S CONTENTIONS:
Defendant's expert Dr. William Klein testified that the cause of death was chronic obstructive pulmonary disease (COPD) coupled with multi system organ failure consisting of respiratory failure (severe hypoxemia), end stage renal failure and cardiovascular failure.

He also testified that the decedent had a less than 50 percent chance of surviving but if he had been discharged his life expectancy was approximately six months.

Settlement Discussions

The plaintiffs demanded $250,000. Defendant Thompson served a C.C.P. section 998 offer to dismiss for a mutual waiver of costs.

Result

Defense verdict as to Dr. Thompson. Dr. Simmons was given a voluntary dismissal on Feb. 15, 2008 after opening statements were made. All other named defendants had been dismissed at time of trial.

Other Information

Plaintiffs requested an autopsy because of suspected asbestosis related to an on-going disability claim made by the decedent. Plaintiffs agreed to drop an appeal in exchange for mutual waiver of costs. FILING DATE: Nov. 8, 2006.

Deliberation

two days

Poll

12-0 (defense)

Length

five days