Facts

On June 7, 2013 at 4:30 p.m., plaintiff Genae Harrington, 22, and at the 16th week of her pregnancy, presented to Samsun Clinic Urgent Care with a documented complaint of heavy vaginal bleeding that began approximately 30-45 minutes earlier. According to the corresponding records, plaintiff reported bleeding approximately two to three tablespoons of bright red blood but denied any clots or passing tissue. Plaintiff was then immediately referred to the emergency department at Lompoc Valley Medical Center for further evaluation and treatment.

Upon arrival in the emergency department at Lompoc Valley Medical Center, plaintiff underwent a nursing triage, stating that she had abdominal cramping all day and now had heavy vaginal bleeding.

At approximately 4:40 p.m., the attending physician assistant assessed plaintiff, noting a chief complaint of vaginal bleeding, which he described as "active" and "moderate." The physician assistant also documented plaintiff's complaint of cramping pelvic pain.

With plaintiff's consent and in the presence of a female nurse, the physician assistant performed a vaginal examination, noting an open cervix and the presence of dark tissue. The nurse separately charted the presence of red liquid and clots.

At the physician assistant's request and with plaintiff's consent, the attending emergency physician, Steven Reichel, M.D., conducted his own vaginal examination of plaintiff, concluding that plaintiff had a wide-open orifice of the uterus and that the amniotic sac was protruding through the orifice of the uterus. Dr. Reichel also utilized ring forceps, reportedly to better visualize the vaginal canal and remove any tissue and clots, causing plaintiff's amniotic sac to "pop" during the process and a miscarriage.

Dr. Reichel subsequently discharged plaintiff home after discussing the various risks of her miscarriage, including fever, increased bleeding and increased pain. Dr. Reichel also instructed plaintiff to follow up with her obstetrician and to return to the emergency department if her condition worsened or if she delivered the fetus at home. Plaintiff was discharged home at approximately 8 p.m.

Several hours later, plaintiff telephoned the physician assistant to advise that she had delivered her fetus at home. The physician assistant instructed plaintiff to return to the emergency department, which she did.

In the emergency department, plaintiff was seen by an OB/GYN, who confirmed that plaintiff had passed the products of conception. As plaintiff had not passed the placenta, the OB/GYN ordered plaintiff's admission to the hospital for delivery of the placenta. Plaintiff delivered the placenta on June 8, and was discharged home that same day, with instructions to follow up with her obstetrician.

PLAINTIFF'S CONTENTIONS:
Plaintiff contended that Lompoc Valley Medical Center, through "ostensible agent" Steven Reichel, M.D., breached the standard of care causing her claimed injuries and damages. When plaintiff presented to Lompoc Valley Medical Center for the first emergency department admission on June 7, 2013, she was not experiencing vaginal bleeding and was not in labor. Dr. Reichel requested and plaintiff provided her consent for him to visually inspect her vagina only. In violation of the consent granted by plaintiff and the standard of care, Dr. Reichel proceeded to use ring forceps to rupture the amniotic sac in an unsuccessful effort to remove the products of conception. In further violation of the standard of care, Dr. Reichel failed to arrange for an OB/GYN to evaluate plaintiff. In further violation of the standard of care, Dr. Reichel should have arranged for plaintiff's admission to Lompoc Valley Medical Center rather than discharging her home with inadequate instructions on what to do when she delivered the fetus. Plaintiff was a suitable candidate for an emergency cervical cerclage, which would have given plaintiff up to an additional eight weeks of pregnancy and, to a reasonable medical probability, would have resulted in the birth of a viable baby. As a consequence of Dr. Reichel's negligent and deliberate actions, plaintiff suffered severe emotional trauma.

DEFENDANT'S CONTENTIONS:
Lompoc Valley Medical Center contended that hospital personnel at Lompoc Valley Medical Center conformed to the standard of care when providing care and treatment to plaintiff conducting a timely triage of plaintiff, including obtaining a medical history and list of current complaints. Monitoring plaintiff on a regular basis, including recording her vital signs and any complaints she may have had. Timely carrying out orders issued by plaintiff's attending physicians, including the administration of medications. Defendant also timely and regularly documented plaintiff's medical condition and other events pertinent to her medical course. Defendant also provided discharge instructions to plaintiff consistent with those requested by her attending physicians. Any medical complications experienced by plaintiff, including the loss of her fetus and resulting emotional distress, were not the result of any substandard care and treatment by hospital personnel at Lompoc Valley Medical Center.

Lompoc Valley Medical Center further contended that plaintiff's "ostensible agency" claim against the hospital was likewise without merit. Plaintiff executed Lompoc Valley Medical Center's Conditions of Admission form, which disclosed that her treating physicians were independent contractors, not employees or actual agents, of the hospital. Under California law, a party is generally bound by the provisions of an agreement that she signed, even if she claims that she did not read or understand the document.

By presenting plaintiff with the hospital's Conditions of Admission form for review and execution, Lompoc Valley Medical Center did not intentionally, or negligently, create the impression of any agency or employee relationship between the hospital and her physicians. An authorized representative from Lompoc Valley Medical Center never advised plaintiff that her treating physicians, including Dr. Reichel, were employees or agents of the hospital. Regardless, purported "ostensible agent" Dr. Reichel did not negligently cause the loss of plaintiff's pregnancy and resulting damages since plaintiff's pregnancy was not viable when she first presented to Lompoc Valley Medical Center, as her symptoms (including abdominal cramping, bleeding and the amniotic sac protruding through a fully dilated cervix) were consistent with a miscarriage at 16 weeks pregnancy. Plaintiff's amniotic sac was bulging, fragile, and prone to rupture.

The rupture of plaintiff's amniotic sac with ring forceps was accidental and does not reflect substandard care by Dr. Reichel. During plaintiff's initial presentation to the emergency department, her medical condition did not require an OB/GYN consultation. Dr. Reichel's discharge instructions were appropriate, as plaintiff was medically stable and not in need of ongoing hospitalization.

Result

The case settled with Dr. Reichel for $255,000. Lompoc Valley Medical Center was dismissed for a waiver of costs on the third day of trial.

Other Information

FILING DATE: Aug. 18, 2014.