Confidential
Settlement – $1,700,000Court
Case Not Filed
Attorneys
Plaintiff
Experts
Plaintiff
Scott Serdan
(medical)
Agnes M. Grogan R.N.
(medical)
Robert W. Johnson CPA
(technical)
Donna M. Barras
(medical)
Paul Satz
(medical)
Barry D. Pressman M.D.
(medical)
Howard Liebman
(medical)
H. Ronald Fisk M.D., Ph.D.
(medical)
Carl T. Boylen
(medical)
Defendant
James D. Leo M.D.
(medical)
Jeffrey M. Lulow
(medical)
Ted Vavoulis
(technical)
Thomas L. Hedge Jr., M.D.
(medical)
Gene Bruno M.S., C.R.C., C.C.M., C.D.M.S.
(technical)
Gary Hankins
(medical)
Thompson Adams
(medical)
Lorna J. Lord
(medical)
Facts
On Nov. 17, 2003, the plaintiff, a 31-year-old OR nurse, expecting her third child, went into labor on the scheduled due date. The pregnancy had been normal and uneventful. During the second stage of labor, the plaintiff began to throw up small amounts of blood. The baby was delivered with vacuum extraction without difficulty, at about 7 p.m. After delivery of the baby and placenta, the plaintiff continued to bleed excessively from her uterus and began to bleed at the site of insertion of her epidural needle. The plaintiff also complained of shortness of breath. The anesthesiologist and obstetrician diagnosed amniotic fluid embolism with DIC and ordered appropriate stat testing, which confirmed this diagnosis. The anesthesiologist intubated the plaintiff at about 8 p.m. and placed her on a ventilator and the plaintiff did not become hypoxic. He ordered packed red blood cells, fresh frozen plasma and obtained a consultation from the internist on call. He arranged for transfer to the ICU, which occurred at 9 p.m. The internist on call for consultations outside of the Internal Medicine Service was a rheumatologist, who had not recently been a primary physician for a patient with DIC, or ever for a patient with amniotic fluid emboli. He obtained a phone consultation with a hematologist, and ordered supportive care. An intensive care specialist was on duty in the hospital but was not called. Four hours after her transfer to the ICU, the plaintiff suffered a cardiac arrest which resulted in permanent brain damage. Between the patient's arrival in the ICU and her cardiac arrest, the attending internist ordered minimal transfusion with blood and clotting factors, and the orders he did give were carried out either with delays up to several hours or were not carried out at all. Over these four hours, the plaintiff received four out of six ordered units of packed red blood cells; two out of 10-14 ordered units of fresh frozen plasma, and 0 out of 10 ordered units of cryoprecipitate. A "stat" fibrinogen level ordered at about 10 p.m. was extremely low, requiring emergency cryoprecipitate treatment, but this report did not reach the ICU for about two and a half hours. At about midnight, the plaintiff's blood pressure, normally in the 130s dropped to below 100 systolic. At about 12:20 a.m., an arterial blood gas showed a pH of 7.15, a profound purely metabolic acidosis. Her hematocrit at 11 p.m. was 36; at 1:45 a.m. it was 16. There were no notes in the ICU record reflecting any bleeding during this period of time. At about 12:45 a.m., the plaintiff's husband, a nurse, noted abnormal beats on her cardiogram strip and reported this to the ICU nurse. Nursing care was 1/1 in this unit; the plaintiff's nurse had no other patients. No physician was informed at the abnormal test. At 1:15 a.m., the patient had a cardiac arrest and was in asystole for 10 to 11 minutes. She sustained severe kidney damage and needed dialysis for several months and she sustained liver damage, from each of which she recovered fully. She remained unresponsive for more than a week, and it was apparent as she recovered that she had sustained permanent hypoxic brain damage, affecting her ability to remember, to function, or to take care of herself. It took several months before she recognized her husband or her two older children. She continues to need custodial care a year after her injury, to keep her from wandering out of doors or getting lost. She cannot care for her children or do ordinary household chores. She is, however, otherwise, a physically healthy 32-year-old woman.
Settlement Discussions
Settlement was $1.7 million, in settlement of all claims of the plaintiff, of her husband for loss of consortium, and for all potential future claims of her husband, children or eventual heirs. Of the $1.7 million, $250,000 will be allotted to the plaintiff's family with annuities for the three children to cover college expenses and a lump sum to the husband. The large majority will go into a lifetime annuity for the injured plaintiff to cover lost earnings and cost of custodial care.
Injuries
Hypoxic brain damage during cardiac arrest.
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