Facts

Plaintiff Jane Doe, 53, was admitted to an Orange County hospital on Aug. 1, 2017 after developing severe hyponatremia in the setting of heavy alcohol usage. Plaintiff had a history of alcoholism and alcohol abuse.

For blood collected at 3:20 p.m. on Aug. 17, laboratory tests showed that her sodium levels were 113 mmol/L, below the normal range of 135-145 mmol/L. An emergency physician ordered an IV NS 1,000 mL (.9 percent NaCL) at 3:46 p.m., spoke to Roe hospitalist, and admitted the patient to telemetry.

Roe hospitalist was assigned to plaintiff and ordered more normal saline to correct her severe hyponatremia. Roe hospitalist then ordered NS 1,000 mL intravenously (.9 percent NaCL), which occurred on Aug. 1, at 5:26 p.m. At 8:05 p.m. on Aug. 1, a nurse administered 1,000 mL intravenously with a bag/syringe of 150 mL/hr. These amounts were again repeated by another nurse on Aug. 2, at 2:31 a.m. Another nurse then twice-more administered the 1,000 mL intravenously with a bag/syringe of 150 mL/hr at 8:06 a.m. and 5:20 p.m. on Aug. 2. Plaintiff's sodium was measured at 128 mmol/L for blood collected on Aug. 2, at 6:55 a.m. For blood collected at 2:45 p.m. on Aug. 2, plaintiff's sodium measured at 132 mmol/L.

PLAINTIFF'S CONTENTIONS: Plaintiff contended that in treating hyponatremia, the provider should aim for no more than a correction of 8 mmol/L per 24 hours and certainly not more than 12 mmol/L. Here, the correction was 15 mmol/L in less than 16 hours and 19 mmol/L in less than 24 hours. Moreover, nothing was done to address the overcorrection of hyponatremia, such as administering DDAVP. Plaintiff contended that these actions were below the standard of care.

Plaintiff contended that the alleged overcorrection articulated above lead to a week-long hospitalization from Aug. 12-19, 2017, where plaintiff was diagnosed with central pontine myelinoslysis with corresponding brain and neurological damage.

DEFENDANT'S CONTENTIONS: Roe Hospitalist contended that it met the standard of care and, indeed, the NS saved plaintiff's life. Roe hospitalist contended that plaintiff's hyponatremia was so severe that it has to be corrected by NS.

Damages

Plaintiff made a recovery and was able to return to work without much limitation. As such, this case was almost entirely limited by the MICRA limits of $250,000 for general damages.

Result

The parties settled for $150,000.