Isidro Celeste, Sr.; Mary Ecalnea; Isidro Celeste, Jr.; Albert Celeste; Charles Celeste and Theodore Celeste v. Kaiser Foundation Hospital
Published: May 24, 1997 | Result Date: Apr. 30, 1997 | Filing Date: Jan. 1, 1900 |Case number: DUM0001538 – $270,000
Judge
Court
Orange Superior
Attorneys
Plaintiff
Peter J. Polos
(Panish, Shea & Boyle LLP)
Defendant
Thomas G. Scully
(Foley & Mansfield PLLP)
Experts
Plaintiff
Joel Erickson
(medical)
Defendant
Gregory Thomas
(medical)
Facts
In October 1987, decedent Lourdes Celeste, a 45-year-old woman, underwent a kidney transplant and thereafter retired from her employment. On Feb. 29, 1992, the decedent's cholesterol level was noted to be rising to 598 and then to over 900 in August 1993. The decedent was placed on medication to help control her cholesterol. On Aug. 27, 1993, the decedent was hospitalized at defendant Kaiser Foundation Hospital with a chief complaint of severe chest pain, arm pain and a lower chest pain for one to two days, which frequently occurred after meals. The decedent indicated that Mylanta provided questionable relief and that the pain radiated to the neck, with tightening of the jaw, and to the left shoulder and back. The decedent also reported nausea. At this time, the decedent was admitted to the hospital to rule out unstable angina, myocardial infarction (MI) and gastritis. EKGs during the hospitalization were abnormal and indicated left ventricular hypertrophy. However, because of the decedent's left ventricular hypertrophy and digitalis medications, these studies were unable to rule out whether she had ischemic heart disease. The respondent claimed CPK tests ruled out an MI. The decedent was discharged from the hospital. Dr. Gonzales, the decedent's treating internist and cardiologist, ordered an upper GI to rule out gastrointestinal cause of the pain. The GI was performed on Sept. 10, 1993 and came back normal. On Sept. 16, 1993, a treadmill examination was performed. The treadmill examination was abnormal but did not rule out the possibility of ischemic heart disease because it was also "non-diagnostic." The respondents concluded that the decedent's symptomology was due to gastritis at this time and was not related to ischemic heart disease. No further work-up for the decedent's heart condition was performed at that time. In February 1994, the decedent's nephrologist, Dr. Poon, referred her to UCLA for evaluation of her failing kidney. He noted that she had chest pain at that time. On April 11, 1994, the decedent again complained to Dr. Poon about feelings of her body being pressed at night, including pressure on her arms. On June 10, 1994, the decedent was again assessed in the emergency room for chest pain. Her chief complaint was midsternal chest pressure times one-and-a-half hours which came on while sitting and radiated from shoulder to shoulder. The respondents' conclusion at this hospitalization was chest pain of unknown etiology. It was noted that prompt relief by nitroglycerin would be consistent with ischemia. The respondents again concluded that her chest pain was non-cardiac. On July 17, 1994, during a hospitalization for renal therapy, it was noted that the decedent again had chest pain which was relieved by nitroglycerin. On July 22, 1994, the decedent was examined by Dr. Gonzales. Dr. Gonzales indicated that he felt the chest pain may be cardiac in nature, and suggested that the decedent undergo an angiogram, which she refused at that time. An appointment was allegedly set for 10 days to two weeks away to discuss the matter further, but the decedent died before the appointment took place. On July 24, 1994, the decedent was again hospitalized again after a motor vehicle accident. During this hospitalization, the decedent also reported chest pain, which was diagnosed as musculoskeletal because of the automobile accident. On July 30, 1994, the date of her death, the decedent presented to the emergency room, and was referred to the urgent care clinic, where she presented to Dr. Rappaport with a history of on and off left-sided chest pain, with radiation occassionally. Nitroglycerin relieved the pain. At this time, Dr. Rappaport assessed the decedent as having unstable angina. **** SEE CONTINUATION OF FACTS ON "THE RESULT"
Settlement Discussions
The claimants made a settlement demand for $100,000. The respondent made a settlement offer of $60,000.
Injuries
Death of a 52-year-old wife/mother.
Result
******** CONTINUATION OF FACTS: The claimants claimed unstable angina carried with it a 50 percent chance of an immediate acute myocardial infarction, and that it was undisputed that the decedent was having a heart attack at the time she was turned away from the emergency room. Dr. Rappaport immediately referred the decedent back to the emergency room for admission. The decedent was then taken back to the emergency room for the second time, where she was monitored but with no treatment. Cardiac enzyme laboratory studies were done several hours later to determine if the decedent had or was having a myocardial infarction. The test came back positive and was indicative of a prior acute cardiac event. However, no cardiac consultation was obtained and no treatment was instituted except symptom relief. At 9:13 p.m., over 12 hours after her second time in the emergency room visit, the decedent suffered a massive myocardial infarction that caused her death. The claimants, the decedent's husband and five adult children, brought this action against the respondent based on medical negligence and malpractice theories of recovery.
Other Information
The award was rendered approximately one year and eight months after the case was filed. The arbitration was held before Sean Burke, Esq., and George McDonald, Esq., resulting in the reported award. EXPERT TESTIMONY: Claimants' medical expert, Joel Erickson, M.D., testified that the left anterior descending artery was likely the cause of the myocardial infarction on the day of the decedent's death.
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