Arturo Sanchez and Graciella Alcaraz, individually, and as surviving heirs of Arthur Alcaraz, deceased v. Kaiser Foundation Hospitals, Kaiser Foundation Health Plan, Inc. Southern California Permanente Medical Group and Mario Hemsley, M.D.
Published: Jul. 3, 1999 | Result Date: Jan. 12, 1999 | Filing Date: Jan. 1, 1900 |Case number: DUM0001768 Arbitration – $407,000
Arbitrator
Court
Case Not Filed
Attorneys
Claimant
Respondent
Experts
Claimant
Richard X. Hanson
(technical)
Robert Popper
(Judicial Watch Inc.)
(medical)
Jerome Brown
(medical)
James K. Ribe
(medical)
Respondent
Michael E. Fishbein
(medical)
Wiliam Friedman
(medical)
Gary Rachelefsky
(medical)
Facts
The claimants were the parents of the 6-year-old boy who, a few days prior to his death, was brought to the defendant's Pediatric Clinic Facility in Panorama City. At that time, the child was diagnosed with a sore throat and cough, and was put on cough medicine and penicillin and sent home. On May 26, 1994 at approximately 10 p.m., the child was brought to the same facility's after-hours urgent care department. At that time, the child had been vomiting for several days and was in respiratory distress. The defendant urgent care physician on call, a board-certified pediatrician, initially diagnosed the child with asthma/pneumonia. However, an X-ray taken at approximately 11:30 p.m. was inconsistent with a diagnosis of asthma, and was somewhat inconsistent with a diagnosis of pneumonia. At that time he went to the urgent care center. The child did not have a fever or cough (which should have ruled out viral pneumonia), and he did not have expiratory wheezing (which should have ruled out asthma). The child did have rales, and the 11:30 p.m. X-ray showed fluid behind the heart, which was consistent with viral myocarditis, an infection in the heart, a treatable condition if caught in time. By 12:50 a.m., the child was doing poorly enough for the defendant urgent care physician to order him to be admitted to the hospital. According to the admission notes, at 12:50 a.m., the child's respiratory rate was 68 respirations a minute, (over one breath a second), over three times the normal rate for the child his age. At that time, the child was too weak to stand to be weighed, and his pulse was 172, more than twice normal. Other than administering intravenous fluids, it is unclear whether any further diagnostic testing or treatment was rendered between 11:30 p.m. and about 2:30 in the morning, when the child "crashed." According to the medical records, the child was only checked once or twice by the nursing staff, and the defendant urgent care physician who was covering both the first and ninth floors of the hospital that night, only looked in on him two times in two hours. The child was left alone in a regular pediatric room with his mother, in respiratory distress, for over 90 minutes. He was not admitted to the intensive care unit until approximately 3:30 a.m., when he was beyond saving. By 2:30 a.m., the child was spitting out a white frothy substance, choking, and his pulse oximetry dropped from normal in the 90s and 84 and then to 65. All of these events were witnessed by his mother, and some by his father. At approximately 2:30 a.m., the child was going into respiratory arrest, and he was finally transferred to the intensive care unit at about 3:30 a.m. At that time, a follow-up X-ray was taken, showing an extensive fluid build up in the lungs (pulmonary edema) which was the ultimate casue of the child's death. Extensive resuscitation efforts were undertaken, but were unsuccessful. The child was pronounced dead at approximately 4:30 a.m. Initially, the Los Angeles County Coroner's office concluded that the death was caused by pulmonary edema, secondary to viral myocarditis, a heart infection, which was treatable, and from which a significant percentage of children recover with no serious residuals. Both the defendant and the Coroner's office had some concern that the child's death may have been caused by the Hanta virus, or by some other overwhelming viral illness of the lungs. The case was referred to the County Health Department; however, testing done by the County Health Department on the lung disease did not turn any unusual viruses. * * *
Settlement Discussions
There were no settlement discussions during the 3+ years the case was pending.
Specials in Evidence
$50,000 - $100,000
Damages
$7,000 was claimed for funeral/burial expenses.
Injuries
The plaintiffs sustained the death of their 6-year-old child.
Result
* * * (CONTINUATION OF FACTS) Four years after initially opining that the death was caused by pulmonary edema secondary to a heart infection, the County Coroner's office backed off of that position somewhat, and agreed with the defendant's position that the death might have been the result of an overwhelming, untreatable infection; however, the Coroner still believed the death was more likely than not caused by an undiagnosed heart ailment. The case was rendered difficult due to the fact that the microscopic studies of both the heart and lung tissue showed an absence of the types of cells one would expect to see from either cause.
Other Information
The award was reached approximately three years and three months after the case was filed.
Deliberation
½ days
Poll
2-1
Length
four days (for arbitration)
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