Rodriguez v. Donley-Kimble, Woman to Woman OB/GYN Medical Group
Published: Apr. 27, 2004 | Result Date: Dec. 13, 2004 | Filing Date: Jan. 1, 1900 |Case number: SCVSS81705 Verdict – $3,998,800
Judge
Court
San Bernardino Superior
Attorneys
Plaintiff
Bruce G. Fagel
(Law Offices of Bruce G. Fagel & Associates)
Defendant
Experts
Plaintiff
Juan C. Felix
(medical)
Jeffrey E. Galpin M.D.
(medical)
William A. Frumovitz
(medical)
Peter Formuzis Ph.D.
(technical)
Defendant
Michael S. Adams
(technical)
Homer G. Chin
(medical)
Shirley Fannin
(medical)
Arturo E. Mendoza
(medical)
Facts
The plaintiffs' mother was 28 weeks pregnant when she went to San Bernardino Community Hospital on the night of Oct. 4, 2000, with complaints of decreased fetal movement and cramping. The nurses were unable to find a fetal heart beat and an ultrasound confirmed fetal demise. Dr. Donley-Kimble was on-call for the Woman to Woman OB/GYN and was called about the patient. She had the patient seen at the hospital by a certified nurse midwife from Woman to Woman. She ordered that the patient be discharged from the hospital to return on the following morning for induction of labor to deliver the fetus. The patient had a slightly elevated temperature and asked to go home. The patient returned on the morning of Oct. 5, where she was seen by Dr. Daniels, her regular OB at Woman to Woman. Dr. Daniels did not think that there was any risk to the mother as a result of the fetal demise as she had normal vital signs and was not in acute distress. and ordered the patient discharged again to return on Oct. 9 for induction of labor unless she spontaneously started labor before that time. The patient returned on the morning of Oct. 6 with complaints of pain and bleeding. Again, she had normal vital signs. Dr. Donley-Kimble ordered the patient discharged again to return again on Oct. 9 without seeing the patient, but having been informed as to her condition by highly experienced labor and delivery nurses. The patient returned to the hospital on the night of Oct. 6, complaining of more pain and stating that she "wants the baby out." The nurses recorded a temperature of 102 degrees and a pulse of 119 with a normal blood pressure. When Dr. Donley-Kimble was called with the patients' complaints and vital signs, she ordered a CBC, which showed a white blood count of 9,900 with 88.7 percent neutrophils. Dr. Donley-Kimble thought the patient had some type of infection and ordered that she be admitted to the hospital. On Saturday morning, Oct. 7, Dr. Donley-Kimble saw the patient for the first time and ordered an induction of labor with Pitocin, and also ordered IV Ampicillin. The patient's vital signs showed a temperature of 101.8 degrees, a pulse of 135, respirations of 40, with a normal blood pressure. After the antibiotics were started, Dr. Donley-Kimble ordered a blood culture. At 10 a.m., the patient was given a VBAC consent form for induction of labor, since her two prior deliveries were by c-section. The patient refused to sign the consent for induction of labor and told the nurse that she wanted a c-section. The nurse called Dr. Donley-Kimble who ordered the Pitocin stopped and ordered another CBC. The CBC showed a white blood count of 6,900 with 87.8 percent neutrophils. When informed of these results, Dr. Donley-Kimble ordered Gentamycin and Clindamycin added to the earlier antibiotic order. At 3 p.m., Dr. Donley-Kimble came to see the patient and told her that she wanted to avoid doing a C-section because of the risks of such surgery. She was still optimistic that the patient would go into labor since the patient was having some contractions, although the vaginal exam still showed the cervix to be thick and closed. A vaginal delivery of the premature fetus would be much safer for this morbidly obese patient. Another CBC that was ordered at 4:15 p.m. showed a white blood count of 6,200 with 39 percent bands. * * *
Settlement Discussions
The plaintiff demanded $400,000 per C.C.P. Section 998, subsequently reduced to $250,000 in April 2003. The defendant made no offer and refused to participate in mediation. The defendant would not consent.
Damages
According To The Plaintiff: Loss of earnings and household services until the youngest child is 18 - approximately $300,000, exclusive of any off-set from Social Security. According To The Defendant: No economic loss since Social Security survivor benefits exceeded the earnings and household services value, since the decedent had little work history.
Injuries
Wrongful death of a 36-year-old single mother, survived by two children, aged 11 and 14.
Result
The trial court granted the plaintiffs' request for prejudgment interest and costs, but reduced the non-economic damage award citing that the court was compelled to do so although the court agreed with the plaintiff's argument. After the judgment was entered, the defendant paid the judgment, including prejudgment interest. A motion on costs is pending.
Other Information
* * * (CONTINUATION OF FACTS) At 6:30 p.m., Dr. Donley-Kimble called in an order to have the patient scheduled for a hysterectomy in the main OR at 10 a.m. Sunday morning. She testified that she scheduled the surgery for the morning because she did not want to do such surgery in the middle of the night in case she needed assistance for an emergency during surgery. She also wanted to discuss further with the patient again the benefits to her of a vaginal delivery. The surgery started at 10:40 a.m., and the dead fetus was removed along with the marginal placenta. Dr. Donley-Kimble noted that the placenta was attached in the lower uterine segment and she diagnosed a placenta previa on the operative report. There was 1500 cc of bleeding during surgery and foul-smelling fluid was noted. The surgery ended at 11:40 a.m., and the patient was taken to PACU where she continued to have vaginal bleeding and over the next two hours she was given six units of packed red blood cells. At 12:45 p.m., a CBC showed 26,900 white blood cells with 41 percent bands and a hemoglobin of 9.9 gms. At 1:45 p.m., the blood pressure was "hard to find" and there was no urine output. At 2:30 p.m., the patient was transferred to the ICU with a blood pressure of 80/50, pulse of 150, and respirations of 34. Consults were requested from internal medicine, infectious disease and hematology. At 4:05 p.m., Dr. Donley-Kimble diagnosed the patient in septic shock. She knew the patient had an infection at the time but did not know it was listeria which does not emit endotoxins that cause a septic shock reaction. This was reported after the patient's death. After experts were hired by the defense who reviewed slides prepared at the private autopsy was a true diagnosis made of placenta accreta. The WBC at 4 p.m. was 56,000 with 46 percent bands and a hemoglobin of 9.4. At 4:15 p.m., the patient was intubated and placed on a ventilator. At 10:08 p.m., a Code Blue was called and after 22 minutes of attempted resuscitation, the patient was pronounced dead. The San Bernardino County Coroner refused the request by the family for an autopsy, so the family paid for a private autopsy prior to retaining an attorney. The private autopsy concluded that the patient died from sepsis due to a fetal demise due to placenta previa. The autopsy also noted that there were portions of placenta left imbedded in the uterus. However, the doctor at autopsy failed to note placenta accreta on the slides. The blood culture obtained on Oct. 7 was reported back after the patient's death showing listeria monocytogenes. Both sides' pathology experts agreed that placenta accreta was clearly present on the slides.
Deliberation
one day
Poll
12-0 (liability), 11-1 (damages)
Length
11 days
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