Facts

On Dec. 28, 2003, plaintiff Paris Campen was born extremely premature and low birth weight twin. Because of her prematurity and low birth weight, she remained in the neonatal intensive care unit (NICU). She acquired an e-coli infection at birth and was treated with antibiotics for approximately three weeks. On Feb. 3, 2004, during her fifth week of life, she acquired an aggressive serratia bacterial infection. The infection was not treated for approximately 11 hours. Prior to the administration of antibiotics, the infection led to meningitis. The meningitis primarily injured the plaintiff's temporal lobe and also damaged her frontal and parietal lobes of her brain. A shunt was placed to relieve pressure caused by hydrocephalus.

PLAINTIFF'S CONTENTIONS:
The plaintiff stipulated that the serratia infection was a risk of a long hospital stay, but alleged that the defendant negligently delayed in diagnosing and treating the infection that then lead to meningitis.

The infection probably entered her blood on Feb. 3 at approximately 4 p.m. when a central catheter was surgically removed. By 7 p.m., the plaintiff was exhibiting signs of infection including repeated apneas and bradycardias along with lethargy and a floppy tone.

By 8:20 p.m., a CBC, blood and urine cultures, and a chest x-ray should have been ordered STAT and antibiotics should have been started for a presumed infection. The CBC and the chest x-ray were not ordered until 9 p.m., and the blood was not drawn until 10 p.m. The blood was not timely tested and it clotted. The laboratory notified the NICU of the clotted blood at midnight and blood was redrawn for a CBC for blood cultures.

By 1:40 a.m., a preliminary report of possible infection was noted. Antibiotics were not ordered until 2:30 a.m., when the final CBC results came in indicating infection.

The plaintiff presented expert testimony that premature infants are prone to developing infections and if they do, the infections spread quickly and therefore antibiotics must be given before blood results come back whenever there is a 10 percent chance of infection.

The plaintiff further contended that had antibiotics been given before midnight, she would not have had any demonstrable brain damage and every minute thereafter increased the damage to her brain.

DEFENDANT'S CONTENTIONS:
The defendant contended that it is below the standard of care to give antibiotics to a premature infant unless required. Antibiotics can make the infant more susceptible to aggressive hospital-acquired infections and can lead to the creation of a super bug that could endanger not only the infants in the NICU, but the public at large.

In this case, the apneas and bradycardias experienced by plaintiff on Feb. 3 were not different from the apneas and bradycardias she experienced in the days and weeks before. Her floppiness and lethargy could be explained by the anesthesia she was given prior to the removal of the central line.

There was no delay in getting back the blood test results. It can take two to four hours to get them back on a STAT request. Clotting of blood for a blood test is not uncommon with premature babies because only a small amount of blood can be collected.

As far as the damages, the defendant maintained that plaintiff made a remarkable recovery. She is in the same grade and class as her twin brother and the only defect that the teachers and school district has noted is with coordination due to her prematurity. She has no cognitive defects or psychological problems. If she does, it is just as likely due to her prematurity at birth, her low birth weight, or possible meningitis from the e-coli infection. The plaintiff does not have any clinical seizures and does not need anti-seizure medication.

Finally, the defendant claimed that because serratia is such an aggressive infection, even if antibiotics had been started at 8:20 p.m., it would not have prevented the serratia meningitis. The damage to her brain would have been the same.

Settlement Discussions

The plaintiff made a C.C.P. Section 998 demand of $750,000. The defendant made a C.C.P. Section 998 offer of $95,001.

Specials in Evidence

$50,000; $1.7 million to $3 million $5.5 million to $12 million;

Damages

The plaintiff asked for zero in non-economic damages. The defendant claimed that plaintiff will be able to take care of herself and will not have any loss of earnings and her future medical expenses will be less than $50,000.

Injuries

The plaintiff sustained a brain injury. Her left temporal lobe was significantly destroyed and her frontal and parietal lobes were injured. She developed hydrocephalus and a shunt was placed to relieve pressure on her brain. During the next six months, the shunt had to be revised and replaced on multiple occasions. The plaintiff's mother is a physician and her father has a Master's Degree. The plaintiff's I.Q. is low or dull average and her neuropsychological tests indicate impairment to her frontal lobe. She is currently taking anti-seizure medication for sub-clinical seizures. It is expected that when she reaches 18 years of age, she will not be able to live independently and will need 24-hour supervision. She will not be gainfully employed except perhaps in a sheltered workshop.

Result

The jury awarded the plaintiffs $7,379,566 ($50,000 past medical; $5,497,323 future medical; $1,832,243 future loss of earnings).

Other Information

The director of Cedar-Sinai's NICU admitted that it is their policy to treat NICU babies with antibiotics if there is a 10 percent possibility of an infection. INSURER: Lloyd's of London insured Cedars-Sinai Medical Center.

Deliberation

one day

Poll

12-0 (liability), 11-1 (damages)

Length

four weeks