Jasmine Haddad, a minor, by and through her guardian ad litem, April Haddad v. Northridge Hospital Medical Center
Published: Jan. 29, 2000 | Result Date: Nov. 29, 1999 | Filing Date: Jan. 1, 1900 |Case number: PC018661 Verdict – $0
Judge
Court
L.A. Superior San Fernando
Attorneys
Plaintiff
Defendant
Robert B. Packer
(Packer, O'Leary & Corson APLC)
Experts
Plaintiff
Sharon K. Kawai M.D.
(medical)
Ronald S. Gabriel M.D.
(medical)
Vickie Twitchell
(medical)
Raymond G. Schultz
(technical)
George Iskandar
(medical)
Defendant
Theodore Vavoulis
(technical)
Perry R. Lubens M.D.
(medical)
Gene Bruno M.S., C.R.C., C.C.M., C.D.M.S.
(technical)
Martin Feldman
(medical)
Facts
In April 1993, the plaintiff mother, April Haddad became pregnant and was followed through this pregnancy by Dr. George Iskander, OB/GYN. During the course of the pregnancy, ultrasound revealed a suggestion of placenta previa and this development was monitored throughout the balance of the pregnancy by serial ultrasounds. Approximately one month prior to delivery, ultrasound examination concluded that the placenta previa had resolved and was no longer a problem. Otherwise, the mother's pregnancy was uneventful. On Dec. 20, 1993, at approximately 11:30 p.m., the mother's membranes ruptured at home revealing clear fluid. She and her husband, Jobe Haddad, drove from their home in Palmdale to Northridge for admission to the labor and delivery unit. At 12:55 a.m. on Dec. 21, 1993, the mother was admitted to the defendant's labor and delivery department and her care was assigned to Teresa Harrison, R.N., a labor and delivery nurse with one year of experience. An initial evaluation by Harrison revealed the mother to be in very early labor with a good fetal heart tracing with a baseline heart rate of approximately 140. Dr. Iskander was notified that his patient was in the hospital for labor and standard labor orders were implemented. At 1:25 to 1:30 a.m., the electronic fetal monitor showed a deceleration of the fetal hearbeat down to approximately 90 for two minutes and then a recovery over another two minutes to the 140 baseline. Concurrently with this development was the detection of a significant vaginal bleed. Dr. Iskander was immediately telephoned and so advised. He then ordered that the patient be prepared for a "stat" cesarean section and said that he was on his way to the hosptial. He further ordered that the pediatrician Milton Kochins, M.D. be notified (inasmuch as there was a hospital regulation that a pediatrician had to attend all cesarean sections), that an assistant surgeon be requested that the anesthesia service be notified. No other orders were given. Dr. Iskander testified that he arrived at the hospital at 1:45 a.m., and was surprised not to find the patient in the operating room, which is on the same floor as labor and delivery, but in a different tower. He therefore changed into his surgical scrub suit and then returned to the operating room, but the patient was still not there. He walked over to labor and delivery, found the patient being prepared for a cesarean section and suggested to the nurses that it was "time to go." Dr. Isklander testified at trial that he did not believe the fetal monitor strip at the time indicated fetal distress. While in labor and delivery, Dr. Iskander discussed anesthesia with Carole Turek, the anesthesiologist. Due to mother's size (5'5", 270 pounds), Dr. Turek recommended an epidural anesthesia. Although Dr. Iskander wanted a general anesthesia (which if faster), he acquiesced to the plan for an epidural. Dr. Iskander then returned to the operating room to await arrival of the patient. According to the fetal monitor strip timing, it appears that the mother was transported on a gurney to the operating room somewhere around 2 a.m. At 2:07 a.m., the fetal monitor strip in the operating room indicated that the patient was sitting up for an epidural. The last fetal heart rate was 190. Minutes later, the strip also had notations indicating that the nurse in the operating room could not hear a fetal hearbeat any longer. At 2:22 a.m., another expulsion of blood was noted from the mother's vagina. Allegedly, Dr. Iskander was not advised of either of these developments. Dr. Iskander wanted to go ahead with the surgery, but was waiting for the arrival of the pediatrician, Dr. Kolchins. Unbeknownst to all (and to the jury), Dr. Kolchins apparently fell back asleep after being notified at 1:30 a.m. of the need for his presence at the cesarean section. * * *
Settlement Discussions
In June 1998, plaintiff settled with the obstetrician Dr. Iskander and the pediatrician, Dr. Kolchins, for a total of $900,000. One week prior to trial, plaintiff settled with Dr. Turek, the anesthesiologist, for $60,000. The jury was not advised of these settlements or the fact that any of these doctors were formerly defendants in the lawsuit. Defendant Northridge Hospital Medical Center offered $100,000 in May 1999 pursuant to C.C.P. Section 998. Just prior to commencement of the trial, defendant raised its offer to $350,000 with an indication of $500,000 if that would settle the case. Plaintiff demanded $1,299,000 pursuant to C.C.P. Section 998 from defendant Northridge Hospital Medical Center. This was reduced to $1.2 million prior to jury selection.
Damages
Physically, plaintiff has moderate to severe spastic quadriplegia primarily affecting her lower extremities. According to plaintiff's experts, the child is retarded as well. According to the defendant's expert, the quadriplegia is moderate and principally in the lower extremities. Recent IQ testing shows, according to defendant's experts, that intelligence is probably in the normal range, although all experts agreed that it is highly unlikely that plaintiff will ever be employable. Plaintiff's life care planner indicated that the child's needs were extensive now and in the future and plaintiff's economist estimated that the present value of medical-related needs is approximately $10 million with a total value of approximately $140 million over a normal life expectancy. All of the experts agreed that the child's life expectancy would probably be normal. Plaintiff's expert economist also opined that the present value of the child's loss of earning capacity was approximately $1.7 million. Defendant's damage experts essentially agree to the loss of earning capacity figures, but contested the need for extensive medical services, equipment and attendant care that plaintiff was alleging entitlement to. Furthermore, defendant's expert testified that many of the services required by this child now and in the future will be provided by various state and local agencies free of charge. Defendant's economists believe that the medical, medical equipment and attendant care needs had the present value of approximately $1.3 million.
Result
CONTINUATION OF FACTS*** Finally, at 2:35 a.m. Dr. Iskander asked the nurses to try to find Dr. Kolchins and also to call the neonatal intensive care unit team. When the nursing supervisor called Dr. Kolchins, she found out that he was just leaving his home. Therefore, she called for the family practice resident from the emergency room to attend the cesarean section. At 2:42 a.m., an incision was begun and at 2:47 a.m., a child with Apgars of 0 at 1 minute and 0 at 5 minutes was delivered. After extensive resuscitation by the family practice resident and the NICU team, a spontaneous hearbeat was finally established at approximately 20 to 25 minutes into the resuscitation. Allegedly, during this time, Dr. Iskander advised the father (who was in the operating room) that his baby was dead. At delivery, it was determined that the vaginal bleeding was not due to placenta previa, as thought by Dr. Iskander, but was due to vasa previa, which is a rupture of a vessel in the umbilical cord due to an unusual implantation of the cord into the placenta. The difference between these two emergencies is that placenta previa is blood loss from the mother, which usually is not life threatening, versus blood loss from the fetus, which is immediately life treatening. The baby stayed in the neonatal intesive care unit until the Northridge Earthquake on Jan. 17, 1994, and was then transferred to UCLA. The child is now nearly six years old and, according to plaintiff's pediatric neurology expert, suffers from severe spastic quadriplegia and mental retardation.
Other Information
The jury was out for approximately three and one half hours. They returned with a verdict that defendant was negligent, but that the negligence was not a cause of the child's injuries. Therefore, no damages were awarded to plaintiff.
Poll
10-2 (defendant was negligent), 11-1 (no causation)
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