Facts

Mark Oates presented to Sutter Lakeside Hospital with acute upper abdominal pain. He was diagnosed by Dr. James Pretorius, the on-duty hospitalist, with alcohol-induced pancreatitis. He was transferred to the surgical floor. Pretorius wrote the admitting orders that included an order for Dilaudid to treat the pain.

He was treated with 1 milligram of Dilaudid, as needed, every two hours. By approximately two and a half hours, his pain still had not subsided. Pretorius increased the dosage and ordered vital signs to be taken every four hours. No other monitoring was ordered to be performed.

Pretorius went off duty and gave a verbal report to the oncoming hospitalist. The specifics for the order for pain medication was not discussed with the oncoming doctor. Oates' pain continued and he was given pain medication.

On Feb. 24, at 5:30 a.m., his vital signs revealed that he had decreased oxygen saturation levels and was tachycardic. The abnormalities were not reported to the on-call physician, and even though there was an order for Oates to use his BiPAP machine for his sleep apnea, it was never brought in by his girlfriend, as planned, nor brought to the doctor's attention.

Oates had a decreased oxygen saturation level in the morning, but again, the matter was not brought to the physician's attention. When he was checked at 11:20 a.m. he was found to be in respiratory arrest. He was not immediately intubated due to partial airway obstruction. By the time he was intubated, about 45 minutes later, he had already suffered a massive hypoxic ischemic brain injury.

Pretorius did not go on duty until two days later. He was informed that Oates crashed and that although efforts to revive him had been successful, he had suffered a significant brain injury and was on life support.

Oates remained on life support until Feb. 27, when he was pronounced brain dead. His father, Harth Oates, sued Pretorius, Sutter, and other doctors for medical malpractice. All defendants, besides Pretorius, settled prior to trial. The matter proceeded to trial only against Pretorius.

PLAINTIFF'S CONTENTIONS:
Plaintiff contended that Pretorius was negligent in increasing the original 1 mg PRN dosage of Dilaudid to a sliding scale dosage of 2mg/3mg/4mg PRN without providing for proper monitoring. Plaintiff further contended that his respiratory arrest could have been avoided had Pretorius set parameters on the vital signs, and had appropriate monitoring in place.

DEFENDANT'S CONTENTIONS:
Defendant Pretorius contended that the dosage was reasonable under the circumstances. Defendant further contended that the respiratory arrest was not due to an overdose of the drug. Also, that the decedent had multiple comorbidities that could have contributed to or caused the respiratory arrest.

Damages

Oates' father sought recovery for wrongful death, but later dropped the initial survival action. Plaintiff sought $250,000 in damages for loss of care, comfort, society and support.

Injuries

Oates suffered from brain damage and coma due to a respiratory arrest and subsequently died.

Result

The jury rendered a unanimous defense verdict.

Deliberation

two hours

Poll

12-0

Length

seven days