Swani Hang Thach, et al. v. Kenneth Tam, M.D., John Tsakonas, M.D., and Li Poa, M.D.
Published: Sep. 18, 1999 | Result Date: Aug. 18, 1999 | Filing Date: Jan. 1, 1900 |Case number: PC020771X Verdict – $0
Judge
Court
L.A. Superior San Fernando
Attorneys
Plaintiff
Gary M. Schneider
(Law Office of Gary M. Schneider )
Defendant
Loren S. Leibl
(Leibl, Miretsky & Mosely LLP)
Gregory M. Hulbert
(Hulbert & Hulbert)
Experts
Plaintiff
William Mandel
(medical)
Bryan C. Conley
(technical)
Defendant
Daniel Rieders
(medical)
Facts
The plaintiffs were the widow and minor children of the decedent, then 44-year-old Phong Thach. In August 1996, the patient sustained a myocardial infarction while away on vacation. He was first hospitalized in Mexico for two days and then in Florida for nine days. However, multiple attempts at angioplasty were unsuccessful. He subsequently returned to Los Angeles, at which time he was referred to the defendant cardiologist, defendant Dr. Kenneth Tam. Additional diagnostic studies suggested that the patient may benefit from revascularization of his occluded coronary arteries and resection of the left ventricular aneursym caused by his prior myocardial infarction. The patient was referred to the defendant, cardiothoracic surgeon, Dr. Li Poa. Based upon all of the available information, it was felt that the patient was an appropriate candidate for surgery, and, accordingly, it was scheduled to proceed the following week, on Oct. 2, 1996. The patient was experiencing various arrhythmias prior to surgery and, intraoperatively went into ventricular tachycardia and cardiac arrest. He was immediately placed on bypass, and the surgery accomplished without further difficulty. The surgeon, prior to the conclusion of the surgery, placed the patient prophylactically on Lidocaine, an anti-arrhythmic medication, to address the rhythm abnormalities. Following the surgery, the cardiologist and cardiac surgeon concluded that the Lidocaine was not effective in suppressing the patient's arrhythmias and, in view of the potential side effects of the drug, ordered that it be discontinued and utilized only if the patient went into a rhythm pattern of sustained ventricular tachycardia. The patient was, in accordance with the plan of management, weaned off Lidocaine over the course of the next 12 hours, such that it was shut off by the late morning of the first post-operative day. Later that day, when the night duty nurse came on at 7 p.m., she noted that the patient was having runs of frequent non-sustained ventricular tachycardia. The nurse testified that when she first saw the patient he was receiving Lidocaine although there was no record of the Lidocaine ever being restarted. In response, she called the cardiologist and was put in touch with the third defendant, Dr. John Tsakonas, who was covering Dr. Tam's call schedule. Dr. Tsakonas, who had been apprised of the plan of management for the patient during the sign out call from Dr. Tam, immediately advised the nurse to discontinue the Lidocaine and institute magnesium therapy in an effort to addresss the arrhythmias. Approximately 30 minutes later, the nurse called Dr. Poa, to advise him of the patient's status. Dr. Poa, upon being advised of the situation, concurred in the propriety of the patient's management and issued no further orders. Three hours later, at midnight, the nurse again called Dr. Poa at home to advise him that the patient was continuing to have frequent runs of non-sustained ventricular tachycardia. Dr. Poa again ascertained the patient's overall condition, felt that the plan of management was appropriate and reinforced the plan to treat only sustained ventricular tachycardia and otherwise gave no orders. Shortly before 3 a.m., the patient went into sustained ventricular tachycardia and subsequently cardiac arrest, for which a code blue was initiated. Both Lidocaine and cardioversion (as well as multiple other anti-arrhythmic medications) were unavailing. The cardiac surgeon, who had been contacted at the time of the patient's condition began to deteriorate, returned to the hospital and reopented his chest for purposes of performing cardiac massage, resulting in the restarting of the patient's heart. Unfortunately, the patient had experienced poor cerebral perfusion during the course of the extended code, such that later that day all life support was withdrawn and the patient died.
Damages
$71,985 (past economic losses); $67,358 (future economic losses, assuming 5-year-work life); $304,136 (assuming 10-year-work life); $611,245 (assuming 15-year-work life) and $988,703 (assuming 20-year-work life)
Injuries
Death of a 44-year-old husband and father of two minor children.
Other Information
The hospital, which was originally joined as a defendant, entered into a pretrial settlement with plaintiffs for $90,000.
Deliberation
two hours
Poll
9-3 (no negligence)
Length
seven days
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