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Personal Injury (Non-Vehicular)
Professional Negligence
Medical Equipment

Alice Jackson v. William Brien, M.D., Cedars-Sinai Medical Center

Published: Dec. 31, 1999 | Result Date: Oct. 27, 1999 | Filing Date: Jan. 1, 1900 |

Case number: BC155762 –  $0

Judge

Alexander H. Williams III

Court

L.A. Superior Central


Attorneys

Plaintiff

Norman W. Alschuler


Defendant

Mark M. Rudy

James D. Nichols


Experts

Plaintiff

Madeleine Bruning
(medical)

Stephanie R. Rizzardi-Pearson
(technical)

Jerry Floro
(medical)

F. Warren Lovell M.D.
(medical)

Defendant

Susan Zavala
(medical)

Michael E. Fishbein
(medical)

James V. Luck
(medical)

Facts

Decedent Kim Jackson was a 43-year-old stagehand for television studios. He suffered a knee injury in August 1994 and never returned to work after that injury. Within two months, he underwent an arthroscopic surgery by an orthopedic surgeon not a party to the case. Over the next year, he remained out of work and continued to have problems with significant pain. In October 1995, he received a second opinion from defendant William Brien, M.D., orthopedic surgeon, at the request of his original orthopedist. Dr. Brien indicated the options, risks and complications of total knee replacement with the patient at that time. Initially, the patient elected to see another orthopedist who specialized in tendon transplant. Ultimately, that physician determined that the decedent was not a candidate for the procedure due to the extent of damage in the knee. The decedent contacted Dr. Brien and requested the total knee replacement surgery. Dr. Brien indicated that he again discussed with the decedent the potential risks and complications of the proposed surgery. The surgery was then scheduled to take place at Cedars-Sinai Medical Center on Jan. 4, 1996. Because the decedent did not have a regular physician, Dr. Brien's office referred him to a local internist to obtain medical clearance. The decedent was seen by an internist on the afternoon of January 3. An EKG was performed which indicated inverted T waves in four out of six precordial leads. This potentially could represent a number of conditions, including cardiac ischemia. However, it could also represent a normal variant. The internist concluded that it was a normal variant. The internist dictated his findings directly to the dictation line at Cedars-Sinai Medical Center, and his report was on the patient's chart the following day. It mentioned the EKG findings, but indicated that the patient was cleared for surgery "but would monitor cardiac status closely." Prior to surgery, the patient was seen briefly by Dr. Brien, who indicated that he again went over the risks and complications of surgery. The patient was also examined by a board-certified anesthesiologist (dismissed prior to trial), who elected to proceed with a spinal anesthesia. The surgery went uneventful. The patient was seen in the recovery room by the anesthesiologist, who thought he was doing great and made a note that the patient should be transferred to a room near the nurses' station when he left the recovery room because of the potential for alcohol withdrawal symptoms. There was already an order on the chart by Dr. Brien for the patient to go to the regular orthopedic floor after the recovery period. The recovery room nurse charted that at 5:40 p.m., she called the office of the internist, but he was not available and she left a message on his answering machine. She testified that the message was to report that the patient had come out of surgery, as well as the location of the room he would be going to, along with the phone number to call for medical orders. The recovery room nurse testified that it was not her duty to actually obtain the medical orders, but rather to get the information to the internist so he could call or come in with medical orders, if he had any. *** (FOR CONTINUATION OF FACTS)

Settlement Discussions

As to Dr. Brien, plaintiff made a C.C.P. Section 998 demand of $29,999 two years prior to trial. There was no offer by Dr. Brien. As to Cedars-Sinai, plaintiff made a C.C.P. Section 998 demand of $49,999 two years prior to trial, raised to $150,000 prior to trial, and lowered to $85,000 during trial. Cedars-Sinai offered nothing until $15,000 at the start of trial and raised to $25,000 during trial.

Specials in Evidence

$31,000 $95,000

Result

*** (CONTINUATION OF FACTS) The patient was then transferred to the orthopedic floor between 6 p.m. and 6:30 p.m. He was seen and evaluated at least twice by the first floor nurse, whose shift ended at 7 p.m. The patient was found unresponsive by the oncoming night nurse at 8:05 p.m. A Code Blue was performed, but the patient could not be resuscitated. The internist testified at deposition and trial that he was waiting for the nurses to call him for the medical orders. He denied that he ever received any call. Had he been reached, he stated he was planning on ordering the patient to be sent to a special telemetry bed with cardiac monitoring capabilities, rather than the regular orthopedic floor.

Other Information

A mediation was held in 1997 before Judge Burton Bach, resulting in no settlement. The plaintiff settled prior to trial with internist for undisclosed amount.

Deliberation

2½ hours

Poll

12-0 (for both defendants)

Length

eight days


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