Elizabeth Kurrus v. Covenant Care California Inc., Dennis Ashley, Thomas Kennedy
Published: Jul. 6, 2002 | Result Date: Feb. 8, 2002 | Filing Date: Jan. 1, 1900 |Case number: 1035657 Verdict – $0
Judge
Court
Santa Barbara Superior
Attorneys
Plaintiff
Defendant
Christoph T. Nettesheim
(Nettesheim Law)
Hugh S. Spackman
(Clinkenbeard, Ramsey, Spackman & Clark LLP)
Gregory M. Hulbert
(Hulbert & Hulbert)
Experts
Plaintiff
Roberta Lee Block
(medical)
Jeffrey Bronstein
(medical)
Lawrence Miller M.D.
(medical)
Defendant
Bonnie Faherty
(medical)
Bruce T. Adornato M.D.
(medical)
David Abrams
(medical)
Bruce Woodling
(medical)
N. Paul Rosenthal
(medical)
Facts
The plaintiff is a 79-year old woman; the defendants being Covenant Care Inc., Covenant Care California, Inc.
dba Buena Vista Care Center, a skilled nursing facility, Dennis Ashley, M.D., the plaintiffÆs internist and
attending physician, and Thomas Kennedy, M.D., a treating neurologist.
The plaintiff had been diagnosed with two disease processes, specifically small vessel cerebral vascular disease
(vascular dementia) and normal pressure hydrocephalus (NPH). The latter is a treatable condition, in many
instances, while the former is not.
In March 1999, the plaintiff had a programmable ventricular peritoneal shunt (VP shunt) placed to allow for
the appropriate drainage of cerebral spinal fluid, and thus prevent increased intercranial pressure and an
abnormal ballooning of the patientÆs cerebral ventricles.
She was thereafter discharged from the UCLA Neurosurgical Hydrocephalus Clinic, for the purposes of
adjustment of her psychotropic medications and a course of rehabilitation.
The patient was sent to the Rehabilitation Institute of Santa Barbara, where she remained for three weeks
undergoing intensive therapy. It was concluded that she had gleaned the maximum benefit that could be
provided at that facility and, accordingly, was transferred to a Covenant Care nursing facility, Buena Vista
Care Center (BVCC), for ongoing care at a less intense level.
The plaintiff was transferred to BVCC on June 30, 1999, at which time the defendant, Dr. Ashley was
assigned as her attending physician.
The plaintiffÆs daughter, during the course of the patientÆs stay at Buena Vista, felt that the patient was
deteriorating both cognitively and functionally, and suspected that the VP shunt may be malfunctioning.
The daughter requested that a neurology consultation to ensure that the VP shunt was functioning properly.
Neither Dr. Ashley nor the BVCC staff perceived any substantial change in the patientÆs cognitive or
functional status; rather, they felt that her condition reflected the normal fluctuations of a patient with vascular
dementia, exacerbated by an adjustment to the new facility together with side effects of various psychotropic
medications.
Dr. Ashley ordered a psychiatric consult. The daughter continued to perceive ongoing deterioration in the
patientÆs cognitive and functional status, and became more insistent on the patient being evaluated by a
neurologist.
After three weeks, Dr. Ashley approved the familyÆs request, allowing them to select a neurologist. The family
selected the defendant, Dr. Kennedy, who initially saw the patient on Aug. 2, 1999. He denied knowing of the
daughterÆs perception that the patient had been deteriorating over the course of the preceding month, and was
under the erroneous belief that the reason he was seeing the patient was for a routine shunt check. Dr. Kennedy
concluded that the shunt was pumping appropriately; that the patientÆs condition was consistent with, and
explainable by, her prior diagnosis of vascular dementia.
The family continued to feel that the patient was deteriorating. She was subsequently discharged from physical
and occupational therapy for a failure to progress.
Several weeks later, the family called Dr. Kennedy directly, complaining of her ongoing deterioration since her
arrival at BVCC. Dr. Kennedy thereafter immediately initiated a full work up, including an imaging study of
the brain and a therapeutic lumbar puncture. Following the lumbar puncture, it was noted that the patient
became more alert, talkative and functional, suggesting her neurological problems were being caused by an
inadequately functioning VP shunt.
The patient was readmitted to the Neurological-Hydrocephalus Service at UCLA, where the VP shunt was
reprogrammed to allow for CSF (cerebral spinal fluid) to drain at lower pressure.
Settlement Discussions
There had been various "seven figure" demands by the plaintiff, but, these were reduced to $300,000 during trial. The defendants offered a total of $100,000; $40,000 from the facility and $30,000 from each of the physicians during trial.
Specials in Evidence
$185,000 ($1 million claimed during opening according to the defendant)
Deliberation
four days
Poll
10-2 (for Covenant Care), 9-3 (for Ashley), 12-0 (for Kennedy)
Length
seven weeks
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