Case details

Doctors failed to place patient’s A-line and monitor levels: suit

SUMMARY

$2500000

Amount

Settlement

Result type

Not present

Ruling
KEYWORDS
brain, brain injury, cerebral palsy, developmental delay, mental, psychological
FACTS
When plaintiff Mia Sturm was 5 months old, she underwent cranial vault remodeling, a simple elective procedure, at UCLA Medical Center to address her cranial stenosis, a congenital defect of the forehead. Sturm was previously born with several congenital conditions, which required surgical correction, and she was ultimately diagnosed with cranial stenosis at 5 months of age. Her mother ultimately elected to have her daughter undergo the surgery. Prior to commencement of the remodeling portion of the surgery, the anesthesiologist, Mohamad Iravani, M.D., attempted for three hours to place an arterial line. Rather than cancel the surgery due to his inability to place the A-line, Iravani placed a central-line, or central venous line, which would place the line into a vein. However, this type of line does not monitor fluid volumes. Iravani then told the surgeons, Reza Jarrahy, M.D., and Jorge Lazareff, M.D., that they could proceed with the surgery. Toward the end of the surgery, Mia became bradycardic and went into ventricular arrhythmia, requiring chest compressions, defibrillation, and administration of Epinephrine and Atropine to stabilize her blood pressure. Mia was then transferred to the Pediatric Intensive Care Unit, where she was diagnosed as having suffered strokes to both sides of her brain due to blood fluid loss, resulting in an interruption of blood flow to the brain, during the surgery. As a result, Mia suffers mild cerebral palsy and developmental delay. Lisa Sturm, acting as Mia’s guardian ad litem, sued the Regents of the University of California, UCLA Medical Center, Iravani, Jarrahy and Lazareff. She alleged that Iravani failed to place the A-line, and that Jarrahy and Lazareff failed to properly monitor her daughter’s levels during the surgery. She further alleged that these failures constituted medical malpractice, and the Regents of the University of California and UCLA Medical Center were vicariously liable for the doctors’ actions. All of the physicians were dismissed from the case prior to resolution, and the sole defendant was the Regents of the University of California. Plaintiffs’ counsel contended that an A-Line is inserted into an artery during pediatric general anesthesia to monitor blood pressure and blood fluid levels in real time, and could determine if a patient’s blood levels are getting too low during surgery. Counsel contended that when levels become too low, hypo-profusion can result, which can lead to acidosis and/or cardiac arrest. Thus, plaintiffs’ counsel argued that it was below the standard of care and contra-indicated to commence pediatric surgery with general anesthesia without the placement of an A-Line to monitor blood pressure and blood fluid volumes. Counsel further argued that a central-line was insufficient and caused Mia’s blood and fluid volume loss to go unmonitored, leading to acidosis, hypo-profusion and bilateral strokes to her brain. Defense counsel contended that the anesthesiologist acted within the standard of care at all times, and did not cause or contribute to Mia’s . Counsel also contended that Mia suffered from numerous congenital conditions which caused and/or contributed to the occurrence during surgery. Defense counsel added that it would have been contra-indicated to cancel the surgery three hours into the procedure., Mia went into ventricular arrhythmia, requiring chest compressions, defibrillation, and administration of Epinephrine and Atropine to stabilize her blood pressure during the surgery. She was ultimately diagnosed as having suffered strokes to both sides of her brain due to an interruption of blood flow to the brain. As a result, Mia suffers from mild cerebral palsy and developmental delays. Mia’s mother claimed that her daughter requires some attendant care and compensatory assistance as a result of Mia’s condition. She also claimed that Mia will suffer a loss of earning capacity as a result of the developmental delays. Defense counsel contended that Mia was very bright and though she had some difficulty communicating, Mia would improve over time. Counsel also disputed the claims that Mia needed attendant care or that she would suffer a loss of earning capacity.
COURT
Superior Court of Los Angeles County, Santa Monica, CA

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