Case details
Extubation did not cause patient’s death, doctor claimed
SUMMARY
$0
Amount
Decision-Defendant
Result type
Not present
Ruling
KEYWORDS
cardiac, cardiopulmonary, death, respiratory arrest
FACTS
On Nov. 26, 2010, plaintiffs’ decedent Kennith Nordaker, 27, a dependent adult with cerebral palsy, went into respiratory and cardiac arrest, and was subsequently admitted to Mercy Medical Center, in Redding. Upon his admission, he was placed on a ventilator and Dr. David Johnson, a critical care physician, signed a do-not-resuscitate order. During Nordaker’s hospitalization, Dr. Richard King, another critical care physician, told Nordaker’s mother and conservator that he believed that Nordaker would remain in a persistent vegetative state. He also told the mother that her son would die if Nordaker was taken off the ventilator. As a result, the mother Nordaker agreed to place her son on a ventilator long-term, and arrangements for a tracheostomy and long-term placement were going to be made. Shortly after King addressed Nordaker’s mother about the ventilator, Johnson began his night shift and convinced Nordaker’s mother to allow him to remove her son from the ventilator, stating that the patient would be able to go home, where he could be reintubated if there was any trouble. Two hours and forty-five minutes later, Nordaker went into cardiorespiratory arrest and, due to the DNR order, no attempts to resuscitate him were made. Nordaker was pronounced dead four minutes later. The decedent’s mother, Cindy Nordaker, and the decedent’s younger half-brother, Koddin Nordaker, sued Johnson, King, and Redding Critical Care Medical Group. The decedent’s family alleged that the defendants were negligent in the treatment of the patient, and that this negligence constituted medical malpractice and caused the patient’s wrongful death. The decedent’s mother and half-brother also sued Catholic Healthcare West, which was doing business as Mercy Medical Center, and named a family member who did not participate in the action, Albert Beem, as a defendant. However, Catholic Healthcare and Beem were ultimately let out of the case. In addition, King successfully moved for summary judgment, which plaintiffs’ counsel did not oppose, while Redding Critical Care Medical Group settled with the decedent’s mother and half-brother for a confidential amount. Thus, the matter proceeded to a bench trial against Johnson only. Plaintiffs’ counsel contended that contrary to the decedent’s family’s expressed wishes, and without their knowledge, Johnson signed the DNR order upon the decedent’s admission to Mercy Medical Center on Nov. 26, 2010. The decedent’s mother testified that she had specifically instructed the defendants that all possible measures were to be taken to keep her son alive and that he was to be resuscitated. She claimed her instructions that the defendants should “do anything” to save her son were noted in the decedent’s chart. The decedent’s half-brother claimed that he was in the room when the decedent went into cardiorespiratory arrest and that he insisted that the decedent was not a DNR patient, but that no resuscitation efforts were made. Johnson testified that he obtained permission to enter the DNR order from the decedent’s stepfather. Johnson claimed that his plan, upon the decedent’s admission, was to remove him from the ventilator and place him on “comfort care.” However, he claimed that once the decedent arrested, CPR would have been futile., Kennith Nordaker went into cardiorespiratory arrest and was ultimately died. He was 27. The decedent’s family claimed that decedent died because Johnson extubated him despite numerous indications that extubation would be unsuccessful, including a lack of cough and gag reflex, a Glasgow coma scale of 3, a prior failed spontaneous breathing trial, a partially collapsed right lung, and previous incidents of aspiration of gastric contents into the lungs. The decedent’s family further contended that Johnson was negligent in extubating the decedent after only 20 minutes of spontaneous breathing, when the decedent had failed a spontaneous breathing trial of over 12 hours the day before. The plaintiffs’ critical care expert testified that the decedent died because he suffered an aspiration event as a result of being extubated, and that resuscitation efforts would more likely than not have been successful. Thus, the decedent’s mother and half-brother sought recovery of non-economic wrongful death damages. Defense counsel contended that the decedent died due to a tentorial herniation caused by brain swelling that resulted from an anoxic brain injury. The defense’s critical care expert opined that any effort to resuscitate the decedent would have been futile because the cause of death was a tentorial herniation. Plaintiffs’ counsel countered that a tentorial herniation was not noted in Johnson’s discharge summary or on the death certificate that Johnson signed, and that Johnson had not mentioned a tentorial herniation in a recorded telephone conservation with the decedent’s family that took place a few hours after his death.
COURT
Superior Court of Shasta County, Redding, CA
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