Case details

Failure to timely treat bleeding mother resulted in death: suit

SUMMARY

$9284464

Amount

Verdict-Mixed

Result type

Not present

Ruling
KEYWORDS
low blood pressure, pregnancy bleeding
FACTS
On March 9, 2014, plaintiffs’ decedent Ling Nie, 26, a chief financial officer from China, went into labor and presented to Garden Grove Hospital Medical Center, in Garden Grove, Calif. Nie had traveled to the United States from China in early February 2014, while late in her pregnancy, and established a treatment relationship with an OB-GYN, Dr. Long-Dei Liu. As a result, when Nie presented to Garden Grove Hospital Medical Center, Liu performed a caesarean section and delivered Nie’s second child. However, at the end of the surgery, at approximately 10:55 p.m., the anesthesiologist, Dr. Gary Kao, removed the surgical sheets and discovered a massive bleed. Kao subsequently ordered medication and blood products, including four units of packed red blood cells. He then contacted a critical care specialist, Dr. Asaad Hakim, to notify him regarding the transfer of Nie to the Intensive Care Unit and to inform Hakim that Nie was hypotensive, tachycardic, hypovolemic, and possibly still actively bleeding. Believing that Nie’s condition was stabilized, she was transferred to the ICU at 12:35 a.m. on the morning of March 10, 2014. Since Liu considered Nie to be “normal,” he left the hospital 17 minutes after Nie arrived in the ICU. However, upon her arrival, Nie’s blood pressure was found to 90/37, her heart rate was 149, her oxygen saturation was 89 percent, she had a distended abdomen, and she was lethargic. The findings indicated that there was a high likelihood that Nie was continuing to actively bleed. At 3:13 a.m., a Code Blue was called as a result of Nie’s severe blood loss. She subsequently required resuscitation and placement on a mechanical ventilator. Nie was eventually returned to surgery, but she never recovered in any meaningful fashion. As a result, the family ultimately elected to remove Nie from life support, and she passed away on March 14, 2014. Nie’s husband, Yuanda Hong, and their two minor sons, William Hong and Harry Hong, sued Liu; Hakim; Kao; a neurologist, Dr. Douglas Chang; a hematologist, Dr. Kambiz Afrasiabi; and the operator of Garden Grove Hospital Medical Center, Prime Healthcare Services-Garden Grove, LLP (which was initially erroneously sued as Garden Grove Hospital and Medical Center). The decedent’s family alleged that the defendants failed to appropriately and timely treat Nie, resulting in her wrongful death, and that the defendants’ failures constituted medical malpractice. Prime Healthcare Services-Garden Grove ultimately entered into a confidential settlement with the plaintiffs prior to trial. Kao, Chang and Afrasiabi were also dismissed from the case. Thus, the matter continued against Liu and Hakim only. Plaintiffs’ counsel argued that Liu and Hakim failed to appropriately and timely intervene and respond to clear signs of continued bleeding in Nie, resulting in her ultimately bleeding to death. Plaintiffs’ counsel contended that at the end of the surgery, at approximately 10:55 p.m. on March 9, 2014, Liu left the operating room unaware that his patient, Nie, was bleeding. Counsel also contended that the anesthesiologist, Kao, recognized the massive bleeding after removing the surgical sheets and attempted to contact Liu, but without success. Counsel asserted that as a result, Liu was absent from the operating room for about 50 minutes, during which time, Kao ordered the medication and blood products. Plaintiffs’ counsel contended that Nie was eventually transferred to the ICU at 12:35 a.m., but that she was actively bleeding and required immediate surgery to save her life. Counsel argued that although Nie had a blood pressure of 90/37, a heart rate of 149, oxygen saturation of 89 percent, and a distended abdomen, as well as being lethargic, Liu considered Nie to be “normal” and left the hospital 17 minutes after Nie arrived in the ICU. Plaintiffs’ counsel contended that Liu testified that he was unaware of Nie’s vital signs in the ICU before leaving and had “assumed” that her vital signs had not changed since the time the patient left the operating room. According to plaintiffs’ counsel, Liu also testified that he did not utilize any of Nie’s vital signs in deciding whether to go home or to take Nie to surgery. In addition, counsel pointed out that Liu never called the hospital to check on Nie’s condition after arriving home. Plaintiffs’ counsel argued that as a result, Nie continued to bleed and, within two hours, essentially bled to death. Counsel further argued that as a result of this case, Liu is no longer practicing at Garden Grove Hospital Medical Center. In regard to Hakim, plaintiffs’ counsel noted that the notes of the ICU nurses reflected that after Nie arrived in the ICU, her blood pressure was at all times quite low and her heart rate was at all times quite high, which indicated a high likelihood that Nie was continuing to actively bleed. Counsel also contended that as a result, an ICU nurse claimed that she had to call Hakim on three separate occasions to request his assistance with Nie, who was worsening, but that Nie was essentially left to bleed to death. Liu claimed that after the end of the surgery at 10:55 p.m., he never left the operating room and was present when it was discovered that Nie was experiencing a post-partum hemorrhage. He also claimed that he was present when efforts were undertaken to both control the bleeding, via the placement of an intrauterine balloon and administration of medications to encourage uterine contractions, and to replenish Nie’s lost blood volume. He further claimed that Nie remained under his care while in the ICU, where he replaced the intrauterine balloon and became satisfied that Nie was stable before departing for home at 12:52 a.m. that morning. Liu’s counsel disputed the accuracy of the ICU nursing notes about Nie’s blood pressure being “at all times” quite low and her heart rate being “at all times” quite high. Counsel noted that the accuracy and reliability of the nursing notes, particularly with regard to specific times, was a topic of constant debate among the various witnesses and experts during trial. However, Liu’s counsel argued that the ICU nurses never attempted to contact Liu regarding Nie’s tachycardia, hypotension, or continued bleeding once Liu left the hospital and that this was uncontradicted at trial. Thus, Liu’s counsel argued that Liu responded appropriately to Nie’s bleeding complication and that Nie’s condition was stabilized when Liu left the hospital at 12:52 a.m. that morning. Counsel further argued that the nurses never contacted Liu again after he left the hospital or before the Code Blue was called at 3:13 a.m., depriving Liu of any opportunity to save Nie. It was agreed by all expert witnesses that Nie could no longer be saved to a reasonable medical probability once the Code Blue occurred and that Nie needed to have been returned to surgery by 2 a.m., if she was going to be saved in the absence of further resuscitation with blood products. (Evidence was admitted at trial to demonstrate that further blood products simply were not available at the hospital for resuscitation before 3:13 a.m.) Hakim disputed the content of the telephone conversation he had with Kao, the anesthesiologist. He claimed that Kao did contact him to notify him regarding the transfer of Nie to the ICU and to inform him that Nie was hypotensive, tachycardic, hypovolemic, and possibly still actively bleeding. However, Hakim testified that in response, he informed Kao that if Nie was still bleeding, then she needed to return to the operating room and not remain in the ICU. He also claimed that although he was contacted about Nie’s presence in the ICU at 12:35 a.m., he was not asked to intervene at that time and that there was no need for him to intervene given the presence of both an anesthesiologist and an OB-GYN at Nie’s bedside. Hakim also denied being called by an ICU nurse “on three separate occasions” and testified that no nurse or physician ever contacted him after the 12:35 a.m. call or any time before the Code Blue at 3:13 a.m., which also deprived him of any opportunity to save Nie. However, he claimed that even if he had come in to the hospital to evaluate Nie, there were no further blood products available for resuscitation, which meant that only surgery could have been performed to save Nie., A Code Blue was called at 3:13 a.m. on March 10, 2014, as a result of Nie’s severe blood loss. As a result, she required resuscitation and placement on a mechanical ventilator. She was eventually brought back to surgery, but she never recovered in any meaningful fashion. (It was agreed by all experts that Nie could no longer be saved to a reasonable medical probability once the Code Blue occurred.) As a result, the family elected to remove Nie from life support, and she died on March 14, 2014. Nie was survived by her husband, Yuanda Hong, and their two sons, William Hong, then age 4, and Harry Hong, then age 1. Nie was 26 years old at the time of her passing. Plaintiffs’ counsel argued that the Hongs were deprived not only of the love, support and guidance of Nie, and the loss of her anticipated household services, but also of Nie’s significant financial support over her remaining work-life expectancy. Thus, the family sought recovery of past loss of financial support in the amount of $290,107, future loss of financial support in the amount of $8,360,316 (present value) or $15,111,350 (future value), and funeral and burial expenses in the amount of $47,768. They also sought recovery of past loss of household services in the amount of $43,270, and future loss of household services in the amount of $820,550 (present value) or $1,533,181.
COURT
Superior Court of Orange County, Santa Ana, CA

Recommended Experts

NEED HELP? TALK WITH AN EXPERT

Get a FREE consultation for your case