Case details

Nurses failed to properly monitor patient, suit alleged

SUMMARY

$15026260

Amount

Verdict-Plaintiff

Result type

Not present

Ruling
KEYWORDS
brain, brain damage, coma
FACTS
On the night of Nov. 8, 2011, plaintiff Dioresly Lora, a 26 year old with a history of childhood asthma that resulted in multiple prior emergency room visits and hospitalizations, presented to Palmdale Regional Medical Center with difficulty breathing. After she was treated in the Emergency Room with three breathing treatments, the ER physician noted some improvement and called the on-call hospitalist, who decided to admit Lora to the Telemetry Unit of the hospital with a diagnosis of an exacerbation of asthma. The hospitalist then ordered continuous oxygen saturation monitoring and supplemental oxygen to keep the oxygen saturation at or above 92 percent. When Lora was transferred to the telemetry floor at around 3 a.m. on Nov. 9, 2011, she was attached to cardiac telemetry monitoring, but not to an oxygen saturation monitor. Over the next 30 hours, Lora had six more breathing treatments with oxygen saturation measurements and had vital signs taken every four hours, all of which showed oxygen saturations above 92 percent. On the morning of Nov. 10, 2011, Lora asked for a breathing treatment, so a nurse called for respiratory therapist. However, when the nurse returned to the room, she discovered Lora to be non-responsive and having difficulty breathing. The respiratory therapist then came in to the room and attempted the breathing treatment while the nurse called for the Rapid Response Team, which brought a second respiratory therapist into the room to take over bag-mask ventilation. The Intensive Care Unit nurse checked Lora’s pulse and found it to be thready, or weak, but she then lost the pulse. The respiratory therapist next drew blood for an arterial blood gas, which showed a pH of 7.05, with a PCO2 of 91 and PO2 of 223. A Code Blue was then called, and two additional ICU nurses, another respiratory therapist and an ICU physician responded within 30 seconds. Within the next three minutes, Lora was intubated, and Epinephrine and Atropine were given. As a result, Lora’s heart rate and blood pressure returned. She was then moved to the ICU, where she remained comatose and on a ventilator until Dec. 19, 2011. She was then moved to a rehabilitation hospital in Lancaster, where she was weaned from the ventilator. Dioresly Lora’s mother, Hortensia Lora, acting as her daughter’s guardian ad litem, sued the operator of Palmdale Regional Medical Center, Lancaster Hospital Corp. (The operator was initially erroneously sued as Universal Health Services of Palmdale Inc.) The plaintiff’s experts opined that the nurses at Palmdale Regional Medical Center were negligent in their failure to properly monitor Dioresly Lora in conformity with the doctor’s orders. They also opined that the nurses and respiratory therapists were negligent for not calling a Code Blue when they found Lora to be non-responsive and having difficulty breathing. The plaintiff’s experts testified that had the hospital properly monitored Lora, respiratory difficulty would have been evident in time to prevent cardiopulmonary arrest and that the delay of the hospital’s staff in calling a Code Blue was a substantial factor in causing Lora’s . Defense counsel acknowledged that the hospital’s staff failed to initiate the order for a continuous pulse oximeter — a non-invasive device used to measure a patient’s blood-oxygen saturation level and pulse rate — but argued that even if the device was used, it would not have prevented the cardiopulmonary arrest. The defense’s causation expert testified that the arterial blood gas showed that Lora was well oxygenated and that the cause of the arrest was not due to asthma. Instead, the expert opined that Lora’s arrest was caused by an unpredictable, unpreventable, anaphylactic allergic reaction to the antibiotic Zithromax, which was given to Lora intravenously just prior to her arrest. Thus the expert opined that oxygen saturation monitoring would not have prevented Lora’s arrest., Dioresly Lora went into cardiopulmonary arrest and was found to be non-responsive. The respiratory therapist subsequently attempted a breathing treatment while the nurse called for the Rapid Response Team. A Code Blue was eventually called, and Lora was intubated and given Epinephrine and Atropine. As a result, Lora’s heart rate and blood pressure returned, but she was determined to have suffered a severe hypoxic brain injury, resulting in a persistent vegetative state. As a result, she remained comatose and on a ventilator at the hospital until Dec. 19, 2011. She was then moved to a rehabilitation hospital in Lancaster, where she was weaned from the ventilator. Lora was then moved to a skilled nursing facility in March 2012. The plaintiff’s life expectancy expert testified that as a result of Lora’s condition, she would only survive for an additional 12 to 13 years. Thus, plaintiff’s counsel contended that Lora’s past medical care amounted to $538,316 and that her future medical care costs will amount to $6,227,792, based on a present cash value for a 12-year life expectancy. Counsel also contended that Lora will suffer future lost earnings in the amount of $1,783,873, and an unspecified amount of non-economic damages for her past and future pain and suffering. The defense’s life expectancy expert testified that Lora had a life expectancy of only six to eight years from the date of the incident. Thus, defense counsel argued that Lora’s future medical care costs would only amount to $2,991,179, based on the present cash value of someone with life expectancy of 5.8 years, and that Lora’s future loss of earnings would only amount to $1.2 million.
COURT
Superior Court of Los Angeles County, Lancaster, CA

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