Case details
Surgery outweighed benefits, decedent’s family claimed
SUMMARY
$0
Amount
Verdict-Defendant
Result type
Not present
Ruling
KEYWORDS
death
FACTS
On Feb. 12, 2007, plaintiffs’ decedent Simmie Wright Sr., 89, called 911 and was admitted by paramedics to the emergency room of Community Hospital of Long Beach. Upon examination, he was discovered to be dehydrated, malnourished, over-anticoagulated on Coumadin, and had an apparent right hip fracture. The patient was subsequently admitted to the service of Dr. Siamak Rouzroch, an internist who was on call. Rouzroch called in various consultants to assist in a plan for stabilization, including Dr. Philip Hill, an orthopedist, to consult on the hip fracture. Hill saw the patient on Feb. 13, 2007, and confirmed an old, complete intertrochanteric fracture of the right hip through an X-ray and CT scan. Hill claimed he recommended a right hemiarthroplasty, which is a partial artificial hip replacement, to be done after the patient’s condition was stabilized sufficient for surgery. Plaintiff Samella Johnson, Wright’s daughter, opposed the surgery, but Wright was declared mentally competent to make his own decision. On Feb. 17, 2007, Rouzroch postponed the surgery due to Wright’s high while-blood-cell count and asked a hematologist whether this finding should delay the surgery. Hill ultimately went forward with the surgery on Feb. 18, 2007, and no intraoperative complications arose. While Wright’s recovery initially went well, but he was transferred to the Intensive Care Unit on Feb. 22, 2007, when he was determined to have low blood pressure and a high heart rate. When his blood studies showed significant anemia, he began receiving blood transfusions. However, Wright developed kidney failure, respiratory failure and, ultimately, multi-organ failure. As a result, a “Do Not Resuscitate” order was agreed to by some of Wright’s family members, although not by Samella Johnson, and Wright died after extubation on March 8, 2007. The decedent’s children, Samella Johnson and Simmie Wright Jr., sued Rouzroch, Hill and Community Hospital of Long Beach. They alleged that the defendants failed to properly treat their father and failed to obtain proper informed consent to perform the surgeries. They contended that these failures constituted medical malpractice. In addition, they claimed Rouzroch’s treatment of their father constituted elder abuse and that Hill’s treatment of their father constituted medical battery. However, at trial, a nonsuit was ordered regarding the elder abuse cause of action, but the court allowed the plaintiffs to allege medical battery against Hill. Wright’s children claimed that their father was clearly demented and could not legally consent to the surgery. They also claimed the surgery was unnecessary for an 89-year-old man with multiple medical problems, and that it exposed him to a high risk of complications, with death being reasonably certain. They noted that a right hip replacement was recommended to their father 3.5 years earlier, but the treating orthopedic surgeon at that time did not perform the procedure because the decedent was not medically stable enough for surgery. Plaintiffs’ counsel contended that the consent obtained from the decedent on Feb. 17, 2007, was invalid due to his dementia, which was supported by the plaintiffs’ medical experts. Counsel argued that the defendants should have all been able to make the diagnosis of dementia or should have had a neurologist consult on the patient prior to surgery. The plaintiffs’ expert internist opined that the defendants obtained consent from a person clearly incompetent to give consent, and that Rouzroch and Hill should have consulted hospital administration and neurologist for assistance. In addition, Johnson claimed that she was unaware of the surgery taking place and that it was performed after she left the hospital. Plaintiffs’ counsel further argued that the decedent was never cleared for surgery by Rouzroch and, therefore, Hill acted prematurely. The plaintiffs’ expert orthopedic surgeon opined that Hill never should have performed the surgery because that the risks far outweighed the benefits. Rouzroch contended that he met the standard of care in all respects, both before and after surgery. He claimed that after Feb. 13, 2007, neither he, nor any consultant or nurse expressed any concern over the decedent’s mental capacity. Rouzroch further contended that he did not clear the decedent for surgery, but, instead, was deferring that decision to the hematology consultant. He claimed he did not hear about the surgery the morning it was performed and when he was told after the fact, he presumed the hematologist provided the necessary clearance. Hill adamantly denied Johnson’s claim of ever promising that the patient would walk again. He claimed that on the afternoon of Feb. 17, 2007, he noted that the hematologist had ordered that decedent have nothing by mouth after midnight, and that blood sugar should be typed and cross-matched for two units of blood for typical replacement after surgery. Hill claimed he interpreted those orders as clearance for the surgery. The defendants all claimed that they obtained written consent from the decedent while he was competent, and that charts noted that he was acting appropriately and within normal limits. Defense counsel contended that it is not uncommon for an elderly (89-year-old) hospital patient to show some mental confusion, and that’s why he was documented as “abnormal.”, Simmie Wright Sr. developed kidney failure, respiratory failure and, ultimately, multi-organ failure. As a result, he died after extubation on March 8, 2007. He was 89. Wright’s children claimed that the defendants’ negligence caused their father to essentially bleed to death. Plaintiffs’ counsel argued that, after surgery, the decedent essentially bled to death, most likely from undocumented and persistent bleeding from the surgical incision. Thus, counsel argued that the defendants failed to control the bleeding, which led to underperfusion of the patient’s vital organs, which ultimately caused Wright’s death. The plaintiffs’ expert orthopedic surgeon also opined that Hill failed to correct the decedent’s post-operative hemorrhaging. Thus, plaintiffs’ counsel presented a range of values, from $100,000 to $1 million, depending on the decedent’s life expectancy, in order to compensate for their damages suffered by Wright’s children as a result of their father’s wrongful death. However, defense counsel claimed that the plaintiffs asked for $1.7 million in total wrongful death damages. Defense counsel argued that the decedent died from complications of multi-organ failure, and not due to bleeding. Both Rouzroch and Hill denied the patient was bleeding to death, claiming that there was no significant surgical wound bleeding noted, and that Wright’s anemia was corrected by transfusions. The defense’s expert internist opined that the decedent’s kidneys began failing prior to the surgery and that Wright had contrast-induced toxic nephropathy, as proven by a pre-operative abnormal rise in kidney function tests. The expert further testified that after the surgery, the decedent went into an “atrial flutter,” which caused all his organs to ultimately fail.
COURT
Superior Court of Los Angeles County, Central, CA
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