May 16, 2019
DBMS successfully obtains verdict on behalf of defendant Internal Medicine Resident in a lawsuit arising from the death of a 20-year old sickle cell patient involving the resident’s care of the patient in an intensive care unit. The plaintiff’s 20-year old son presented to the hospital with sickle cell pain crisis. A chest x-ray in the emergency room was abnormal and acute chest syndrome was in the differential. The patient was admitted to the general oncology floor and vital signs, including pulse oximetry, were monitored every 4 hours. Throughout the day and evening, the defendant ordered substantial doses of intravenous morphine to control pain. Vital signs, including pulse oximetry, were within normal limits for a patient in sickle cell pain crisis when last taken at midnight. A nursing assistant provided the patient with hot packs and a light snack at about 1:00 am. At 1:55 a.m., a nurse entered the room and found the patient unresponsive with no pulse or respirations. A Code was called but despite aggressive resuscitation attempts, the patient did not survive. An autopsy revealed an area of old scar at the pacemaker center of the heart and the pathologist commented that a sudden lethal arrhythmia related to the scar could not be entirely excluded as the cause of death.
The plaintiff claimed that the defendant negligently failed to transfer her son to the intensive care unit or step-down unit for continuous cardiac and pulse oximetry monitoring given his acute chest syndrome and morphine administration, which the plaintiff alleged caused respiratory depression resulting in hypoxia and respiratory arrest, leading to cardiac arrest and death. The plaintiff argued that had her son been placed on continuous monitoring, his condition would have been recognized immediately, resuscitation efforts would have been initiated sooner, and he would have survived.
The defense contended that the patient never had acute chest syndrome, there was no evidence of respiratory depression, and no reason to transfer the patient to a higher level of care for continuous cardiac and pulse oximetry monitoring. Furthermore, patients with sickle cell disease do not respond well to resuscitation and even with earlier recognition and treatment, the plaintiff’s decedent would not have survived. The defense maintained that the sole proximate cause of the patient’s death was an unpredictable, unpreventable, sudden and lethal cardiac arrhythmia caused by the scar in the heart.
In Closing argument, the plaintiff’s counsel asked the jury to award $6,000,000 in damages to the family. After approximately three-and-a-half hours of thoughtful deliberation, the jury returned its verdict for the defendant.