94-373 La.App. 3 Cir. 11/23/94, Bush v. Arrow Intern.
| Decision Date | 23 November 1994 |
| Citation | 646 So.2d 1173 |
| Parties | 94-373 La.App. 3 Cir |
| Court | Court of Appeal of Louisiana — District of US |
Kenneth N. Simmons, Many, for Angela Bush.
James Brewster Gardner, Shreveport, for Arrow Intern., et al.
Lawrence Wayne Pettiette Jr., Shreveport, Patient's Compensation Fund.
Before THIBODEAUX, COOKS and SAUNDERS, JJ.
[94-373 La.App. 3 Cir. 1] SAUNDERS, Judge.
In this medical malpractice action, the jury found a medical corporation consisting of ten anesthesiologists ninety (90%) percent liable and the hospital ten (10%) percent liable for plaintiff's epidural abscess and spinal meningitis and awarded plaintiff $30,000.00 in general damages plus medical specials of $36,000.00.
While this appeal was pending, plaintiff Angela Bush and defendants, Schumpert Medical Center and Medical Center Anesthesiologists, settled all issues except quantum, of which plaintiff complains. On this remaining issue, we amend the $30,000.00 general damage award to $125,000.00, the lowest legally permissible award.
[94-373 La.App. 3 Cir. 2] PROCEDURAL HISTORY
Plaintiff brought this action against the Sisters of Charity of the Incarnate Word d/b/a Schumpert Medical Center (Schumpert), Dr. Robert A. Robertson ("Dr. Robertson"), Dr. Gary Madden ("Dr. Madden"), Medical Center Anesthesiologist, Inc. ("MCA"), and Preferred Physicians Insurance Company, the doctors' and MCA's insurer, for the damages alleged to have resulted from defendants' negligence. 1
After a week-long trial by jury, a special verdict form was returned by the jury with responses to four questions. The jury concluded that the anesthesiologists had obtained informed consent from Angela Bush for the epidural procedure and that neither Dr. Robertson nor Dr. Madden violated the standard of care required of them in the treatment rendered to Angela Bush; however, the jury did find negligence as to MCA and Schumpert, apportioning the fault 90% to MCA and 10% to Schumpert. The jury further awarded plaintiff general damages of $30,000.00 and medical expenses of $36,000.00 for a total of $66,000.00.
The parties having stipulated to the jury's liability determinations, we consider plaintiff's final contention, that her general damage award of $30,000.00 was too low under the circumstances.
On September 4, 1990, 23 year old Angela Bush was admitted to Schumpert Medical Center in Shreveport, Louisiana, to have her second baby. The baby was delivered by Caesarian section. Prior to the child's delivery, Angela was given an epidural block for her anesthesia. As stated in plaintiff's brief, to perform the block, the anesthesiologist, in this case Dr. Robert Robertson, used a kit containing items manufactured and purchased for that purpose. Using the kit's components, the doctor [94-373 La.App. 3 Cir. 3] sterilizes a portion of the patient's back with betadine and uses a pencil lead sized needle to inject medication into the patient's back near the spinal cord to anesthetize the region. Eventually, the syringe is detached from the needle and a plastic catheter was threaded through the needle into the patient's back to enable a pump to infuse pain medication.
As a consequence of defendants' conceded negligence, plaintiff Angela Bush sustained an epidural abscess in her spinal column and spinal meningitis. The sole question before us is whether plaintiff's general damages award is too low.
According to Mrs. Bush, her reaction to the epidural block began while she was still in Schumpert. When she awoke from surgery, her legs felt "numb and heavy." She was advised by her nurse that the sensation would pass once her epidural catheter was removed. The catheter had been inserted in her back Wednesday morning and removed two days later, on Friday morning. Plaintiff further indicated at trial that she had back problems and problems with light sensitivity while she was in the hospital.
When she returned home a few days after her baby was born, on September 8, plaintiff's symptoms continued and apparently worsened. She took the pain medication she was prescribed, but still could not sleep due to the pain. When she awoke at home September 9, the pains she was experiencing required her to call her mother to pick up her two children, including the newborn.
Plaintiff returned to the hospital thirty hours later with an epidural abscess, an infection that developed into spinal meningitis. There, physicians performed a laminectomy affecting three levels of her lower back and drained and treated the abscess. According to Dr. Coughlan, a specialist in infectious diseases who treated Mrs. Bush when she was admitted the second time, Ms. Bush was experiencing back pains, having trouble "passing water," had not had a bowel movement in several days, [94-373 La.App. 3 Cir. 4] and had abnormal feelings in her legs suggestive of neural involvement, dizziness, and light sensitivity, in addition to headaches.
When Ms. Bush was sent home the second time, she remained very sick, receiving intravenous antibiotics from nurses affiliated with a Natchitoches home health care service. In her 13 years of nursing, Registered Nurse Odom had never seen a patient with complications from an epidural abscess of the magnitude suffered by plaintiff. When Nurse Odom initially assessed plaintiff at her mother's home, plaintiff was in bed and appeared to be very depressed. She also appeared to be in considerable discomfort due to infection and necessarily invasive procedures performed to correct the effects of her epidural abscess.
Plaintiff complained to the nurse of her difficulties with urination and constipation.
Urination required plaintiff to sit on the commode for five to ten minutes before commencement and its limited success was attributable to gravity. Her discomforts were compounded by the feeling that she could not fully empty her bladder.
To address her problems with constipation, Ms. Bush was required to take laxatives regularly, in addition to an occasional enema. When the nurse returned the second day, she gave Ms. Bush an enema "with poor results" and found the abdominal area soft and undistended, with very sluggish bowel sounds.
On the third consecutive day, Nurse Odom had to visit plaintiff twice, the second time because excessive use of one arm required her to move the IV to the other. Ordinarily, according to Nurse Odom, only three consecutive days' visitation are required before less frequent contacts are appropriate, but in this case, she was required to go to visit a fourth day. Plaintiff's complaints of urination and constipation continuing, the nurse advised plaintiff to keep emptying her bladder by gravity. When her examination of plaintiff for a fecal impaction, a plug of hard stool, revealed [94-373 La.App. 3 Cir. 5] no impaction, Ms. Bush was advised to eat a high fiber diet, in addition to taking laxatives.
Nurse Odom returned again October 2, three or four days later. Plaintiff was very weak and depressed. When the nurse saw that the veins in plaintiff's arms could tolerate no more intravenous care, plaintiff was again required to return to Shreveport, this time to have a doctor cut her jugular vein and insert tubes in her neck to administer the intravenous antibiotics through the main artery of plaintiff's neck.
Plaintiff's complaints concerning the bladder, bowel, numbness in the lower extremities and general discomfort continued when Nurse Odom visited with plaintiff three days later.
In fact, plaintiff's complaints continued through November 17, 1990. On this date, Nurse Odom removed the central line, advised plaintiff how to detect complications, and discharged her from the home health service.
The nurse indicated that plaintiff seemed quite sincere in her efforts to improve her health through exercise but to no avail, exacerbating her depression. According to the nurse, plaintiff indicated that she wanted to return to work at least part-time; although she was still having problems with her bowels and her bladder and some (although less) numbness and tingling in her lower extremities.
RESIDUAL COMPLAINTS:
Plaintiff maintains that the physical and emotional strains she was forced to endure by defendants' negligence between September 4, 1990, and November 17, 1990, alone render inadequate the jury's general damage award. She further claims that any lingering question as to the award's inadequacy should be dispelled by the lingering effects on her of defendants' negligence. As to these longer-term effects, in brief plaintiff maintains that the testimony of Dr. Martinez, in addition to her own, corroborates her case for greater damages than those awarded.
[94-373 La.App. 3 Cir. 6] Defendants dispute the duration of plaintiff's injuries. They make great issue of the fact that plaintiff's motor function had improved and that in January and February, 1992, she made no complaints concerning her bowels or bladder.
Quoting Dr. Martinez's trial testimony concerning an October 11, 1991, visit, defendants maintain that as of that date, plaintiff continued to have complaints of lumbar area pains as well as some numbness and tingling in the right leg, but mentioned nothing about the bladder or bowel. The doctor also indicated that her neurological examination showed that her strength was normal. He could not detect any weaknesses in the right leg. When she returned to see Dr. Martinez on January 27, 1992, her motor function was completely normal and she was able to walk on her toes and heels. Defendants also underscore Dr. Martinez's expectation as of February 1992, 15 or 16 months after her surgery, that plaintiff's bowel and bladder situation would have been either static or improved with time.
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