Burris v. Titzell

Decision Date15 May 1920
Docket Number32674
Citation177 N.W. 557,189 Iowa 1322
PartiesHUGH BURRIS, Appellee, v. F. C. TITZELL, Appellant
CourtIowa Supreme Court

SUPPLEMENTAL OPINION ON REHEARING, NOVEMBER 23, 1920.

Appeal from Johnson District Court.--R. G. POPHAM, Judge.

ACTION to recover damages for malpractice. Opinion states the facts. Judgment and verdict for the plaintiff. Defendant appeals.

Reversed.

Dutcher Davis & Hambrecht, for appellant.

W. J McDonald and Cook & Balluff, for appellee.

GAYNOR, J. WEAVER, C. J., LADD and STEVENS, JJ., concur.

OPINION

GAYNOR, J.

This action is to recover damages for alleged malpractice. The plaintiff divides his petition into two counts. In each count, he undertakes to set out a distinct cause of action, upon which he predicates a right to damages.

The first count centers around the escape of a drainage tube into the pleural cavity of the plaintiff on the 6th day of March, 1915. It is the claim of the plaintiff that the defendant was negligent in permitting the drainage tube to escape into the said cavity. The second count centers around an operation performed in an attempt to remove the tube. Before stating the grounds upon which plaintiff predicates his right to recover, we may properly state some of the facts which led up to and made it necessary that the plaintiff be operated upon at all. It appears that, on and prior to the 6th day of January, 1915, plaintiff was a resident of Cherokee County, and while there, was taken sick with pleurisy and pneumonia, some time in January, 1915, and was treated by a local doctor for these troubles until the 20th day of February, 1915, when he was brought to the Homeopathic Hospital at Iowa City. The local doctor testifies that, before plaintiff was taken to Iowa City, he performed a surgical operation on the plaintiff with an aspirating needle. The purpose was to relieve the pus in the pleural cavity. He testified:

"I secured one quart of pus from the pleural cavity. This operation was performed on the 19th day of February. The ailment with which plaintiff was suffering was a serious disease. It is difficult to treat, and more so with a history of alcohol, booze, back of it,--it is very hard. After I found out there was pus in this cavity, and it would be a long-protracted case, I concluded to send the plaintiff to Iowa City."

He was accordingly taken there on the date aforesaid. The plaintiff was brought to this hospital as a county patient, by one of the trustees of the township in Cherokee County in which he resided. The defendant occupied the chair of surgery in the State University, and plaintiff was turned over to him for treatment. The defendant's connection with this Homeopathic Medical College at Iowa City consisted of teaching, and also doing general surgery, such as was found necessary in the hospital. We take it that he was employed by the state at a fixed salary, and received no compensation for the treatment given patients in the hospital, other than he received from the state. The nurses and medical staff of this hospital were employed by the board of education of the state, and were subject to discharge by them. The defendant's relationship to the hospital gave him no authority to employ or discharge internes or nurses. The nurses were assigned to take care of patients operated upon. The defendant attended the plaintiff for the first time on February 22, 1915; or, at least, that is the first time he saw him. He diagnosed his case, and found him suffering from empyema; found him in a badly run-down condition, as a result of his previous illness. On the 24th, the doctor inserted a needle in the chest of plaintiff, for the purpose of ascertaining whether he had pus, or just an ordinary effusion. He found pus in the cavity, and that it was necessary to remove it, in order to effect a cure. Thereupon, the doctor made an incision about two inches long into the cavity, between the seventh and eight ribs, and inserted a tube, for the purpose of draining the pus from the cavity. The tube, after being inserted, was fastened in the body of the patient by suture: that is, a needle threaded with silkworm gut was passed through the skin and through the tube, and then out through the skin on the other side, and tied. All doctors agree that this was one of the usual and approved methods of inserting and fastening such a tube, at the time the operation was performed. Thereafter, the doctor saw the patient twice a day. In the meantime, it was the practice of the hospital and the duty of the nurses and internes to dress the wound; and this was done. On the 6th day of March, it was discovered by one of the nurses that the tube had disappeared. A search was made for it in the bed and clothing, and in the dressing that had been removed from the wound, and it could not be found.

On the 22d day of June following, it seemed that the wound had closed, so that there was not sufficient drainage, and plaintiff's temperature was rising. An effort was made then to enlarge the opening for better drainage, and an attempt made to administer an anaesthetic; but the patient was unable to take the anaesthetic, his heart stopped, he quit breathing, and the attendant had to use artificial respiration to bring him back; and further operation was suspended,--at least the defendant so claimed.

The escape of the tube from its moorings into the pleural cavity, and the consequences that followed its presence there, serve as a basis for the cause of action alleged by the plaintiff in the first count of his petition. In stating his cause of action in this count, he says:

"The defendant, in placing or inserting said drainage tube, undertook to secure the same, so as to prevent it from slipping or sliding into the cavity, by making a stitch with a needle, which the plaintiff believes to have been a silk thread through said tube and the flesh or skin of the plaintiff; that the defendant, not regarding his duty to the plaintiff, so carelessly, negligently , and unskillfully placed the tube in plaintiff's person, and so negligently failed to properly and safely secure it against slipping, falling, or working into the pleural cavity, that the tube did escape or work loose from the insecure fastenings, and did slip or work into the person of plaintiff and into the pleural cavity, and remained there until the same was removed, on the 1st day of January, 1916."

The negligence upon which plaintiff predicates his right to recover in this count is stated in these words:

"1st. That the defendant failed and neglected to use reasonable and proper means of securing said drainage tube to the person of plaintiff, or otherwise, so as to prevent same from slipping or working into the cavity in which it was inserted for drainage purposes.

"2d. That he failed to secure or fasten the tube, to prevent it from slipping or working into the cavity.

"3d. That, knowing the tendency of the tube to slip or work into the cavity, he failed and neglected to take any means whatsoever to prevent the same from working or slipping into the cavity.

"4th. That he failed to use any of the means known to the profession generally to prevent the tube from slipping or working into the cavity."

He alleges that, by reason of this negligence, the tube slipped or worked into the cavity, producing injurious consequences, both in health and loss of time, etc., and expenses incurred. On the allegations of this count, he clams $ 15,000.

The second count of the petition is predicated on the alleged negligence of the defendant in attempting to remove the tube from plaintiff's person on the 1st day of January, 1916; and it is alleged that, on that day, defendant, for the purpose of recovering or removing the tube, performed a surgical operation upon the plaintiff. The negligence charged in this operation is:

(1) That the defendant negligently and carelessly failed to locate, by means of an X-ray, or otherwise, the exact and precise location of the tube in the person of the plaintiff before attempting the operation.

(2) That the defendant, knowing or having means of knowing the location of said drainage tube in the person of the plaintiff, proceeded to operate upon the plaintiff, without locating or having located the said tube in the person of the plaintiff.

(3) That the defendant was negligent in making a cut or incision in the plaintiff's back, and through the nerves, muscles, and flesh of his back, when he knew, or should have known, by the exercise of reasonable care, the extent and size of the cavity into which the aforesaid drainage tube had escaped, and was then located; and was negligent in not ascertaining and knowing that the cavity did not extend around plaintiff's right side and into his back; that defendant was negligent in making a cut or incision into plaintiff's back, and in severing the nerves, muscles, and cords leading to his right arm, which are involved in the motion of his right arm, when he knew, or should have known, that the drainage tube which he was seeking to recover was located at or about and under the right nipple, and that the cavity did not extend into the right side or back of the plaintiff, beyond a point drawn directly downward from the shoulder blade of the plaintiff on the right side; that, in the operation, the defendant did not locate the drainage tube.

For the consequences that flowed from this alleged negligence, the plaintiff claims $ 30,000 damages.

It will be noticed that the plaintiff claims to recover for two distinct acts of negligence, one occurring in February, 1915, and the other on January 1, 1916. Each act complained of as negligence serves in the pleading as a basis for a separate cause of action, and the right to recover on either cause of action...

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