Carlyle v. Tuomey Hosp.
| Decision Date | 19 March 1991 |
| Docket Number | No. 23437,23437 |
| Citation | 407 S.E.2d 630,305 S.C. 187 |
| Court | South Carolina Supreme Court |
| Parties | Joan CARLYLE, as Administratrix of the Estate of Mark Carlyle, Deceased, Respondent, v. The TUOMEY HOSPITAL, Petitioner. . Heard |
Charles E. Carpenter, Jr., and Deborah L. Harrison, both of Richardson, Plowden, Grier & Howser, Columbia, and M.M. Weinberg, Jr., of Weinberg, Brown & McDougall, Sumter, for petitioner.
J. Edward Bell, III, of Bell & Bagley, Sumter, for respondent.
Respondent Joan Carlyle, administratrix of the estate of Mark Carlyle, deceased, instituted this action under the wrongful death and survivorship statutes. The jury awarded respondent $100,000 for each cause of action. The Court of Appeals affirmed, Memo.Op. No. 90-MO-067 (Ct.App. Filed April 16, 1990). Petitioner Tuomey Hospital moved for Stay of Remittitur and Rehearing, and the Motion was denied on June 20, 1990. The case is before this Court on a writ of certiorari from the Court of Appeals. We affirm in part, reverse in part and remand.
Respondent filed suit seeking recovery for damages caused by petitioner's alleged negligence which resulted in the death of respondent's decedent. Subsequently, the case was removed from the active trial roster pursuant to SCRCP 40(c)(3). The case was later restored by order of the circuit court over petitioner's objection. Petitioner appealed and moved for a remand.
This Court dismissed the appeal upon remanding the case in a scheduling order, the pertinent portion of which provided as follows:
. . . . .
2. Within thirty days after the case is restored to the roster, each party shall declare the names of expected lay and expert witnesses.
3. Within ninety days thereafter, each party shall complete discovery of the witnesses named.
. . . . .
The case was restored to the active roster on July 17, 1987, and in due course proceeded to trial.
The trial record reflects that Mark Carlyle was admitted to Tuomey Hospital on September 20, 1983, for treatment of extensive decubitus, commonly called bedsores. The decubitus was a complication of spastic quadriparesis, an incurable, progressive paralytic disease which gradually paralyzes the body from the feet up. At the time of his admission, Mark was paralyzed from the waist down and incontinent. On September 24, 1983, during the 3:00 P.M. to 11:00 P.M. nursing shift, an external device, known as a condom catheter, had been affixed to Mark's penis. On September 25, 1983, a nursing supervisor noticed that Mark's penis exhibited discoloration and blistering with swelling. The strap used to secure the catheter had been wrapped around Mark's penis twice. The strap of a correctly placed condom catheter wraps around the penis once.
On September 27, 1983, Dr. Jerry Jackson, a urologist, examined Mark and recommended that he be transferred to Norfolk General Hospital for reconstructive penile surgery. Dr. Jackson testified that half of Mark's penis was black and ischemic and that an indentation circled its base at the origin of discoloration. Dr. Jackson's opinion was that the injury was a recent one. He was not aware of the events which had transpired during the thirty-six hour period preceding his examination.
On October 6, 1983, Mark was transferred to Norfolk. Dr. David A. Gilbert, the plastic surgeon who performed the surgery, testified that Mark's penis was ulcerated and necrotic. Reconstruction consisted of debridement, or removal of dead subcutaneous tissue in two separate procedures; a cadaver graft over the penis shaft in a third procedure; and a skin graft from Mark's thigh to the penis in a fourth procedure.
It was Dr. Gilbert's opinion that the condition resulted from the catheter being secured too tightly or being left on too long without being changed. He testified that Mark's penis would have become necrotic after six to ten hours if the catheter had been secured too tightly. Dr. Gilbert testified that Mark's penis was disfigured, probably irreparably damaged, and that confusion, anxiety, distress and fear of losing his penis had a traumatic psychological effect on Mark.
According to Dr. Gilbert, 60 to 70 percent of Mark's care at Norfolk was devoted to the condition involving his penis, and the remaining 30 to 40 percent was related to treatment of the pre-existing decubitus. He testified further that part of the reconstructive treatment could have been performed on an outpatient basis if decubitus had not required hospitalization.
Norfolk returned Mark to Tuomey on December 10, 1983, and he was discharged in January, 1984. He was cared for at home by a home health care employee, his mother and sister. Mark was hospitalized for a brief period in February, 1984, readmitted in April, 1984, and died on September 11, 1984. The hospital discharge summary lists the cause of death as septicemia with urinary tract infections, multiple decubiti, and pneumonia as contributing factors.
Dr. Phillip Brandt, Mark's internist, testified that pneumonia was the immediate cause of death. Quadriparesis had advanced to Mark's chest area, and he was unable to clear his lungs by coughing. Mark's parents refused to allow a tracheotomy. According to Dr. Brandt, Mark would eventually have succumbed to quadriparesis, but a tracheotomy would have prolonged his life. He testified further that infections at any site in the body could contribute to deterioration and ultimately to the cause of death. Dr. Brandt gave his opinion that any infection of the urinary tract caused by the suprapubic tube in place during penile reconstruction did not contribute to Mark's pneumonia.
Dr. Joseph E. Davis, respondent's expert witness, responded to a hypothetical question based upon records and excerpts from depositions supplied by the respondent. Dr. Davis testified, based upon reasonable medical certainty (1) that the injury to Mark's penis was caused by the condom catheter being incorrectly placed; (2) that the damage to the penis would have occurred after the catheter had been in place between ten and twenty-four hours; (3) that a suprapubic tube could cause septicemia and lead to pneumonia because infection caused by the tube could weaken the body and allow other infections to occur in the respiratory tract and lungs; and (4) that the suprapubic tube and septicemia were significant contributing factors to Mark's death. Dr. Davis also testified that when there are...
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