Greene v. Memorial Hosp. of Burlington County

• Decision Date: 01 April 1997
• Citation: Greene v. Memorial Hosp. of Burlington County, 691 A.2d 369, 299 N.J.Super. 372 (N.J. Super. App. Div. 1997)
• Parties: Geraldine GREENE, Individually and as Administratrix of the Estate of Willyonna Greene, deceased, Plaintiff-Appellant, v. MEMORIAL HOSPITAL OF BURLINGTON COUNTY, a New Jersey Hospital Corporation, Donna Blickle, R.N., Julie Fenimore, R.N. and Barbara Deasy, R.N., being nurses employed by Memorial Hospital in the Emergency Department, Jane Doe, also being a nurse employed by Memorial Hospital in the Emergency Department, Defendants, South Jersey Emergency Physicians P.A., a Professional Association, and Dr. Patti Brown, individually and as an employee of South Jersey Emergency Physicians, P.A., jointly, severally and in the alternative, Defendants-Respondents.
• Court: New Jersey Superior Court — Appellate Division

Page 372

299 N.J.Super. 372

691 A.2d 369

Geraldine GREENE, Individually and as Administratrix of the Estate of Willyonna Greene, deceased, Plaintiff-Appellant, v.MEMORIAL HOSPITAL OF BURLINGTON COUNTY, a New Jersey Hospital Corporation, Donna Blickle, R.N., Julie Fenimore R.N. and Barbara Deasy, R.N., being nurses employed by Memorial Hospital in the Emergency Department, Jane Doe also being a nurse employed by Memorial Hospital in the Emergency Department, DefendantsSouth Jersey Emergency Physicians P.A., a Professional Association, and Dr. Patti Brown, individually and as an employee of South Jersey Emergency Physicians, P.A jointly, severally and in the alternative, Defendants-Respondents.

Superior Court of New Jersey, Appellate Division.

Argued Feb. 20, 1997.

Decided April 1, 1997.

Jeffry A. Mintz, Mount Holly, for appellant.

Timothy P. O'Brien, Pleasantville, for respondents(Paarz, Master, Koernig, Crammer, O'Brien & Bishop, attorneys; Mary Ann C. O'Brien, on the brief).

Before Judges SHEBELL, BAIME and P.G. LEVY.

The opinion of the court was delivered by

BAIME, J.A.D.

PlaintiffGeraldine Greene, individually and as administratrix of the estate of her deceased daughter Willyonna Greene, appeals from a judgment entered at the conclusion of her case dismissing her claims for medical malpractice and negligent infliction of emotional distress against defendantsDr. Patti Brown and South Jersey Emergency Physicians, P.A.Although numerous issues are presented, the principal question is whether a parent who witnesses acts of medical malpractice in the treatment of her child may maintain a claim for negligent infliction of emotional distress where she cannot prove that the doctor's negligence proximately caused the child's death or serious injury.We hold that she may not and affirm the Law Division's judgment.

I.

Plaintiff brought this action against Memorial Hospital of Burlington County, three registered nurses employed in the hospital's emergency department, South Jersey Emergency Physicians--a professional association that had contracted with the hospital to perform emergency room services, and Dr. Patti Brown--a member of the association.Plaintiff settled with the hospital and its employee nurses, and the trial proceeded with the remaining defendants.

On February 4, 1991, ten year old Willyonna returned home from school complaining of chest pains and tiredness.After giving Willyonna a light supper, plaintiff assisted the child to her bedroom where she immediately fell asleep.Plaintiff noticed that Willyonna's breathing was shallow and appeared abnormal.Concerned by Willyonna's listlessness, plaintiff decided to take the child to the hospital.

Upon arriving at the emergency department at 10:23 p.m., plaintiff told the clerk at the desk that Willyonna was experiencing chest pain and had difficulty breathing.Four minutes later, at 10:27 p.m., the triage nurse, Donna Blickle, took Willyonna's vital signs, including her temperature, blood pressure, pulse and respiratory rates.Willyonna had a pulse rate of 101 and a respiratory rate of forty, which Blickle recorded on Willyonna's chart.Willyonna told Blickle that she started experiencing chest pain while walking home from school earlier that day and that the pain increased when she coughed or took a deep breath.Blickle noticed that Willyonna had a cough and was taking shallow breaths, but nevertheless told plaintiff and the child to sit in the waiting area.

Julie Fenimore, whose shift began at 11:15 p.m., was assigned the duties of both triage and charge nurse in the emergency department.Upon her arrival, Fenimore received a report from Blickle, who had completed her shift, respecting the status of the patients who were in the emergency department.Fenimore was informed by Blickle that Willyonna had chest pain and difficulty breathing.Fenimore reviewed Willyonna's chart and concluded that she was not in acute distress.The emergency department was very busy that night and Fenimore gave priority to the patients who appeared in need of immediate treatment.

Fenimore's first contact with Willyonna occurred at 12:15 a.m., when she took Willyonna's chart from the rack and called her name.Plaintiff and Willyonna entered the triage booth and Fenimore took Willyonna's vital signs.At this point, Willyonna's pulse had increased to 170 and her respiratory rate was eighty.Fenimore, who recorded this information on Willyonna's chart, realized that these rates were higher than they had been when Willyonna first entered the emergency department.Fenimore noted that Willyonna was taking shallow, rapid breaths.However, when Fenimore told Willyonna to relax and count her breaths in order to slow her breathing, Willyonna was able to do so.Thus, Fenimore felt that Willyonna was hyperventilating due to anxiety and was not in acute distress.Fenimore also noted that Willyonna's skin was warm and dry, and that she was oriented.Willyonna told Fenimore that she had pain on inspiration and felt "bad."

At this point, Fenimore escorted plaintiff and Willyonna to an examining room in the rear of the emergency department.Willyonna was weighed and instructed to undress and change into a hospital gown.Fenimore then listened to Willyonna's lungs with a stethoscope and found that they were clear "bilaterally in all fields."

At approximately 12:30 or 12:35 a.m., Fenimore informed Brown that Willyonna had a rapid respiratory rate and that her vital signs had changed.Although Fenimore initially testified that she showed Willyonna's chart to Brown, she later claimed that she could not recall whether she had done so.In any event, Fenimore told Brown that she thought Willyonna was hyperventilating and asked Brown for authorization to give Willyonna a paper bag in which to breathe in order to alleviate this condition.Brown authorized this procedure without examining the child.

Fenimore returned to Willyonna and gave her a brown paper bag.After demonstrating how to use the bag, Fenimore instructed plaintiff that Willyonna was to breathe into the container until she felt calmer and her respiratory rate had decreased.She also told plaintiff that she had "informed" Brown of the child's condition and that the physician would examine her as soon as possible.Fenimore instructed plaintiff to summon one of the nurses if there was any change in Willyonna's condition.

After Fenimore left the examining room, Willyonna breathed through the paper bag for a time but then stopped, complaining that she was tired.While they were waiting in the examining room, Willyonna dozed sporadically.Plaintiff noticed that Willyonna continued to breathe in an abnormal manner.Plaintiff peered from the room and observed Brown, whom she recognized from a prior visit to the emergency department.Specifically, she saw Brown take a chart from the board, sit at a desk and begin eating.

At approximately 1:00 A.M., plaintiff turned to Willyonna and observed her suffer a seizure.At trial plaintiff testified that she immediately suspected that her daughter's condition had deteriorated because of Brown's inattention.She screamed for help.Brown, Fenimore, and other emergency personnel arrived on the scene.Oxygen was immediately applied since Willyonna was having respiratory difficulty and copious amounts of frothing sputum were pouring from her mouth and nose.Plaintiff was ushered from the room and sat on a nearby chair while emergency personnel attended Willyonna.Plaintiff then heard them call "respiratory stat code blue" and recognized that Willyonna was in distress.At that point, Brown exited the room and told plaintiff that Willyonna had a "little seizure" and that they were going to move her.Brown accompanied Willyonna as she was moved to another room.Plaintiff went to the family room and remained there while Willyonna was treated.

Willyonna was not breathing and had no pulse.The child was intubated, placed on an IV and cardiac monitor, given various medication, CPR and heart massage, but she never resumed spontaneous breathing and did not regain a pulse.Willyonna was pronounced dead at 1:55 a.m.

Brown approached plaintiff, who was seated in the family room, and informed her that Willyonna had expired.Plaintiff, who related Willyonna's death to the lack of treatment, was near hysteria.She viewed the body later that night.

A subsequent autopsy disclosed that the cause of death was acute pulmonary edema and congestion due to acute viral myocarditis.Acute myocarditis is an inflammation of the heart that has a sudden onset.When the heart muscle becomes inflamed, it cannot pump efficiently and fluid backs up in all of the body's organs causing congestion and poor performance.Pulmonary edema is fluid in the lung spaces which prevents adequate oxygen transfusing from the bronchial tree into the blood stream.

Dr. Bruce Phillips, a physician board certified in emergency medicine, testified on behalf of the plaintiff.Phillips concluded that the triage nurses were negligent in failing to direct Willyonna to a physician for immediate examination.The witness noted that a patient complaining of chest pains and experiencing breathing difficulties and elevated pulse should be evaluated immediately by a physician.Phillips testified that Fenimore was particularly at fault because she took no action even after she knew that Willyonna's vital signs had significantly deteriorated.

Phillips further concluded that Brown deviated from accepted standards by failing to examine Willyonna after being apprised that the patient's vital signs had changed and that her respiratory rate had increased.According to the witness, Willyonna should have been placed on a heart monitor and oxygen administered.Phillips further found fault in Brown's authorization to use the bag to alleviate the child's rapid breathing, noting that the procedure employed deprived the patient of oxygen.

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