Karpinski v. State, 47784

• Decision Date: 20 July 1970
• Docket Number: No. 47784,47784
• Citation: 35 A.D.2d 84,312 N.Y.S.2d 929
• Parties: Tadeusz KARPINSKI, Individually and as Administrator of the Estate of Elvira Karpinski, Deceased, Respondent, v. STATE of New York, Appellant. Claim
• Court: New York Supreme Court — Appellate Division

Page 929

312 N.Y.S.2d 929

35 A.D.2d 84

Tadeusz KARPINSKI, Individually and as Administrator of the Estate of Elvira Karpinski, Deceased, Respondent, v. STATE of New York, Appellant.

Claim No. 47784.

Supreme Court, Appellate Division, Third Department.

July 20, 1970.

Furey, Mooney & Hengeveld, Mineola (James M. Furey, Mineola, of counsel) for respondent.

Louis J. Lefkowitz, Atty. Gen. (Ruth Kessler Toch and Peter J. Dooley, Jr., Albany, of counsel) for appellant.

Before HERLIHY, P.J., and REYNOLDS, GREENBLOTT, COOKE and SWEENEY, JJ.

HERLIHY, Presiding Justice.

This is an appeal by the State from a judgment of the Court of Claims awarding the respondent-administrator the sum of $10,000 for the pain and suffering of his decedent wife; the sum of $20,000 for wrongful death; and the sum of $1,881 for funeral expenses.

The decedent had been a known diabetic since age 21 and was about 36 years of age when she died in 1965. The decedent had apparently been able to control her condition on a self management program of insulin and diet with monthly medical check-ups. She had been employed prior to her marriage in 1953 and after her marriage the diabetic condition in no way disabled her from performing all of the chores and work of a housewife. In March of 1964 she was hospitalized for a short time and treated for mental illness and following her discharge from the hospital she resumed her normal functions. In February of 1965 she was hallucinating and was admitted to Jacobi Hospital with a diagnosis of chronic paranoid schizophrenia. After four days at Jacobi Hospital she was transferred on February 19, 1965 to Bronx State Hospital for treatment of her mental condition. The Bronx State Hospital staff knew that the decedent was a diabetic and upon admission the doctor ordered a special low carbohydrate diet; regular insulin doses; urine tests for sugar four times daily; a blood sugar test; and various other tests. The admitting doctor testified that it was intended that the blood sugar test be done on February 23, 1965.

The claimant contended that the hospital staff so negligently mismanaged the decedent's diabetic condition that she was thereby caused to suffer insulin shock and that the staff did not take appropriate steps to reverse the shock with the result that death occurred on March 12, 1965. The cause of death was listed as lobar pneumonia due to diabetes mellitus.

The initial issue for the trial court and raised on this appeal is the question of negligence in causation of the insulin shock and this issue was resolved on the facts in favor of claimant by the trial court.

With reference to the disease of diabetes, the claimant's medical expert stated: 'A diabetic is incapable of metabolizing carbohydrates in terms of those--of their insulin production by their pancreas. So, we give measured quantities of insulin to diabetics to metabolize the food they're taking, specifically carbohydrates.'

The record establishes that when a patient is receiving insulin he is quite apt to go into shock if the amount of blood sugar drops below a certain level. Aside from clinical signs which indicate that the patient is going into shock, the only way to ascertain the amount of sugar in the blood is by a blood test. Since the amount of insulin necessary to control the diabetic condition is dependent upon the amount of blood sugar, it is obvious that such tests are necessary from time to time to regulate the insulin dosage. The record also establishes that the minimum amount of insulin required can be checked by routine urine tests which will indicate that there is too little insulin in the body. The diabetic condition was apparently satisfactory on the first two days at Bronx State, but on February 21 she required extra insulin which was administered to her. On the morning of February 22 the decedent received her regular dosage of insulin, but refused to eat her breakfast.

The attendant on duty in the decedent's ward testified that when she came on duty at 8:00 A.M. on February 22 she was told that the decedent had refused to eat breakfast and that in accordance with her training she 'gave her some orange juice. And now she did take fluids.' The record establishes that when a diabetic ingests less food and/or carbohydrates than his ordinary diet provides, he is apt to have a deficiency of blood sugar which means an overabundance of insulin and a probability of shock. It is further established that proper care when a patient refuses to eat is to feed the patient orange juice with sugar in it and milk and if the patient will not take such foods, then to force feed glucose intravenously. The record does not disclose how much fluids the decedent consumed on the morning of February 22, or if the fluids had sugar added to them.

The admitting physician testified that the attendants had been instructed to feed diabetic patients orange juice with sugar and milk every hour when the patients refused to eat. She further testified that had she been present when the decedent refused her breakfast she would have been concerned about the possibility of too little sugar in her blood. She stated that a blood test was not required just because the patient did not eat, but that if physical signs or symptoms of an overdose of insulin appear, then a test should be made. The record establishes that no doctor examined the patient for such symptoms on the morning of the 22nd and that in fact, no doctor attended the decedent until after the patient refused her lunch and was fully suffering insulin shock. The ward attendant testified that the decedent 'was unable to talk' and 'wasn't able to talk too well, but she was talking' at 8:00 A.M. on the 22nd. The record indicates that the decedent's mental disorder did not in any way affect her ability to speak.

From the foregoing, it is apparent that the record contains evidence that the hospital personnel knew that the decedent's failure to eat breakfast could precipitate shock and the decedent was exhibiting an unusual symptom as to her speech which...