Kunz v. Little Co. of Mary Hosp.
| Decision Date | 04 May 2007 |
| Docket Number | No. 1-06-1814.,No. 1-06-1707.,1-06-1707.,1-06-1814. |
| Citation | 869 N.E.2d 328 |
| Parties | Betty KUNZ, Plaintiff-Appellant, Separate-Appellee, v. LITTLE COMPANY OF MARY HOSPITAL AND HEALTH CARE CENTERS, Defendant-Appellee, Separate-Appellant (Manor Care Health Services, Inc., Jue-Lin Tang and Metro Infectious Disease Consultants, L.L.C., Defendants). |
| Court | United States Appellate Court of Illinois |
In this medical malpractice case, plaintiff Betty Kunz appeals the judgment on the jury's verdict in her favor of $3,200,000 arguing that the circuit court erred by failing to admit her expert's testimony regarding damages and failing to give the jury her proffered jury instructions regarding damages; defendant Little Company of Mary Hospital and Health Care Centers (LCMH) cross-appeals, arguing that the circuit erred by failing to grant its motion for judgment n.o.v. and that it is entitled to a new trial. These appeals have been consolidated. We affirm in part, reverse in part and remand for further proceedings regarding past and future medical expenses only.
On June 7, 2000, plaintiff, age 75 at the time, was admitted to LCMH for possible further right knee surgery and evaluation of an infection. Plaintiff's infection had developed following total right knee replacement surgery two weeks before. Plaintiff had developed a methicillin-resistant staff aureus (MRSA) infection (a type of staph infection that is resistant to most antibiotics) in her right knee. An infectious disease specialist, Dr. David Beezhold, initially prescribed three antibiotics to treat plaintiff: vancomycin, rifampin, and gentamicin. The gentamicin was to be a short-course treatment because of the drug's potentially harmful effects on the kidneys. Dr. Beezhold ordered a creatinine test which showed that plaintiff's kidneys were functioning within normal limits. Dr. Beezhold's plan for gentamicin was to be discontinued prior to plaintiff's discharge from LCMH. His orders read, "Okay for discharge on IV vancomycin/P.O. [orally] rifampin from infectious disease standpoint."
Plaintiff was discharged on June 10, 2000, at about 9 p.m. to Manor Care nursing home accompanied by a LCMH patient transfer form, a history, a physical exam report, and some lab reports of plaintiff. Contrary to Dr. Beezhold's plan, the transfer form listed "gentamicin 120 milligrams, IV piggyback every 12 hours, next dose, 9:00 p.m. today, 6/10." The transfer form also identified Dr. Beezhold as plaintiff's infectious disease physician, included his phone number, and in accordance with Dr. Russell Petrak's telephone discharge order, requested that Manor Care call Dr. Beezhold on June 12 to set up an appointment.
LCMH nurse Halina Ciezkowski testified that she drafted the portion of plaintiff's transfer form that listed the various medications including the gentamicin. She spoke with Dr. Petrak on the telephone on June 10, 2000, to obtain discharge orders for plaintiff. Doctor Petrak was Dr. Beezhold's infectious disease partner and was contacted because Dr. Beezhold was on vacation. Although nurse Ciezkowski could not remember the particular conversation with Dr. Petrak, she testified that the custom and practice would have been for Dr. Petrak to ask her for the information contained in the patient's chart. She would convey the information contained in the chart to Dr. Petrak. She then would have written the order exactly as Dr. Petrak gave it to her and would have read it back to him for verification. Nurse Ciezkowski knew that Manor Care would have been guided by the transfer form.
Cheryl Vajdik, R.N., plaintiff's nursing expert, and nurse Noreen Buchthal, Manor Care's director of nursing, testified that they would expect a reasonably well-qualified nurse to know that gentamicin is a nephrotoxic drug, that is, it can be damaging to the kidneys. Nurse Vajdik testified that nurse Ciezkowski deviated from the standard of care by listing gentamicin on plaintiff's patient transfer form because Dr. Beezhold's plan did not call for it. She further stated that if nurse Ciezkowski told Dr. Petrak that Dr. Beezhold's plan called for plaintiff to be placed on gentamicin, that was also a deviation from the standard of care. Nurse Buchthal testified that the transfer form provides a "continuity of care" between the hospital and the nursing home. She has never seen a medication listed on a transfer form that had previously been discontinued at the hospital before transfer.
Manor Care nursing home nurse Donna Van Gampler testified that she relied on the medications listed on the transfer form to prepare her own physician order form for medications to be given to plaintiff. Based on the transfer form, she believed plaintiff was to receive gentamicin without any discontinuation.
Dr. Russell Petrak testified that, contrary to Dr. Beezhold's plan, the transfer order stated that plaintiff was to be discharged to Manor Care on IV vancomycin and gentamicin. Dr. Petrak testified that he could not specifically recall the conversation he had with nurse Ciezkowski on the telephone on June 10, 2000, regarding plaintiff but that it was his custom and practice to have the nurse convey to him over the telephone the plan put into the chart by his partner. He relied on nurses to provide him with accurate information from the chart. Dr. Petrak wanted to follow Dr. Beezhold's plan because Dr. Beezhold was familiar with plaintiff's course of treatment and condition. However, the discharge order calling for continued treatment with gentamicin did not match Dr. Beezhold's plan, which called for a discontinuation of gentamicin. Dr. Petrak testified that he would only have ordered gentamicin for plaintiff if he had been told over the phone that gentamicin was a part of Dr. Beezhold's plan. He stated that he must have been "misinformed."
Dr. Petrak testified that Manor Care nursing home was dependent on getting accurate information from LCMH as to what care plaintiff should get after she was transferred. Based on the way transfer forms are used, Dr. Petrak testified that he would expect the Manor Care staff to continue to give plaintiff gentamicin based on the transfer form prepared by nurse Ciezkowski.
Dr. Jue-Lin Tang, the attending physician at Manor Care nursing home, testified that he received his first call regarding plaintiff on the night she was transferred on June 10, 2000, at about 11 p.m. Dr. Tang testified that the transfer form's purpose is "to give the doctor in the nursing home a guidance how to continue treating the patients" but it does not, itself, authorize treatment. The transfer form provided the only information on how to treat plaintiff. Dr. Tang testified that it was up to him to determine whether the medications listed on the transfer form were reasonable and should be continued while the patient was at Manor Care. Because the medications listed on plaintiff's transfer form were initially prescribed at the hospital she was transferred from and appeared reasonable, he prescribed the same medication to her, including gentamicin, on June 11, 2000. Dr. Tang interpreted the transfer form as calling for continued treatment with gentamicin and he relied on the transfer form and prescribed IV gentamicin to plaintiff when she arrived. Plaintiff continued to receive gentamicin until the afternoon of June 14, 2000. Dr. Tang did not order blood tests to check plaintiff's kidneys for two days, did not see plaintiff for three days, and did not contact Dr. Beezhold or Dr. Petrak for three days. Manor Care nursing home did not typically order daily blood tests to check kidney function unless the patient had some known prior history of kidney problems.
Dr. Tang testified that on the morning of June 13, 2000, he was told that plaintiff was having trouble urinating. Dr. Tang examined plaintiff but did not stop the gentamicin because he was concerned about plaintiff's infection; he ordered a creatinine test. Plaintiff continued to receive gentamicin that day and the next day even though plaintiff continued to have trouble urinating and her bladder was distended. On June 14, 2000, plaintiff's creatinine test came back abnormally high. Dr. Tang gave an order for another creatinine test but did not stop the gentamicin. The following day showed an even higher creatinine level and Dr. Tang then ordered the gentamicin stopped. That day, June 15, 2000, Dr. Tang diagnosed plaintiff with acute renal failure (a sudden decrease in kidney function). Although plaintiff reported having trouble urinating, Dr. Tang did not stop the gentamicin earlier because he was concerned about plaintiff's MRSA infection, the diagnosis contained on the transfer form, and the possibility that the MRSA infection may cause plaintiff to lose a limb or her life. He relied on the fact that, according to the transfer form, plaintiff had been prescribed gentamicin and had been discharged from LCMH while still being administered gentamicin. Dr. Tang believed that LCMH transferred a stable patient to his care and that a plan had been put in place which included gentamicin.
Plaintiff's kidney expert, Dr. Vincent Peteras, testified that as a result of this prolonged treatment of gentamicin, plaintiff suffered permanent kidney failure and would require dialysis for the rest of her life.
Dr. Keith Armitage, an expert in internal medicine and infectious diseases, testified that if nurse Ciezkowski failed to accurately communicate Dr. Beezhold's plan to Dr. Petrak, she fell below the standard of care for nurse-physician communications....
To continue reading
Request your trial
-
Greenhill v. Reit Mgmt. & Research, LLC
...causes of the injury. Nelson , 31 Ill. 2d at 88, 199 N.E.2d 769. See also Kunz v. Little Company of Mary Hospital & Health Care Centers , 373 Ill. App. 3d 615, 622, 311 Ill.Dec. 654, 869 N.E.2d 328 (2007) (noting that a defendant may be held liable if its conduct contributed in whole or in ......
-
Olson v. Williams All Seasons Co.
...to exclude all other possible inferences or support only one logical conclusion. Kunz v. Little Company of Mary Hospital & Health Care Centers, 373 Ill.App.3d 615, 620, 311 Ill.Dec. 654, 869 N.E.2d 328 (2007). The inquiry here then is whether Olson presented sufficient circumstantial eviden......
-
Ittersagen v. Advocate Health & Hosps. Corp.
...unreasonable, or when no reasonable person would adopt the trial court's view. Kunz v. Little Co. of Mary Hospital & Health Care Centers , 373 Ill. App. 3d 615, 624, 311 Ill.Dec. 654, 869 N.E.2d 328 (2007). In determining whether there has been an abuse of discretion, the appellate court do......
- Regency Commercial Associates, LLC v. Lopax