Steeves v. United States

• Decision Date: 15 November 1968
• Docket Number: 67-6.,Civ. A. No. 67-256
• Citation: 294 F. Supp. 446
• Court: U.S. District Court — District of South Carolina
• Parties: Robert Frank STEEVES, a Minor by his Guardian ad Litem, Ruth A. Steeves, Plaintiff, v. UNITED STATES of America, Defendant.

294 F. Supp. 446

Robert Frank STEEVES, a Minor by his Guardian ad Litem, Ruth A. Steeves, Plaintiff, v. UNITED STATES of America, Defendant.

Civ. A. Nos. 67-256, 67-6.

United States District Court D. South Carolina, Charleston Division.

October 31, 1968.

As Amended November 15, 1968.

COPYRIGHT MATERIAL OMITTED

Ellis I. Kahn, Charleston, S. C., for plaintiff.

Klyde Robinson, U. S. Atty. for the District of South Carolina, Columbia, S. C., and Thomas P. Simpson, Asst. U. S. Atty., Charleston, S. C., for defendant.

ORDER

HEMPHILL, District Judge.

Action under the Federal Torts Claims Act, 28 U.S.C. § 1346(b) is brought for damages alleged to have resulted from the negligence of defendant.

Complaint alleges that plaintiff is a dependent of a member of the Armed Forces of the United States and is/was entitled to medical treatment at the medical facilities of the United States. The essence of the remainder of complaint is that defendant's servants and agents were negligent in diagnosis and treatment of appendicitis. As a result of this negligence plaintiff's appendix ruptured causing toxic matter to be diffused about the intestines of plaintiff resulting in the forming of adhesions and permanent damage. Plaintiff, it is alleged, was further damaged because of shock to his nerves and mental anguish, resulting from further operative procedures causing susceptibility to other illnesses. It is also alleged that he is unable to perform his usual duties and his abilities to work, play and enjoy life have been imperiled. A companion complaint was filed by parents of plaintiff, Robert Frank Steeves.¹ This complaint re-alleges the causative features of Robert Frank Steeves' complaint and further alleges that they have in the past supported plaintiff and will continue to do so in the future; but, as a result of the alleged negligence of defendant, Robert Frank Steeves, can no longer render or perform work and services for plaintiffs and they have also been deprived of his comfort, companionship and happiness. It is also asserted that they will be required to spend future monies for tutoring, medical and surgical attendants, as well as other expenses. Also plaintiff, Ruth A. Steeves, was initially forced to retire from her job to care for her child. Defendant, United States Government, entered as a defense, a general denial of all allegations of both complaints except the first, second and third paragraphs.

This matter was heard by the court without a jury on March 11th and 12th, 1968. Pursuant to Rule 52(a) of Federal Rules of Civil Procedure, this court finds and separately states its findings of fact and conclusions of law.

FINDINGS OF FACT

1. On July 20, 1966, eleven year old Robert F. Steeves, an Air Force dependent entitled to medical care at Government hospitals, began complaining of pain in his abdomen at approximately 6:30 p. m. He laid down for a while and later began vomiting. At approximately 11:00 p. m. his mother called the Air Force Dispensary, which is a hospital without facilities for major surgery, and was told to watch him for fever and bring him in the next day. On the 21st day of July he continued to complain of severe pain and cramps in his right side and stomach and his mother took him to the Dispensary at approximately 3:00 p. m. where he was examined by Dr. David C. Mullins. Doctor Mullins observed that the child's temperature was 98.6°. His abdomen was soft with generalized tenderness and with more intense point tenderness in the right lower quadrant. There was rebound tenderness in the right lower quadrant and in the right upper quadrant, but the pain in the right upper quadrant was not "referred." Bowel sounds were active. Rectal examination showed tenderness on the left side. Doctor Mullins ordered lab tests which included the following findings:

Blood Tests: White blood count: 13,200. Differential count: Neutrophiles, 89; Bands, 4; Lymphocytes, 7; Hematocrit 40%; Hemoglobin 13.4.

2. Doctor Mullins told the child's mother that the blood test showed a high white count indicating a possibility of appendicitis. He then wrote out a consultation sheet, SF513, and told Mrs. Steeves to take him to the Emergency Room at the U. S. Naval Hospital. Doctor Mullins then had a call placed to the Naval Hospital to inform them that he was sending over a case of possible acute appendicitis. The consultation sheet read as follows:

This is an 11 year old white male with two day history of nausea and vomiting without diarrhea, but with a temperature of 102° last week, then did well, except for general letheragy until yesterday when he began vomiting (times ten) and ran a high subjective temperature. Examination: Abdomen right lower quadrant tenderness with point tenderness and rebound. Bowel sounds, active. Rectal— left side tenderness. White blood count was 13,200 with 89 Polys and 7 lymphs. Urinalysis—within normal limits except moderate amount of occult blood.

3. Additionally, he indicated his provisional diagnosis as "possible appendicitis," checked it as an "emergency" and then for screening purposes addressed the consultation to "EOR—General Surgery." His reason for the latter was:

So that when the corpsman who screens the patients sees that it has got general surgery there, well, he won't have an internal medicine specialist or a pediatrician in this case look at the child, but rather will call a surgeon.

4. They arrived at the Emergency Room at approximately 4:30 p. m. and were seen by Dr. William S. McAfee. He read the referral sheet from the Air Force Dispensary and asked the child where he felt pain. Bobby told him in his side and stomach and pointed. Doctor McAfee ran no lab tests nor did he order x-rays.

His observations on the SF513 were as follows:

Temperature was 101.2° orally, abdomen, tender, right slight, decreasing on the left. No rebound. Rectal, not increasing tenderness left or right. Chest clear. 1. clear fluids only. 2. record temperature every four hours; 3. return if temperature increases to 103° or pain worsens. 4. check in A.M. unless all is well. (He was discharged from the Emergency Room at 5:02 p. m.)

The emergency treatment report at the Naval Hospital, hospital form 6HD, was as follows:

The chief complaint was possible acute appendicitis, see Standard Form 513. Physical findings: Temperature 101.2°. Abdomen tender with hyperbowel sounds. Point tenderness on the right. No rebound, rigidity, little guarding. Rectal negative for specific tenderness. Impression: Not a surgical abdomen. * * *

5. The evidence is in conflict on the issue of whether or not consultation was asked for by Mrs. Steeves. The court finds that consultation was sought but refused. Further, Dr. McAfee failed to record a history to substantiate his difference of opinion with Doctor Mullins, did not think it appropriate to consult a surgeon who was on call, nor did he consult with Doctor Mullins by telephone, although these procedures could have been easily accomplished.

6. Upon returning home, Mrs. Steeves called the Air Force Dispensary and was told not to give Bobby any medication because it might cloud the picture. She was instructed to record his temperature and pains and take him back to the Naval Hospital if the pain became worse or the temperature went over 103°. Bobby stayed in bed all evening and dozed off and on. His temperature would reach 103°, break, and would be followed by chills. He complained of abdominal pain, but not any worse than he previously had.

At approximately 1:00 a. m. on the morning of July 22, Bobby started crying and rolling around. He requested that he be taken back to the doctor. His legs had pulled up into a knot because of the pain and he could not straighten them out. Everytime Mrs. Steeves would move the child's legs, he screamed. She and her daughter placed him in the car and returned him to the Emergency Room of the Naval Hospital. While they were driving over there, the bumps caused by the automobile going over railroad tracks caused additional pain. At approximately 2:30 a. m. on July 22nd, after waiting for awhile, the child was seen by Dr. E. J. Voltolina,² an intern. Doctor Voltolina came in, asked Bobby how he felt and where he hurt. Bobby had to be helped onto the examining table. Doctor Voltolina pressed on his abdomen a few times and told the child that he had gastroenteritis, and it was nothing to worry about because it was common and not dangerous. Mrs. Steeves gave a history and told how the child had acted at approximately 1.00 a. m. and again asked if the "night surgeon" could see the child. This request was refused. Mrs. Steeves said that she could not take the child home in that condition and in that much pain. Doctor Voltolina then gave Bobby a shot. Mrs. Steeves told him of the instructions she had received from the Air Force Dispensary about medication "clouding the picture." Doctor Voltolina said this would not change anything and he administered to the child .3 mgs of atropine sulphate. He ordered no lab tests or x-rays despite the fact that over eleven hours had passed since the tests were made at the Air Force Dispensary.

7. The Emergency Room treatment report for this visit shows:

Chief complaint, 101°, nausea. Was in previously today for possible appendicitis. Physical findings, temperature 99.2°. Patient's temperature decreased consistently since yesterday. Abdomen negative in all respects except slight generalized tenderness. Rectal negative. Impression: Gastroenteritis; Atropine sulphate, .3mgs IM. Sent to Dispensary for follow up on GI disorder. Left at 0300 hours.

8. Bobby was completely asleep by the time he reached home due to the combined effects of the shot and his condition. He did not awaken until approximately 11:00 a. m. Mrs. Steeves took him back to the Air Force Dispensary that afternoon, July 22. At approximately 3:00 p. m. he was seen by Doctor Mullins, the same doctor who had seen him the previous afternoon. The...