Walton v. US, Civ. A. No. 88-0066-F.

• Decision Date: 24 January 1991
• Docket Number: Civ. A. No. 88-0066-F.
• Citation: 770 F. Supp. 731
• Parties: Donna Marie WALTON, Administratrix of the Estate of Curtis Walton, Plaintiff, v. UNITED STATES of America, Defendant.
• Court: U.S. District Court — District of Massachusetts

770 F. Supp. 731

Donna Marie WALTON, Administratrix of the Estate of Curtis Walton, Plaintiff, v. UNITED STATES of America, Defendant.

Civ. A. No. 88-0066-F.

United States District Court, D. Massachusetts.

January 24, 1991.

Marvin K. Rasnick and Greg T. Schubert, Proctor, Rasnick & Goewey, Worcester, Mass., for plaintiff.

Marybeth Carmody, Asst. U.S. Atty., Boston, Mass., for defendant.

OPINION

FREEDMAN, Chief Judge.

I. INTRODUCTION

This is a medical malpractice case brought pursuant to the Federal Tort Claims Act, 28 U.S.C. §§ 1346(b), 2671 et seq., by plaintiff Donna Marie Walton, administratrix of the estate of Curtis Walton, against the United States of America.

Plaintiff alleges that Frank M. Sikora, a dentist at the Veterans Administration Hospital in Northampton, Massachusetts ("Northampton VA"), was negligent in that he administered Xylocaine as a local anesthetic in combination with epinephrine during a dental procedure performed on Curtis Walton. Mr. Walton was in need of extensive dental work and his care was complicated by a long history of hypertension, which is the elevation of systolic and/or diastolic blood pressure. Epinephrine is adrenalin and is used as a vasoconstricting drug to reduce the diameter of blood vessels in the area to which it is administered. Epinephrine can also cause the elevation of a person's blood pressure. Plaintiff alleges that the use of epinephrine in Curtis Walton's case was a departure from good and acceptable medical practice, and was the proximate cause of Curtis Walton's death.

The plaintiff's case was tried to the Court on December 3, 5 and 6, 1990. Having heard the evidence and arguments in the case, the Court makes the following findings of fact and conclusions of law.

II. FINDINGS OF FACT

1. Curtis Walton was born on March 15, 1947 and served in the United States Army from June 16, 1965 until August 8, 1971, when he was honorably discharged due to a medical disability that included hypertension and headaches.

2. On August 10, 1975, Curtis Walton married the plaintiff with whom he had two children, Alfa Omega Walton and Curtis Walton Jr. Curtis Walton was not the biological father of Donald Maurice Garner, who was born to the plaintiff on December 29, 1971.

3. Curtis Walton was also the father of Marquis Walton, born January 25, 1982, whose mother is Cheryl Dozier of Columbus, Georgia.

4. On or about June of 1981, Curtis Walton had a subarachnoid hemorrhage, secondary to a carotid artery aneurism. On July 9, 1981, a craniotomy with microscopic clipping of the aneurism was performed on Curtis Walton at a hospital in Columbus, Georgia. Thereafter, Mr. Walter developed seizure disorder.

5. During the year 1982, Curtis Walton was treated several times for hypertension at the Phenix City Hospital in Alabama.

6. On September 17, 1982, Curtis Walton was first treated at the Veterans Administration Outpatient Clinic in Springfield, Massachusetts for "sky high blood pressure."

7. From 1982 until July 1985, Curtis Walton was treated on a regular basis at the Springfield Outpatient Clinic, where he was closely monitored for hypertension, seizure disorder and headaches. He was treated by Dr. Burton Shayevitz, an internist/cardiologist and Dr. Iosif Tonkonogy, a neurologist.

8. From December 12, 1982 until January 7, 1983, Curtis Walton was admitted to the Northampton VA for treatment of his seizure disorder, hypertension and headaches. During this admission, Mr. Walton was treated by both Drs. Shayevitz and Tonkonogy.

9. During the Northampton VA admission, Curtis Walton was also evaluated by Dr. Frank M. Sikora, the dentist who later administered the anesthetic which plaintiff alleges as the cause of Curtis Walton's death. At the outset of this doctor-patient relationship, Dr. Sikora performed an oral cancer screening and a general dental examination of Curtis Walton and advised him that he had several cavities that needed attention, as well as gingivitis and periodontal disease.

10. During the same admission, Curtis Walton was medically cleared to obtain dental treatment by Dr. Burton Shayevitz. Curtis Walton had several dental procedures performed while an inpatient on December 22, 27, 29 and 30, 1982. During each of these procedures Curtis Walton was injected with a local anesthetic, Xylocaine with 2% epinephrine in 1-100,000 concentration. Curtis Walton did not have any adverse reaction to the local anesthetic used during any of these procedures.

11. During the admission, Curtis Walton also had an electrocardiogram done which indicated that he had left ventricular hypertrophy of the heart, which is evidence of longstanding hypertension.

12. Curtis Walton was again admitted to the Northampton VA on February 15-18, 1983. During that admission, he was treated for hypertension and seizure disorder.

13. From February 23 until March 9, 1984, Curtis Walton was again admitted to the Northampton VA. On March 5, 1984, Mr. Walton had another dental procedure performed by Dr. Green, a dentist at the Northampton VA. Dr. Green filled and treated tooth # 8, which was fractured. Although there is no indication in the medical record whether or what local anesthetic was given to Mr. Walton on this occasion, Dr. Sikora testified that this procedure would not ordinarily be performed without using a local anesthetic. The anesthetic usually administered at the Northampton VA for that procedure was Xylocaine with 2% epinephrine in 1-100,000 concentration. There is no indication in the record that Mr. Walton had any adverse reaction as a result of the procedure performed on March 5, 1984.

14. On March 6, 1984, plaintiff made an application for a life insurance policy on the life of Curtis Walton with Massachusetts Mutual Life Insurance Co. That application was signed by plaintiff, who had been a nursing assistant since 1979. The application denied that Mr. Walton had any history of convulsions, headaches, high blood pressure or seizure disorder. It also denied that Mr. Walton had received any medical treatment, been hospitalized, had an electrocardiogram, x-rays or other diagnostic tests within the prior five years. Plaintiff met with the agent and supplied the answers to these questions. This application was completed while Curtis Walton was an inpatient at the Northampton VA.

15. Although plaintiff testified at trial that it was not her idea to obtain the insurance policy and also that she did not supply the answers to these medical questions to the agent, she testified at deposition in a state court action to rescind the insurance policy that, in fact, it was her idea to obtain the life insurance policy.

16. On April 10, 1984, the medical records indicate that Curtis Walton called the Dental Clinic at the Northampton VA and spoke to the Chief of Dental Services at that time, Dr. James House. The record indicates that Curtis Walton inquired whether he could obtain dental treatment on an outpatient basis for a fracture of tooth # 8 at the Northampton VA. The record reflects that Dr. House advised Curtis Walton that he was not eligible for outpatient treatment because the needed dental work was less than 100% service connected. Dr. House advised Mr. Walton that the only way he could obtain outpatient dental treatment at the VA was to have his medical doctor, Dr. Shayevitz, state in writing that his dental condition was causally connected to his medical disability. According to the note of Dr. House, Mr. Walton because frustrated and told him to "just forget it."

17. On April 12, 1984, Curtis Walton was examined at a clinic at the Northampton VA by a physician's assistant who completed the adjunct authorization for Mr. Walton. The authorization stated that Mr. Walton fractured his tooth as a result of a seizure. As a result, Mr. Walton was entitled to be treated for that tooth on an outpatient basis.

18. On April 12, 1984, Dr. House treated Curtis Walton's fractured tooth. During the procedure, Mr. Walton was given a local anesthetic, Xylocaine with 2% epinephrine in 1-100,000 concentration. Curtis Walton did not have an adverse reaction to that injection.

19. From December 6, 1984 until January 4, 1985, Curtis Walton was again admitted to the Northampton VA. During this admission he was given both an EKG and an exercise stress tolerance test. These tests again showed that Curtis Walton had left ventricular hypertrophy, but did not indicate any other abnormality of his heart.

20. On February 22, 1985, Curtis Walton visited the Dental Clinic at the Northampton VA. Curtis Walton spoke with Dr. House who wrote the following note in the record:

Patient came today complaining that # 8 incisal edge filling came out. He was questioned at length about why he did not have root canal therapy done by a private dentist as he told us he would do 3-5-84. He said he did go to a private dentist in Springfield. That dentist took x-rays and told this patient that he did not need a root canal filling # 8. Further questioning reveals this patient often experienced a "boil" developing on his palate behind # 8 or on labial fold area anterior to # 8 which gets very sore and finally bursts with exit of "a lot of puss." Another apical x-ray was taken today of # 8. It shows the same size radiolucency at apex of # 8 as was there in our previous x-ray taken 3-5-84. I made a drawing for him and spent 20 minutes explaining what a root canal filling is and its purpose. I also told him he has advanced periodontal disease and it is my opinion that he should have the remaining upper teeth extracted and an upper denture constructed. He agreed with that assessment but left not stating what he planned to do.

Medical Record at 126 (emphasis added).

21. Dr. Sikora testified that in his experience and medical opinion, the dental condition which Dr. House detailed in his note on February 22, 1985 would not improve without dental intervention and extractions.

22. During the week before July 8,...