Washington v. City of Columbus, No. 50504

Decision Date30 October 1975
Docket Number2,Nos. 1,No. 50504,3
Citation222 S.E.2d 583,136 Ga.App. 682
CourtGeorgia Court of Appeals

Glenville Haldi, R. Joseph Costanzo, Attlanta, William L. Tucker, Columbus, for appellant.

Lennie F. Davis, E. H. Polleys, Jr., Hatcher, Stubbs, Land, Hollis & Rothschild, A. J. Land, Albert W. Stubbs, Kelly, Champion, Denney & Pease, S. E. Kelly, Ernest Kirk, II, Columbus, for appellees.

STOLZ, Judge.

This case involves an appeal from the Superior Court of Muscogee County following the trial judge's direction of a verdict against the plaintiff and in favor of all defendants after the close of the plaintiff's evidence. The plaintiff's four-count complaint sought a total of $14,000,000 in damages against the defendants, plus costs and attorney fees, for alleged medical malpractice contended to have resulted in the death of the plaintiff's 2-year-old son, for maintaining an inadequate program of instruction and supervision of interns, and for alteration of medical records alleged to have case a suspicion on the plaintiff of murdering her son. The fourth count is in the alternative for damages arising from the alleged mutilation of the plaintiff's son's body, assuming that the defendants' actions did not cause or contribute to the child's death.

The defendants are: Columbus, Georgia, also known as 'City of Columbus, Georgia,' Dr. Richard Lowe, Dr. Edward Prieto, Dr. John W. Crosby, and Dr. Sam Miller.

The following evidence was adduced at the trial. In the late morning of January 31, 1971, following several days of illness (T. 219, 291), the plaintiff's 2-year-old son was found by his stepfather on the floor of the plaintiff's bedroom lying motionless (T. 286, 287), apparently without a pulse (T. 287, 300) and not breathing (T. 287). The child did not respond to being called or shaken (T. 299-300). The child was given mouth-to-mouth resuscitation (T. 300) by his stepfather while the plaintiff went to a neighbor's house to call an ambulance (T. 287). Upon arrival of the ambulance, the child was placed on its resuscitator (T. 228), administered cardiac massage (T. 289), and given mouth-to-mouth resuscitation (T. 288) while being carried to The Medical Center, Columbus, Georgia.

Upon the child's arrival at the emergency room, defendant Dr. Crosby, an intern who was assigned to another department of the hospital, but who was at the moment in the emergency room seeing a patient of his (T. 7), observed the child and caused the Cardiac Respiratory Emergency Alarm to be sounded (T. 9) throughout the hospital, calling all available personnel for emergency assistance. Thereafter, at least four other physicians arrived from other sections of the hospital (T. 10). Those arriving included appellees, Drs. Miller and Prieto, and at least two other physicians not named as defendants in this suit (T. 10). These physicians, together with the assistance of numerous emergency-room nurses (T. 621), performed extensive resuscitative procedures in an attempt to revive the child. All persons present and observing the child during the time the child was in the emergency room, testified that the child was not breathing (T. 590, 594, 596), had no pulse or heartbeat (T. 590, 594, 596, 632), that his pupils were fixed and dilated, and that no blood was in the veins when a vein was incised (T. 64, 65, 76). In sum, there was a complete absence of vital signs. The emergency procedures utilized by these physicians included administering cardiac massage (T. 39), clearing the airways and inserting a trachial tube (T. 11, 623), injecting a stimulant into the child's heart (T. 596, 612, 622), forced breathing (T. 64, 622), and attempting to inject fluids into the child's body intravenously (T. 10, 64, 595-97). During the period of resuscitation, the EKG monitor to which the child was connected showed a continuous straight line, demonstrating that all of the emergency measures pursued did not restore a heartbeat (T. 594). At 12:50 p.m., after having failed to detect any heartbeat, breathing or other signs of life, all five of the physicians present mutually agreed that the child was dead, and the emergency procedures were ordered discontinued. (T. 11-12, 40, 42, 43, 587). At this point, all personnel administering treatment to the child left the room in which the body of the child was located with the exception of appellee Dr. Miller and two nurses (T. 580-81, 629). After noticing a distension of the child's abdomen, Dr. Miller performed a four-quadrant tap on the child's abdomen in an attempt to ascertain the cause of the distension and the cause of death of the child (T. 69, 76, 83). Doctor Miller's plans to perform the taps were never discussed with any of the other physicians (T. 20, 46, 70) and were not performed as the result of the direction or suggestion of any other physicians. The following day the child's body was taken to the hospital laboratory for an autopsy, which autopsy was performed by a hospital pathologist, Dr. Andres Franco (T. 380). Also present throughout most of the autopsy was Dr. Robert Shuffstall (T. 380), who was the appellant's sole medical witness at the trial.

Dr. Shuffstall, a former pathologist with The Medical Center, testified in substance that his opinion, based upon the autopsy and his subsequent examination of the body and tissues and slides of tissues of the child, was that the child was alive when brought into the emergency room, that the cause of the child's death was intra-abdominal hemorrhage secondary to needle punctures (T. 426), and that the needle punctures causing the hemorrhage were the taps performed by Dr. Miller. The autopsy report prepared by Dr. Franco (T. 924) and concurred in by Dr. Shuffstall (T. 461-463, 503, 506-507, 535), concluded:

'The post mortem findings are as noted in the gross and microscopic descriptions. Based upon these and subsequently received information, the following conclusions are made.

'1. The massive intra-abdominal and retroperitoneal hemorrhages are unequivocally due to the four (4) quadrant abdominal taps.

'2. The massiveness and extent of these hemorrhages could not possibly occur in the absence of life.

'3. The specific influence of this (sic) massive hemorrhages in bringing about death in a dying patient is purely conjecture. However, I believe this most likely, served as the final insult.

'4. The basic cause of death remains obscure.' Held:

1. Defendant Dr. Lowe is alleged to have been negligent in maintaining 'an inadequate program of supervision, control, direction, and teaching of Dr. Sam Miller' (R. 43); and in that he, 'in an effort to conceal the true facts, attempted to and did (through an unknown person) alter the medical records concerning . . . petitioner's (deceased) minor child,' resulting in the plaintiff's coming under suspicion of having caused the death of her child, thus causing the plaintiff 'great emotional trauma and stress.' (R. 44).

The record shows that defendant Dr. Lowe, the senior, full-time, emergency-room physician on the date of the child's admission to the emergency room, was not present in the hospital due to the day being his 'off day.' (T. 634). The plaintiff offered no evidence of any duty on the part of Dr. Lowe to train or supervise Dr. Miller. The plaintiff did prove, by the hospital administrator, Mr. Joseph Mitchell, that The Medical Center had a Director of Medical Education for interns (Dr. Cabaniss) and that he and two other full-time hospital physicians (none of the named defendants) were responsible for the hospital's education program to interns. (T. 388, 686). The uncontroverted evidence shows that Dr. Lowe neither was in any way connected with Dr. Miller's making the taps on the plaintiff's child nor knew of nor participated in any alteration of the medical records. (T. 22, 51, 648-649). Likewise, the record conclusively shows that neither Dr. Miller nor Dr. Crosby was assigned to the emergency room. The record fails to disclose any evidence of negligence by Dr. Lowe relating to the incident involving the plaintiff's child. The trial judge correctly granted the motion for directed verdict as to defendant Dr. Lowe.

2. (a) The plaintiff's theory of liability against Dr. Prieto, another full-time physician employed by The Medical Center, was the same as that against Dr. Lowe-the failure to give any sort of training, instruction or supervision to any of the interns prior to the occurrence involving the plaintiff's child. Dr. Prieto was the senior physician present in the emergency room at the time of the admission of the plaintiff's child to The Medical Center and subsequent treatment in the emergency room. Negligence is alleged in his failure to properly supervise the emergency-room rescue effort and failure to detect life in the patient.

As mentioned in Division 1, the plaintiff offered no evidence of any duty or obligation on the part of Dr. Prieto to train and supervise Dr. Miller or any other physician. The plaintiff's own uncontroverted evidence conclusively showed that three other full-time physicians (none of whom were defendants) had the responsibility for the intern education program. The plaintiff's evidence also showed that neither Dr. Miller nor Dr. Crosby, both interns, was assigned to the emergency room at the time in question. The former was assigned to surgery; the latter was assigned to medicine. Dr. Miller came to the emergency room in response to the Cardio-Respiratory Emergency (CRE) alarm.

(b) Likewise, the record is bare of any evidence that Dr. Prieto had any knowledge of, participated in, caused or ratified the alleged alteration of medical records.

(c) As to Dr. Prieto, the remaining issues relate to the performance of emergency medical procedures upon the plaintiff's child without first having made a diagnosis of the cause of the child's condition and subsequently erroneously...

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