The below is an argument our firm made on behalf of a client who developed a life threatening infection after what should have been a routine trip to the hospital. The client suffered permanent injury and disability. Medical malpractice cases are considered the hardest cases to win. Infection cases are the hardest medical malpractice cases. Our firm successfully prosecuted this case for our client and obtained a large settlement. In the world of personal injury cases generally, any good lawyer can handle a car accident case. Very few personal injury lawyers want to or know how to handle cases this complicated. The law firm of Kenneth D. St. Pe’ has experience in these cases.
PATIENT’S COMPENSATION FUND STATE OF LOUISIANA
PCF NUMBER: 20XX-00565
ABC MEDICAL CENTER, INC.
POSITION PAPER ON BEHALF OF NG
KENNETH D. ST. PÉ
La. Bar Roll No. 22638
311 W. University Ave.
Lafayette, Louisiana 70506
This is a very straightforward case. NG acquired MSSA sepsis during an admit to the defendant’s hospital. She suffered very serious injuries as a result of the infection to include multiple surgeries and an extended hospital stay. Recovery and treatment continue to date.
The source of the infection was an IV line. The IV line had been started by Acadian Ambulance paramedics but it is believed that it was compromised during her stay at the defendant’s facility. The IV line was never changed during the plaintiff’s first hospital stay of three (3) days. This violated the hospital’s own policy and procedure for the care and maintenance of IVs. Additionally, plaintiff’s complaints of pain when medications were pushed were ignored by the staff. Similarly, the presence of redness and swelling at the site of the IV was ignored. These are breaches in the standard of care.
Plaintiff would like this panel to address whether the IV infection could have been prevented or at least its serious affects lessened had the defendant acted within the appropriate standard of care.
On June 7, 2010 the plaintiff, NG, was transported via Acadian Ambulance to the defendant’s hospital for complaints of shortness of breath related to her asthma. Ambulance personnel noted that her speech was broken, nasal passages were flaring, she was wheezing and that there was “severe insp and exp wheezing diminished breath sounds”. The records reflect that a right AC SL IV saline lock was started under these emergent conditions. (Acadian Ambulance medical record of June 7, 2010 attached herewith as Exhibit “A”)
She was transported to defendant’s hospital and admitted. She was treated for her asthma, stabilized and discharged on June 10, 2010. (a copy of the Discharge Summary of Dr. Norris Guidry dated June 10, 2010 is attached herewith as Exhibit “B”)
A review of the nurses’ notes and the multiple records of assessments for the IV site during the plaintiff’s stay in the hospital show nothing. They all read exactly the same. These report that the site condition was “intact, no pain, redness, or edema at site”. (A copy of the June 8, 2010 Nursing Notes Powerforms is attached herewith as Exhibit “C” as an example) Despite what is represented in the defendant’s hospital notes, the plaintiff maintains that during her stay she began to have complaints of severe pain at the IV site when medications were pushed. She also noted redness and swelling at the IV site. These complaints were apparently ignored by the nursing staff.
After discharge on June 10, 2010 plaintiff returned home. She was already; however, experiencing the signs and symptoms from the IV infection. She continued to grow weaker and sicker over the next three (3) days until she was transported back to defendant’s hospital on June 13, 2010. The Acadian Ambulance record for that transport is attached herewith as Exhibit “D”. This panel will note Acadian’s description of the present illness, “As per pts family the pt had
been experiencing weakness for three days, the pt had been discharged from HBCM on
06/10/2010 after being admitted for complications with asthma. The Pt also showed signs of sepsis, the pt had an IV site that was swollen and she had a fever of 102, the Pt also complained of pain all over her body.” (emphasis ours)
She was transported to the defendant’s hospital and readmitted for a stay that lasted roughly six (6) weeks. A copy of the Discharge Summary from this second admit dated July 30, 2010 is attached herewith as Exhibit “E”. The panel will note a discharge diagnosis which
included right Iliopsoas abscess with MSSA status post percutaneous drainage, MSSA Bacteremia, lung and brain mass with evidence of improvement on CT and MRI most suggestive of infectious etiology, right hip Osteomyelitis status post drainage. Consultation reports from the doctors who treated her during this second admit are attached herewith as Exhibit “F” in globo.
ARGUMENT AND ISSUES
Attached herewith as Exhibit “G” are Interrogatories propounded to ABC Medical Center through their attorney. This panel will note the hospital’s admissions that the IV line was started by Acadian Ambulance on June 7, 2010 and not changed during the first hospital admit. Attached to these discovery responses are excerpts from the hospital’s Policy and Procedure Manual regarding the care and maintenance of an IV. On page 4 of 8 under the section title “Maintenance”, subsection 1b, it should be noted that the policy and procedure requires the IV to be changed if inserted under emergency conditions within 24 hours. By the hospital’s own admission and as is born out in the hospital’s medical records, this was not done. Failure to change the IV line within 24 hours is a breach of the standard of care.
As was mentioned above, plaintiff maintains she had pain when medications were pushed into the IV and that there was also redness and swelling at the site. These were ignored by the hospital’s staff and this is also a breach of the standard of care. Obviously, there is a factual conflict between what the hospital records indicate and what the patient reports. This panel is not allowed to resolve factual disputes. The attorney chairman will instruct you further in this regard. If there is a factual dispute which prohibits this panel from rendering a decision, then it cannot render a decision one way or the other. However, plaintiff would point out that her reports to the ambulance attendants on the second transport as well as the advanced state of her
sepsis at the time she was readmitted on June 13, 2010 would tend to suggest that the signs and symptoms of the infection were present during the first hospital admit as she claims.
Plaintiff summarizes the issues to be addressed by this panel as follows:
(1) Was the failure to change the IV line started by Acadian Ambulance a breach of the standard of care?
(2) If this was a breach, would it have prevented the infection or at least lessened the affects of the infection? 1
(3) Was the failure of the hospital staff to note the patient’s complaints of pain when the medications were pushed a breach of the standard of care?
(4) Was the hospital staff’s failure to address redness and swelling at the site of the IV a breach of the standard of care?
(5) Is there an issue of fact precluding the decision by this panel as to whether the hospital is to be believed or the patient is to be believed regarding her complaints of pain, redness and swelling?
KENNETH ST. PÉ
La. Bar Roll No. 22638 311 W. University Ave.
Lafayette, Louisiana 70506
(337) 534 4043
1 This panel should be aware that under Louisiana law, the plaintiff can recover for the “lost chance of a better outcome”. As it applies to this case, it would mean the lost chance of a less severe infection had the IV line been changed timely and the infection caught sooner.
GLOSSARY OF EXHIBITS
- June 7, 2010 Acadian Ambulance Medical Record
- June 20, 2010 Discharge Summary from ABC Medical Center
- June 8, 2010 Nursing Notes Powerforms is attached as an example
- June 13, 2010 Acadian Ambulance Medical Record
- July 30, 2010 Discharge Summary from ABC Medical Center
- Consultation reports from the doctors who treated her during this second admit
- Interrogatories propounded to ABC Medical Center