Hanna v. Defendant Pediatric Resident Physician

  • Circuit Court of Cook County, Illinois (Judge Gregory Wojkowski)02/28/2012
    Client: Defendant Pediatric Resident Physician
    Outcome: Defense Verdict

Synopsis:

On February 28, 2012, a Cook County jury reached a verdict in favor of the firm's client, a pediatric resident physician.

The plaintiff's decedent, an eleven-year old male, was admitted to University of Illinois Medical Center on February 18, 2007 with vomiting and a history of propionic acidemia. Propionic acidemia is an inborn error in metabolism that causes acids to accumulate in the body, which can lead to brain damage and heart problems.

The child had been primarily managed since infancy by a pediatric geneticist and was doing well in the fifth grade. Children with propionic acidemia may not survive to adulthood but survival is quite variable.

The defendant was a third year resident in pediatrics at the University of Illinois when she participated in the care of the child. The defendant performed the admission history and physical exam and consulted with the attending pediatric geneticist regarding the plan of care.

On the morning of February 19, the child was doing better and was alert with stable vital signs. At 1:00 pm, the child complained of shortness of breath and was restless and the pediatric geneticist and the defendant were summoned to the room. The exam and vital signs were within normal limits and the child calmed down and the impression was of anxiety at that time.

The attending physician left the hospital to attend to patients at his clinic and approximately 30 minutes later, the defendant was again summoned to the room due to the child's complaints of shortness of breath and agitated behavior. A nurse at the hospital and several family members present in the room testified that the defendant insisted that the child was merely anxious despite that he was pale, disoriented, with cool skin and extremely distressed. The nurse also claimed that the defendant refused to come to the room several times when requested to do so.

The nurse charted and testified that she informed the defendant that the child might be anxious but that there was something else wrong. The child was assisted to the bathroom and his IV leads and cardiac monitor were accidently disconnected. The defendant testified that she notified the attending physician and stayed with the child.

After approximately 20 minutes, the nurse called a "Code Blue." The nurse charted and testified at trial that the child was pulseless and unresponsive but the defendant cancelled the code. According to the nurse, the nurse "ignored" the defendant and re-called the Code Team to the room. Family members corroborated the nurse's testimony.

The Code Team responded and eventually the child was intubated and transferred to the Pediatric Intensive Care Unit where his blood acid levels were found to be extremely high. He initially was stabilized but the following afternoon, his acid levels increased and his heart function deteriorated and despite aggressive resuscitation, he died late on the evening of February 20, 2007.

An autopsy revealed chronic cardiac abnormalities and possible viral myocarditis as well as severe carnitine deficiency in the heart secondary to his propionic acidemia. The plaintiff claimed that the defendant negligently failed to appreciate a life threatening condition (cardiogenic shock) on the afternoon of the 19th, failed to timely notify the attending physician of a significant change in the child's condition, improperly delayed resuscitative efforts and attempted to prevent others from intervening to assist the child, all diminishing the child's chances of survival.

The plaintiff's experts testified that the child "decompensated" on the defendant's watch, resulting in depletion of his body reserves which led to his continued deterioration and death the next day from cardiogenic shock.

The defense argued that the defendant was a physician in training and practicing under the direction and supervision of the attending physician; she responded immediately when called, stayed with the child, continued to evaluate the child and notified the attending of the situation in a timely manner. Further, when the Code Team initially was called by the nurse, there was no need for intervention because the child was breathing and had a pulse (though the nurse had mistakenly believed the child was pulseless because of a straight line on the cardiac monitor while the leads were disconnected).

The defense argued that the child was electively intubated in a timely manner to protect his airway due to a change in his level of consciousness noted when the Code Team was leaving the room. The defense also argued that the child did not suffer any permanent injury as a result of the events of the 19th and that his death could not have been prevented.

In closing argument, plaintiff's counsel asked the jury to award $2.5 million. After several hours of thoughtful deliberation, the jury returned a verdict for the defendant.