In New York medical malpractice lawsuits, it’s true that proof of a physician or health care worker’s mistake is critical to a claim. But presentation of that fact alone won’t mean much unless you can also show injury or death was the proximate result of this mistake/breach of care standard.
To be the “proximate result” means one has to show causation. In other words, “but-for” the doctor’s breach-of-care, plaintiff’s injury would not have materialized.
This was the fatal flaw that sunk the case of Kraselsky v. Calderwood, before the Alabama Supreme Court.
As our Manhattan medical malpractice attorneys understand, the case was brought by a man serving as personal representative of his mother’s estate, following her death in 2010.
According to court records, the 80-year-old woman was in poor health when she was admitted to a local hospital that July after a fall. She sustained compression fractures to her vertebra as a result.
Following her admission and initial treatment for these injuries, she was discharged and sent to a local rehabilitation hospital for additional treatment therapy. However, within two weeks, she went into cardiac and pulmonary arrest and was resuscitated.
She was then readmitted to the first hospital. At that time, she had serious pulmonary emboli in both lungs, in addition to fluid in her chest and multiple rib fractures, resulting from resuscitation efforts. It would later be found she also suffered from congestive heart failure and gastrointenstinal bleeding.
Throughout her treatment over the next week, she was in immense pain and begged her doctors to provide something to ease her suffering. The medication she previously received was discontinued because she had difficulty swallowing as a result.
However, patient was allergic to 20-plus medications – a fact she had indicated on numerous visits with her treating physicians. Doctors at the hospital had access to these records as well. The medications to which she was allergic included a number of pain medications, including Motrin, codeine, Dilaudid, Darvon and Darvocet, Demerol and Vicodin. She had a red arm band at the hospital to alert staffers to her numerous medication allergies.
In spite of these, she had been given a medication that contains the same active ingredients in Vicodin without any apparent side effects.
In response to her requests for pain medication, the doctor prescribed her intravenous Demerol every six hours. A nurse noted the discrepancy and informed the doctor, who indicated he was aware of the allergy. (He later said he discussed the allergy with patient, and she reported experiencing a headache after taking Demerol in the past. He concluded the headache was a side effect, rather than a true allergy.) The medication was administered.
Prior to receiving medication, her vital signs were normal. Five hours later, her rate of respiration and pulse had increased and her oxygen saturation decreased. She was moved to intensive care and resuscitated. Still, she died three days later.
Her son filed a medical malpractice lawsuit the following year, alleging doctors breached the standard of care by allowing his mother to be given a medication to which she was allergic, despite her fragile state.
Doctor sought summary judgment, asserting there was no substantial evidence the doctor breached the applicable standard of care, or even if he did, that his action proximately caused the woman’s death. Motion was granted and plaintiff appealed to the Alabama Supreme Court, which affirmed.
The court noted that while there was some evidence by which a reasonable jury might find the doctor had breached the applicable standard of care by giving his patient medication to which she previously stated an allergy, there was no indication this alleged breach caused her death.
In order to prove the claim, plaintiff would have needed to show doctor’s actions probably rather than just possibly caused his mother’s death. Plaintiff here had no expert witness to establish causation. Plaintiff’s expert witness had testified on cross-exam that an allergic reaction to a medication would typically be seen immediately – not five hours later, as in this case. Additionally, he noted patient was seriously ill with a poor prognosis from the time she was admitted, so the causation or even correlation between the pain medication and her decline was weak, at best.
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Kraselsky v. Calderwood, Oct. 17, 2014, Alabama Supreme Court
More Blog Entries:
Beebe v. St. Joseph’s – Injury Alone Insufficient to Prove Medical Malpractice, Oct. 28, 2014, Manhattan Medical Malpractice Lawyer Blog