Hospital Patient's Cervical Spine Broken During Intubation - Ventilator- Dependent Quadriplegic - $15 Million Confidential Settlement

January 14, 2002

Medical Malpractice

Hospital Patient's Cervical Spine Broken During Intubation — Ventilator- Dependent Quadriplegic — $15 Million Confidential Settlement

Brief Statement of Claim: A 38-year-old man, disabled from the combined effects of Crohn's disease and ankylosing spondylitis (an arthritic condition resulting in flexed fusion of the cervical spine) was hospitalized under the care of a family practitioner in intensive care for sepsis of unknown origin. He was able to walk prior to his admission.

On the third hospital day, he developed respiratory distress secondary to fluid overload. A pulmonologist was consulted, and diuresis attempted. Ultimately, the pulmonologist ordered the patient intubated.

Two respiratory therapists went to the patient's room to perform the procedure. They noted the abnormal flexion of the patient's neck but failed to recognize the difficulty this posed for intubation via laryngoscopy. They were unable to intubate and sought orders to sedate, and then to paralyze the patient. The paralytics were ordered by the family practitioner and given by an RN.

More than an hour after ordering the intubation, the pulmonologist returned to find the patient paralyzed, unable to breathe on his own, and still not intubated. He performed the laryngoscopy, but found the view too poor to attempt intubation. He requested a fiberoptic bronchoscope.

When this was brought into the room, it would not work. The pulmonologist left the room to get additional equipment. While he was gone, one of the respiratory therapists performed the laryngoscopy and inserted an endotracheal tube, but it went into the esophagus and had to be withdrawn.

The pulmonologist finally intubated with the bronchoscope one hour and 40 minutes after the procedure was ordered.

Following the intubation, the patient was bloody. His lips were torn. According to his family, he was lying flat, with the back of his head touching the bed. They commented that they had not seen his throat in years.

None of the health care providers noticed the change in the patient's appearance.

Three days later, family members reported to the nurse that the patient could not move or feel his feet. The nurse confirmed this, but did nothing.

The following day a head CT was ordered as well as EMG and nerve conduction studies. The doctors (a family practitioner and a pulmonologist) had no differential diagnosis.

The paralysis slowly ascended up the patient's legs, to his torso, abdomen and chest.

The nerve conduction studies were not done until four days after the paralysis was first noted. These tests were performed by a physiatrist. He interpreted the results as consistent with Guillain-Barre syndrome. Based upon that diagnosis, the patient was transferred to a large medical center for plasmapheresis.

Within hours of arrival at the second hospital, the patient was diagnosed with a cervical spine fracture. The attending physician, a pulmonologist, suspected this based upon the history of a difficult intubation, together with the clinical picture, which he felt was inconsistent with Guillain-Barre syndrome.

Suit was filed against the local hospital, four physicians and a medical group.

Principal Injuries (in order of severity): The patient was left a ventilator-dependent quadriplegic.

Special Damages: n/a

Tried or settled: Settled

County where tried or settled: Confidential

Case Name and number: Confidential

Date Concluded: May 4, 2001

Name of Judge: n/a

Amount: Total settlement with all defendants was $15 million. As part of the settlement, the plaintiff will receive $54,000 per month, increasing annually by four percent.

Should he achieve his full life span, the payments will exceed $58 million.

The plaintiff has remained hospitalized since his injury in a facility owned by the same entity that owns the defendant hospital. As part of the settlement, the charges for the patient's entire stay were waived, and it was agreed that he can remain there free of charge for up to six months while suitable housing is obtained.

Insurance Carrier: Confidential

Expert Witnesses and areas of expertise: n/a

Attorneys for plaintiffs: Wade E. Byrd, Fayetteville, and Sally A. Lawing, Greensboro, of the Law Offices of Wade E. Byrd; Thomas F. Taft, Greenville, and Kenneth E. Haigler, Wilmington, of Taft, Taft & Haigler

Other Useful Info: Discovery was very intensive, with approximately 70 depositions being taken.

According to plaintiff's counsel, the defense position was that the patient broke his neck at home, before coming to the hospital; that all health care providers met the standard of care; and that the plaintiff's health is so precarious that he had already exceeded his life expectancy and was living on borrowed time.

All of the physicians were insured by the same carrier. Settlement was reached with them on March 2, 2001. The settlement with the hospital was concluded on May 4, 2001, with the trial set to commence three days later.

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