January 14, 2002
Child Bled Heavily From Catheter Puncture Sites — Congenital Heart Problems — Severe Brain Damage — $4.5 Million Confidential Settlement
Brief statement of claim: A six-month-old infant suffered severe brain damage after heavy bleeding during catheterization for evaluation of congenital heart disease.
Principal injuries (in order of severity): Cardiorespiratory arrest with resultant global brain damage
Tried or settled: Settled
County where tried or settled: Confidential
Case name and number: Confidential
Date concluded: Dec. 3, 2001
Name of judge: n/a
Amount: $4.5 million
Insurance carrier: Confidential
Expert witnesses and areas of expertise: n/a
Attorneys for plaintiff: Wade E. Byrd, Fayetteville, and Sally A. Lawing, Greensboro, of the Law Offices of Wade E. Byrd; Joe G. Adams Jr., Asheville
Other useful info: In January 1997, a six-month-old infant was admitted to a hospital for evaluation and treatment of congenital heart disease. The child underwent an uneventful cardiac catheterization, but developed a clot at the site of a groin puncture.
Heparin was started but the child began to bleed from puncture sites in both groins and in the neck. Heparin was stopped and restarted. Physicians (residents and an attending) attempted to draw blood to run a complete blood count and clotting studies, but could not get any blood from any vein. According to plaintiffs’ counsel, there was conflicting evidence as to whether the child was experiencing diarrhea during this time.
After the heparin was restarted, there was more bleeding. Dressings were described in the nurses’ notes as “soaked.” No attempt was made to quantify the blood loss from the puncture sites, and the child also had a groin hematoma, perhaps from the blood drawing attempts. More than 12 hours after the catheterization, the child arrested.
She was difficult to resuscitate, but ultimately survived with severe brain damage, spastic quadriparesis, mental retardation and seizures. As of the date of the settlement, she had not undergone surgery for her congenital heart disease because she is now deemed a poor surgical risk and her remaining life expectancy is reduced.
One of the attending pediatric cardiologists testified that children with cyanotic congenital heart disease require higher levels of hemoglobin in their blood to maintain adequate perfusion, and that a loss of five percent of this child’s blood volume could cause significant problems. This amount would have been only about one-and-one-half tablespoons of blood.
According to the plaintiffs’ counsel, the attending physicians admitted the importance of maintaining adequate hydration in these children because they are prone to develop hyperviscosity if allowed to become dehydrated.
The plaintiffs contended that through a combination of blood loss (clot, hematoma and external bleeding) and dehydration from diarrhea, this child became hypovolemic and anemic, leading to her decompensation and arrest.
Since these events, the child’s parents have divorced and the child is cared for by her mother. A life care plan prepared by Cynthia Wilhelm was priced at $16.8 to $1.9 million by Finley Lee.
The case was settled at an early stage after depositions of the fact witnesses. Settlement of the case was facilitated by use of a structured settlement. According the plaintiffs’ counsel, an excellent return was realized largely because the child received a rated age of 70 years.