| Patient Suffers Status Epilepticus and Subsequent Brain Damage Due to the Failure of the Hospital Staff to Suction Her Airway |
| Below Standard Care |
| Proper Charting Might Have Saved the Hospital |
Floor nurses are often under tremendous pressure and time constraint while caring for a patient in emergency, and proper documentation of the care provided usually becomes a casualty. Unfortunately, it is just this documentation that can protect the nurse and the hospital later when the patient sues for medical negligence. Charting, in and of itself, is never a complete defense, but without it the case is likely to crumble.
Arthur C. Esteve, Sr. commenced this survival action as the surviving spouse of Anna Belle Latiolais Esteve. Esteve sought damages for alleged acts of medical malpractice which resulted in irreversible brain damage to Anna Belle. This suit named only the Iberia General Hospital, as a defendant.
Charting Was the Weakest Link
Facts: Anna Belle Esteve, at the time of the event in question, February 1, 1979, was a fifty-seven-year-old woman with an approximately thirty-year history of epilepsy and a twenty-year history of asthma. On the morning of February 1, 1979, between 7:00 and 7:30 Anna Belle experienced at least one grand mal convulsion and was rushed by ambulance to the Iberia General Hospital. The expert medical testimony, including the testimony of her treating physician, Dr. G. Douglas Sagrera, described and diagnosed her condition as Status Epilepticus. Status Epilepticus is a condition in which one major epileptic seizure succeeds another with little or no interruption.
The evidence is conflicting as to whether Anna Belle ever regained consciousness. Anna Belle's treating physician, Dr. Sagrera suggested that she had begun to come out of the seizures, but other witnesses, the ambulance attendant, the head emergency room nurse and members of her family, to name only a few, testified that they never saw her enter a postictal state. A postictal state is a condition experienced by seizure victims subsequent to their seizure. It is characterized by a deep sleep or extreme drowsiness, but during which time the patients are generally subject to being aroused.
The principal question which confronted the jury was whether Anna Belle suffered a cerebral vascular accident, a stroke, which caused her brain damage or whether, as the plaintiffs maintain, she aspirated vomit which was not suctioned from her airway, thereby, inhibiting the ability of her lungs to provide her body, particularly her brain, with the oxygen necessary to sustain life. It must be noted at this point that Anna Belle did not die until March of 1982, but the brain damage she suffered on February 1, 1979 left her in a vegetative state.
Court Decision: The Trial Court, subsequent to a nine to three jury verdict, rendered judgment in favor of the plaintiffs for $159,770.50.
On appeal, the hospital maintains that the judgment of the lower court should be reversed. As one of its assignments of error the appellant urges that any damages incurred by Anna Belle Esteve were caused by her treating physician. The appellant urges that the care and treatment provided by the hospital was proper and adequate under the circumstances.
The duty and causation questions presented the jury necessitated inquiry into the care and attention Anna Belle received. The jury determined that the care fell below the standard which she should have received and that, as a result of the breach, Anna Belle suffered irreversible brain damage.
The plaintiffs presented evidence indicating that Anna Belle suffered brain damage as a result of the failure of the hospital staff to suction her airway. The testimony established that Anna Belle's condition should have placed the hospital staff on guard that she might aspirate vomit. The evidence further established that when Anna Belle was transferred from her "floor room" to Iberia General's Intensive Care Unit fluids and material suctioned from her airway included vomit.
The evidence received on behalf of the hospital was primarily expert testimony by persons not directly involved with her care during the critical period in question. The weakest link in the hospital's chain of evidence was the lack of detailed record keeping of all of the attention Anna Belle received. Speaking in terms in which medical personnel are accustomed, the "charting" of the care Anna Belle received had deficiencies. We must note for the record, however, that deficient record keeping in and of itself does not establish a plaintiff's case.
We are aware that the demands on "floor nurses" are great, particularly when a patient in the condition of Anna Belle Esteve is placed in their care. Notwithstanding the pressures placed on the hospital staff in this instance, we are unable to conclude that the decision of the jury is clearly erroneous.
For the above and foregoing reasons the judgment of the District Court is affirmed.
Esteve v. Iberia Parish Hospital 539 So. 2d727; 1989 La. App.
