Bolton v. Nagalla

609 So. 2d 1134, 1992 WL 350833
Louisiana Court of Appeal·Decided December 2, 1992·No. 24,242-CA·Published·Cited by 6 cases

Opinion

609 So.2d 1134 (1992)

Donnie BOLTON, et ux., Plaintiffs-Appellees,
v.
Ratnam NAGALLA, M.D., Defendants-Appellants.

No. 24,242-CA.

Court of Appeal of Louisiana, Second Circuit.

December 2, 1992.
Rehearing Denied January 14, 1993.

*1135 Lunn, Irion, Johnson, Salley & Carlisle by James B. Gardner, Shreveport, for appellants, Ratnam Nagalla and LA Patient's Compensation Fund.

Craven, Scott & Randow by Samuel H. Craven, Alexandria, for appellees, Donnie and Carrie Bolton.

Before MARVIN, SEXTON and LINDSAY, JJ.

MARVIN, Chief Judge.

In this medical malpractice action the Louisiana Patient's Compensation Fund appeals a judgment awarding the plaintiff husband and wife a total of $480,000 before crediting the $100,000 amount for which the defendant doctor is liable under the law.

We amend to reduce the award for the husband's lost earnings and to delete the award for his lost earning capacity and the award to the wife for her medical expenses. In all other respects, we affirm.

PROCEDURAL POSTURE

Donnie and Carrie Bolton sued Dr. Ratnam Nagalla, her malpractice insurer, and the Louisiana Patient's Compensation Fund. They assert that Donnie Bolton suffered inner ear damage from Dr. Nagalla's negligent administration of Garamycin, an antibiotic, to him while he was hospitalized for treatment of severe stomach pain in October 1983. Bolton's injuries, which are permanent, include a partial loss of hearing in each ear, positional vertigo or dizziness, and tinnitus, a constant ringing or roaring in his ears.

Before trial, the Boltons settled with Dr. Nagalla's insurer, reserving their rights against Dr. Nagalla and the Fund. While agreeing that Dr. Nagalla breached the applicable standard of care in administering the Garamycin to Bolton, the Fund contested whether that conduct caused Bolton's ear problems and contested the measure of damages in excess of $100,000, the statutory limit of Dr. Nagalla's base liability under LRS 40:1299.42.

The Boltons were awarded judgment against the Fund for about $480,000 in damages, subject to the credit of $100,000 because of plaintiffs' settlement with Dr. Nagalla's insurer. Dr. Nagalla was not named in the judgment and is represented on appeal "in name only" by the attorney for the Fund.

The awards to Donnie Bolton, totaling about $430,000, include $200,000 in general damages, $42,797 in past lost earnings and $184,421 for loss of earning capacity. Carrie Bolton was awarded $50,000 for loss of consortium and $617 in medical expenses for treatment of her depression, which began after her husband was injured.

The Fund's appeal primarily challenges the amount of the damage awards. The Fund also claims that Bolton's partial hearing loss in each ear was not caused by Garamycin, but by his cumulative exposure over many years to loud noises while working as a welder before 1983. The Fund now concedes that Garamycin caused Bolton's tinnitus and vertigo.

The trial court's finding on the cause of Bolton's partial hearing loss, a factual issue, is not clearly wrong. The general damage and loss of consortium awards are not excessive. Plaintiffs effectively concede *1136 Mrs. Bolton's medical expenses are not legally recoverable. We reduce the award for Mr. Bolton's past lost earnings from $42,797 to $2,312. His award for loss of earning capacity is simply not supported by the evidence in this record and is deleted.

FACTS

The Boltons live in Atlanta, about 20 miles from Winnfield. On October 8, 1983, Donnie Bolton, age 40, went to the emergency room of the Humana Hospital in Winnfield complaining of severe stomach pain. Dr. Nagalla, who was on duty in the emergency room, admitted Bolton to the hospital that day. She discharged him on October 10 and readmitted him on October 15 for about a week. During both hospital stays, and on Dr. Nagalla's orders, Bolton was given intravenous doses of the drug Garamycin, an antibiotic whose known potential side effects include inner ear damage.

When Bolton left the hospital the second time, on October 21, 1983, he had nausea, dizziness and ringing in his ears. The nausea went away but the ear problems did not. Bolton sought treatment from several doctors, including Dr. Nagalla, who sent him to Dr. Jack Pou, an ear, nose and throat specialist in Shreveport.

From tests done in 1984, Dr. Pou found that Bolton had a hearing loss in the high-frequency range in both ears, tinnitus (ringing or roaring) in both ears, and positional vertigo or dizziness resulting from damage to the balance mechanism in his left ear. According to Dr. Pou, these conditions are permanent and are not treatable medically or surgically.

In 1988 Dr. Pou's assessment was confirmed by additional testing of Bolton by two other doctors: Dr. Charles Neal, a Ruston ENT specialist, and Dr. Jack Vernon, an experimental psychologist in Portland, Oregon, a nationally recognized specialist in the study and treatment of tinnitus.

These three doctors testified by deposition. They agreed that inner ear damage is a well-known potential side effect of Garamycin. Dr. Pou attributed Bolton's vertigo to the Garamycin but opined that his high-frequency hearing loss and tinnitus were probably caused by his having worked around loud noises and equipment in his 20-year career as a welder, which Bolton reported in the history he gave Dr. Pou.

Dr. Neal was aware of Bolton's history of noise exposure and said it could account for some of Bolton's hearing loss and for his tinnitus. Dr. Neal concluded, however, that those problems as well as the vertigo were caused by the Garamycin because Bolton had no history of vertigo or tinnitus before 1983 and the extent of his pre-1983 hearing loss, if any, had never been objectively measured.

Dr. Vernon agreed that noise exposure can cause both a high-frequency hearing loss and tinnitus, but said that about 85 percent of his patients who have a hearing loss and tinnitus caused by noise exposure exhibit some degree of "residual inhibition," meaning that the tinnitus temporarily subsides, for a period of minutes, hours or even weeks, when the patient is exposed to a low-level masking sound. According to Dr. Vernon, Bolton's residual inhibition was "almost nothing ... one or two seconds at best in one ear only," and no relief in the other ear. Dr. Vernon said this "would tend to mitigate or negate the theory of a noise-induced hearing loss or tinnitus."

The high-frequency hearing loss causes Bolton to have difficulty hearing speech when other noises are present, such as when he is in a crowd or near several people who are conversing.

Tinnitus produces constant screeching or a shrill tone in Bolton's ears. The pitch of the tone is generally about 8,000 hertz, which is an octave higher than the pitch of the highest note on a piano. The tone goes up and down in intensity or volume but is always present. Tinnitus worsens when Bolton becomes worried, stressful or is near several people who are talking at once. It interferes with Bolton's concentration and his sleep. Bolton goes to bed before 9:00 p.m., while background noises *1137 in his home mask the tinnitus. He often awakens during the night and experiences difficulty in going back to sleep and fatigue the next day.

Dr. Vernon said there are no effective medical or surgical treatments for Bolton's tinnitus. Dr.

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