Bourne v. Seventh Ward General Hosp.

546 So. 2d 197, 1989 WL 51636
CourtLouisiana Court of Appeal
DecidedMay 16, 1989
Docket88 CA 0502, 88 CA 0503
StatusPublished
Cited by11 cases

This text of 546 So. 2d 197 (Bourne v. Seventh Ward General Hosp.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bourne v. Seventh Ward General Hosp., 546 So. 2d 197, 1989 WL 51636 (La. Ct. App. 1989).

Opinion

546 So.2d 197 (1989)

Mrs. Helen Dunn BOURNE
v.
SEVENTH WARD GENERAL HOSPITAL, et al. (Two Cases)

Nos. 88 CA 0502, 88 CA 0503.

Court of Appeal of Louisiana, First Circuit.

May 16, 1989.
Rehearing Denied June 23, 1989.

*198 Joseph Simpson, Atty., Amite, and Paul Due, Atty., Baton Rouge, for plaintiff-appellee.

Daniel A. Reed, Baton Rouge, for Seventh Ward Gen. Hosp.

Tom H. Matheny, Atty., Hammond, for State of La., Dept. of Health and Human Resources.

Gary M. Cooper, Baton Rouge, for Sherman A. Bernard.

Philip O. Bergeron, Atty., New Orleans, for M.L.G. Winkler, M.D.

Before WATKINS, CRAIN and ALFORD, JJ.

WATKINS, Judge.

Three Louisiana health care providers appeal an adverse judgment totalling $201,838.55 for the pain and suffering and wrongful death of a 20-year-old woman.

The decedent, Kathy D. Harper, was the daughter of Mrs. Helen Dunn Bourne, appellee. On February 17, 1978, the daughter attempted suicide by swallowing the contents of two bottles of prescription pain pills. However, she did not die until February 21, 1978. The mother brought a medical malpractice action against several health care providers that treated her daughter during the interval.

A long and complicated legal contest culminated in a trial on the merits nine years after the death. The trial court decided in favor of the plaintiff and awarded judgment *199 against Dr. M.L.G. Winkler, Seventh Ward General Hospital, and the State D.H. H.R. through Southeast Louisiana State Hospital.[1]

The death on February 21, 1978, was preceded by the following unfortunate chain of events.

February 10: Ms. Harper was in an automobile accident in Houston, Texas, in which she suffered a painful cervical strain. She returned to her mother's home in Natalbany, Louisiana.

February 14: Ms. Harper consulted Dr. Larry Fambrough, who prescribed two drugs for relief of pain, Flexeril and Darvocet-N 100.

February 17: Between midnight and 1:00 a.m., Ms. Harper attempted suicide by swallowing the remaining pills of the two prescriptions. She left a suicide note with the time of 12:15.

February 17: Shortly before noon she was taken by her mother to the emergency room at Seventh Ward General Hospital. She was seen by Dr. Fambrough, who ordered her stomach pumped out. He recommended that her case be turned over to an internal medicine specialist, the defendant Dr. Winkler.

Dr. Winkler ordered Ms. Harper's admission to the intensive care unit, where the patient received appropriate treatment.

February 18: Ms. Harper appeared to be progressing well, and she was transferred to a semi-private room. Dr. Winkler ordered laboratory testing (SMA-20) during the afternoon.

February 19: The blood sample for the SMA-20 was drawn. Because Seventh Ward General Hospital did not do that kind of laboratory work in 1978, the sample was sent by courier to a pathology laboratory in Metairie, Louisiana.

February 20: At 7:00 a.m. Dr. Winkler visited Ms. Harper and ordered a liver profile study, a test which was performed in-house at that time. The doctor's orders were for the test "now," which meant that the sample would be drawn within an hour but that the sample would not be processed by priority. The length of time between the drawing of the sample and the availability of the test results depended upon the number of tests being run in the laboratory on that particular day and at that particular time.

Dr. Richard Strobach, a psychiatrist who had been alerted to Ms. Harper's case because it was an attempted suicide, also visited Ms. Harper during the morning hours. However, he did not interview her because of her apparent sleepiness.

Around noon, Ms. Harper began exhibiting bizarre, violent behavior. Dr. Winkler was called, and she ordered the patient restrained. Ms. Harper was restrained with bed linens, the only device available for such a procedure since Seventh Ward did not have facilities to handle psychiatric patients. Dr. Winkler summoned Dr. Strobach for the purpose of getting his order to transfer the patient.

Mid-afternoon, Ms. Harper was transferred by ambulance to Southeast Louisiana State Hospital, a psychiatric unit. At the time of the transfer Dr. Winkler had not yet received the results of the two sets of tests she had ordered; nevertheless she assured Dr. Strobach that the patient was medically stable. Neither doctor sent the patient's records with her, each assuming that the other was going to do so.

At Southeast Louisiana State Hospital, the admitting physician was Dr. Alfred Hott, now deceased. Dr. Thomas C. Roach, an internist and psychiatrist employed by the state facility, was present in admissions at that time. He ordered that the patient be taken directly to the ward, but he did not suggest that the medical work-up normally performed before a patient is admitted be bypassed. The patient's *200 record shows that her skin was "icteric" (jaundiced) at the time of admission.

February 21: From 6:00 a.m. until 6:30 p.m., the patient was kept in full restraints, despite her vomiting and soiling her bed with urine and excretions; her temperature varied from 100.2° to 104.6°.

During the late afternoon, Ms. Harper vomited and aspirated. Resusitation measures were started at 6:00 p.m., but the patient was pronounced dead at 6:30 p.m.

The protocol of an autopsy performed 24 hours later by Dr. Friedricks H. Harris listed as the cause of death: "acute necrotizing toxic hepatitis with jaundice probably secondary to overdose of Flexeril and Darvocet deliberately ingested by the patient with suicidal intent."

The thrust of Mrs. Bourne's claim was that the defendants deprived her daughter of a reasonable chance of surviving the overdose. The plaintiff introduced proof that the substandard care which the decedent received at the hands of Dr. Winkler caused her daughter to exhibit violent behavior at Seventh Ward General Hospital, which in turn resulted in her being transferred to a psychiatric facility instead of a medical facility with a psychiatric unit.

Accepting plaintiff's version of the medical incidents, the trial court noted its favorable impression of the testimony of plaintiff's expert, Dr. Jay Shames. In that doctor's opinion, in 1978 an internist such as Dr. Winkler should have known the potential of liver toxicity from the drugs Ms. Harper had swallowed. He stated that Dr. Winkler should have watched carefully for the possibility of the patient's developing hepatitis, and the patient should have been supported properly through that illness. The patient should have been given intravenous fluids, instead of a regular diet, to "rest" the liver.

Dr. Shames also faulted Dr. Winkler for not having detected that the patient was hypoglycemic. He cited hypoglycemia as the probable cause of the bizarre behavior of the patient immediately before and after her transfer to Southeast Louisiana State Hospital.

The trial judge reached the following conclusions concerning the various defendants:

Dr. Winkler breached the standard of care owed by her as an internal medicine specialist in assuring Dr. Strobach that the patient was medically stable, as a result of which Dr. Strobach, with the concurrence of Dr. Winkler, made arrangements to get the patient transferred from a medical facility to a psychiatric hospital.... Dr. Winkler was negligent in not ascertaining the critical tests results.
. . .

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Bluebook (online)
546 So. 2d 197, 1989 WL 51636, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bourne-v-seventh-ward-general-hosp-lactapp-1989.