Chapman v. Carlson

240 So. 2d 263
CourtMississippi Supreme Court
DecidedOctober 19, 1970
Docket45893
StatusPublished
Cited by10 cases

This text of 240 So. 2d 263 (Chapman v. Carlson) is published on Counsel Stack Legal Research, covering Mississippi Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Chapman v. Carlson, 240 So. 2d 263 (Mich. 1970).

Opinion

240 So.2d 263 (1970)

Norwieda CHAPMAN
v.
David I. CARLSON, M.D., Individually, H.L. Boone, M.D., E.E. Ellis, M.D., and James Waites, M.D., d/b/a Boone Clinic, a Partnership.

No. 45893.

Supreme Court of Mississippi.

October 19, 1970.

*264 Walker & Sullivan, Laurel & Waynesboro, R.L. Willett, Laurel, for appellant.

Gibbes & Graves, Laurel, Heidelberg, Woodliff & Franks, Jackson, for appellee.

SMITH, Justice.

Norwieda Chapman was plaintiff in a malpractice action brought in the Circuit Court of Jones County against David I. Carlson, doctor of medicine, and Doctors H.L. Boone, E.E. Ellis and James Waites, a copartnership doing business as Boone Clinic, his employers, as defendants. The case was submitted to a jury which returned a verdict for the defendants. Norwieda Chapman has appealed from the judgment entered pursuant to that verdict.

As finally amended, the declaration charged that defendant, Doctor David I. Carlson, in the discharge of his professional duties toward her as his patient, and in the course of his employment by Boone Clinic, was guilty of negligence in connection with administering a blood transfusion, and that such negligence proximately resulted in the loss of appellant's left leg. The original and amended declarations demanded both actual and punitive damages.

No request was made by appellant in the trial court for a directed verdict upon the issue of liability. Nor is it suggested on this appeal that the evidence did not give rise to a factual issue as to the negligence charged which required its submission to the jury for determination.

Appellant, a patient of Dr. Carlson, was admitted to the Boone Clinic as an obstetrical case. The usual examination and tests gave no indication that she was otherwise than in a normal and satisfactory condition. In due course, in what appeared a normal delivery (her fifth) she gave birth to a healthy child.

The child was removed to the nursery and Dr. Carlson was removing his gloves preparatory to leaving the room when a sudden and massive vaginal hemorrhage occurred. In moments blood was inches deep in a two gallon "kick pan" beneath the delivery table. As Dr. Carlson described it, *265 before he could get his gloves back on, she had lost a large portion of her total blood volume. Dr. Carlson at once began seeking the source of the hemorrhage, explored the inside of the uterus for retained placenta and checked the cervic for lacerations. The uterus he found to be normal and there were no lacerations.

Dr. Carslon knew that he was confronted by a grave emergency of the utmost urgency. The massive flow of blood must be stopped without delay and the lost blood replaced immediately if the patient were to survive. As an emergency measure, Dr. Carlson inserted a roll of five yards of gauze bandage into the uterus as a tamponade and to compress the blood vessels, hoping thus to stop the bleeding. This proved ineffective. Blood "continued to pour," and the patient became unconscious, her pulse weak and thready, her blood pressure low and at shock level, her skin cold and damp, all conditions indicating that the patient was in shock. Dr. Carlson instructed a nurse to find and call another doctor at once to give him assistance and she returned promptly with Dr. White. Dr. Carlson instructed Dr. White to start a drip into the patient's forearm while he continued his attempts to control the bleeding. It was necessary that the patient have blood in large quantities immediately. Dr. Carlson testified that the bleeding was the result of a clotting defect in the blood known as afibrinogenemia or hypofibrinogenemia. In this situation the patient was in imminent danger of dying or suffering serious brain damage. Dr. White tried to restart the drip into the patient's arm but blood squirted from her vein, a further indication of the condition called afibrinogenemia. Six units of blood and three units of fibrinogen and amicar, preparations which aid clotting, were sent for. These had to be administered intravenously and an intravenous drip had to be established. A cut down was done in the right ankle. Through an incision in the ankle, a small plastic catheter was placed in the saphenus vein. The vein was ligated on the foot side of the entrance of the catheter or tube which had been so inserted into the vein and the vein was tied around the tube above its entrance into the vein. At this time the patient had no obtainable blood pressure, a very rapid, weak pulse, and was in shock. Fibrinogen is in powder form and must be dissolved in liquid warmed to a temperature of 70 degrees. The resulting solution is thick and dripped slowly. The immediacy of the patient's need for large volumes of blood, while slowly receiving the fibrinogen, caused Dr. Carlson to do a cut down on the left ankle, similar to the cut down on the patient's right ankle, it having been his opinion that the patient was rapidly bleeding to death and that death might be expected at any moment. This cut down in the left ankle was done in all respects in the same manner as that on the right ankle. Appellant concedes that both were done in a "proper manner." A three-way stopcock syringe, a device for speeding the transfusion of blood into the vein, was used by Dr. Carlson to pump blood into the vein in the left ankle for the next two and a half minutes. Dr. Carlson was in charge of all the overall procedure meanwhile, checking with the nurse and Dr. White as to the patient's blood pressure and pulse, observing the rate of bleeding and the rate at which the fibrinogen and amicar were being administered to the patient through the other cut down in the right ankle. He testified that he was overseeing and supervising the entire emergency procedure, and trying to keep the patient alive. This included the use of oxygen, the transfusion of blood and the administering of decadron, a cortisone derivative drug, aquamephyton, ergotrate and pitocin. After two and a half minutes Dr. Carlson had injected one unit of blood into the vein in the left ankle by means of the syringe. Immediately, a second bottle of blood was put in place to be transfused into the left ankle cut down. This failed to drip and the leg was observed to have become swollen and cold. The catheter was immediately removed from the left ankle cut down and blood and drugs continued to be administered *266 through the right ankle cut down. Throughout this time, the patient was in shock and the use of anesthetics or surgical procedures were contraindicated. All of the medical witnesses agree that, under these conditions, the use of either likely would have caused the immediate death of the patient.

The intensive combined efforts of these doctors, anesthetist giving oxygen, and the nurses were continued for several hours, the patient's blood pressure was restored to the point where she was no longer in immediate danger of dying and had been restored to consciousness. During the next several days her condition, under the treatment of the doctors continued to improve with the exception of her left leg. The left leg had become more swollen. Throughout this period, drugs were given to reduce swelling, penicillin to counteract infection, and other drugs to dilate blood vessels. The patient also was given decadron, cyclospasmol, arliden, endecrin, thiomerin and terramycin.

Notwithstanding this, the condition of the leg worsened, and it was swollen, cold and painful and eventually showed unmistakable signs of morbidity. After several days it was determined that it would be necessary to amputate the left leg between the hip and knee. This was done.

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Bluebook (online)
240 So. 2d 263, Counsel Stack Legal Research, https://law.counselstack.com/opinion/chapman-v-carlson-miss-1970.