Cornelius v. MacOn-bibb County Hospital Authority

533 S.E.2d 420, 243 Ga. App. 480, 2000 Fulton County D. Rep. 1880, 2000 Ga. App. LEXIS 460
CourtCourt of Appeals of Georgia
DecidedMarch 30, 2000
DocketA99A1639
StatusPublished
Cited by11 cases

This text of 533 S.E.2d 420 (Cornelius v. MacOn-bibb County Hospital Authority) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cornelius v. MacOn-bibb County Hospital Authority, 533 S.E.2d 420, 243 Ga. App. 480, 2000 Fulton County D. Rep. 1880, 2000 Ga. App. LEXIS 460 (Ga. Ct. App. 2000).

Opinions

Pope, Presiding Judge.

M. L. Crump, Emma Crump’s husband, and Dexter Cornelius, as administrator of her estate, brought a wrongful death action against Dr. John Williams, Dr. Alan Stevick, and the Macon-Bibb County Hospital Authority d/b/a Medical Center of Central Georgia (“MCCG”) arising out of Mrs. Crump’s death at the hospital. The case proceeded to trial, and a jury returned a defense verdict. Mr. Crump and Mr. Cornelius (jointly referred to as “Crump”) appeal, questioning four evidentiary rulings, disqualification of a juror, and sufficiency of the evidence.

Mrs. Crump, a 55-year-old woman, appeared at the emergency room (“ER”) at MCCG on December 4, 1993, with a complaint of lower abdominál pain and painful urination. She exhibited symptoms of urinary tract infection and was diagnosed as having that. An x-ray of her abdomen was reported as showing air fluid levels in the intestine, which could indicate an ileus, a nonfunctioning portion of the intestine. The significance of this finding was disputed at trial. She was given antibiotics for the infection and sent home.

Mrs. Crump returned to the ER on December 8 with complaints of nausea, vomiting, abdominal pain, and loss of appetite; she reported that she began experiencing these symptoms after taking the prescribed medications. Her medications were changed, and on [481]*481December 9, a repeat x-ray again showed air fluid levels in the bowel. Again the significance of this finding was disputed at trial. Her diagnosis for this visit was urinary tract infection and acute gastritis.

On December 22, she returned to the ER a third time with complaints of upper abdominal pain, nausea, and vomiting. She had a normal pulse and temperature, but her blood pressure was now elevated. She had a history of high blood pressure and was on medications. A nurse noted that Mrs. Crump was “moaning.” An abdominal x-ray again showed air fluid levels which were read by the ER physician as a mild ileus. The patient was treated for peptic ulcer disease and then discharged.

On Saturday, December 25, at 4:05 p.m. she again came to the ER, this time by ambulance, complaining of continued nausea, vomiting, and abdominal pain. The emergency medical technicians reported that they witnessed episodes of nausea and vomiting. Mrs. Crump’s family was with her, and they were upset and wanted something done. This time her pulse was elevated, her blood pressure was up, and her ketone level had increased significantly. There is conflicting testimony concerning whether she was in severe pain and concerning the significance of the ketone level.

An abdominal x-ray showed a soft tissue density in the lower left abdomen. The ER physician, Dr. Meacher (not a defendant in this action), following hospital procedures, called defendant Dr. Williams, a first year surgical resident, for a consultation. (Emergency room physicians have responsibility for the patients while they are in the ER, but a hospital doctor must authorize admitting a patient to the hospital.) Dr. Meacher told Dr. Williams about the patient, that she had been to the ER four times that month, and that she said that nobody was doing anything for her. There is a dispute concerning whether Dr. Meacher told Dr. Williams that he thought Mrs. Crump needed to be admitted and whether they disagreed about admitting her. Before Dr. Williams saw the patient, Dr. Meacher prescribed several medications for the vomiting, some of which may cause drowsiness and ease pain.

Dr. Williams examined the patient and found that she had diffuse, cramping abdominal pain. According to his examination, she did not have signs of more severe pain. He reviewed her medical records for all four visits to the ER, and he saw the mass on the x-ray. Although he did not know what the mass was, he thought that it resembled fecal material in the descending colon and concluded that it was not a finding that needed immediate attention. Dr. Williams diagnosed peptic ulcer disease, gastroenteritis, or gall bladder disease. He then contacted his chief resident, Dr. Stevick, another defendant, and they discussed the case on the telephone. There is an issue of fact concerning whether Dr. Williams told Dr. Stevick about [482]*482the unidentified mass on the x-ray. There is also an issue of fact as to whether hospital policies required Dr. Stevick, as the chief resident, to actually examine the patient himself, which he did not do. Thereafter, at about 8:00 that night, Dr. Williams, with Dr. Stevick’s approval, discharged Mrs. Crump, with an appointment to return Monday morning for an ultrasound and a visit to the general surgery clinic. There is a dispute about whether hospital procedures required Dr. Williams to obtain the ER doctor’s approval for the discharge. The hospital radiologist read the x-ray (after the patient had already left the ER) as showing a “soft tissue density in the lower left quadrant of the abdomen,” and he flagged the x-ray for review Monday morning.

On December 27, Mrs. Crump returned to the ER by ambulance, with abdominal pain, nausea, and vomiting. About an hour after admission she had no blood pressure. She was intubated, and an emergency CT scan was done. The CT scan showed loops of small bowel in the area where the mass was on the earlier x-ray. The patient was then taken to the operating room for exploratory surgery. A nearly two-foot-long section of small bowel from the lower left quadrant of her abdomen was removed, a portion of which was dead, gangrenous, and perforated. There was some question at the time of surgery as to whether the remaining bowel was viable. Since there was doubt, and the patient was very ill, the surgeons elected not to reattach the intestine, with the plan to allow the patient to stabilize and to reconnect the bowel in 24 to 48 hours.1 On December 28 the patient died before an attempt could be made to do the second surgery. The pathologist’s report on the piece of bowel was “segmental ischemic bowel with perforation,” meaning that the segment of bowel died due to lack of blood flow to that segment.

Experts on both sides agreed that the disease responsible for Mrs. Crump’s death is a rare and highly fatal disease that is notoriously difficult to diagnose. They strongly disagreed about when Mrs. Crump was first affected by the disease and about whether it had anything to do with her first two visits to the ER. Further, the plaintiff’s expert radiologist characterized the finding on the December 25 x-ray that there was a soft tissue mass as a “subtle finding” and stated that he would not expect a surgeon to see it.

The family brought a wrongful death suit against the hospital, Dr. Williams, and Dr. Stevick, under the theory that failure to admit, Mrs. Crump on December 25, in the face of continued abdominal pain, worsening vital signs, and the mass on the x-ray, was a breach of the standard of care and that had she been admitted and more thoroughly examined, surgery would have been performed before the [483]*483segment of bowel became gangrenous and perforated, and she would not have died. A jury found for the defendants.

1. Crump asserts the court erred in refusing to allow two hypothetical questions.

(a) During the trial Dr.

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Cornelius v. MacOn-bibb County Hospital Authority
533 S.E.2d 420 (Court of Appeals of Georgia, 2000)

Cite This Page — Counsel Stack

Bluebook (online)
533 S.E.2d 420, 243 Ga. App. 480, 2000 Fulton County D. Rep. 1880, 2000 Ga. App. LEXIS 460, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cornelius-v-macon-bibb-county-hospital-authority-gactapp-2000.