Davis v. Lazarus

927 So. 2d 456, 2006 WL 1028588
CourtLouisiana Court of Appeal
DecidedMarch 8, 2006
Docket2004-CA-0582
StatusPublished
Cited by10 cases

This text of 927 So. 2d 456 (Davis v. Lazarus) 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
Davis v. Lazarus, 927 So. 2d 456, 2006 WL 1028588 (La. Ct. App. 2006).

Opinion

927 So.2d 456 (2006)

Roslyn DAVIS and Murphy Davis
v.
Dr. Edward LAZARUS and Sheila Fontenot, CRNA.

No. 2004-CA-0582.

Court of Appeal of Louisiana, Fourth Circuit.

March 8, 2006.
Rehearing Denied April 12, 2006.

*458 Joseph M. Bruno, Christopher J. Bruno, Bruno & Bruno, New Orleans, Counsel for Plaintiff/Appellee.

Kurt S. Blankenship, Robert I. Baudouin, Blue Williams, L.L.P., Metairie, Counsel for Defendant/Appellant (Dr. Edward Lazarus).

George E. Cain, Ann Marie Leblanc, Frilot, Partridge, Kohnke & Clements, L.C., New Orleans, Counsel for Intervenor/Appellant (The Louisiana Patient's Compensation Fund).

(Court composed of Chief Judge JOAN BERNARD ARMSTRONG, Judge MICHAEL E. KIRBY, Judge MAX N. TOBIAS Jr., Judge LEON A. CANNIZZARO, Jr., Judge ROLAND L. BELSOME).

MICHAEL E. KIRBY, Judge.

In this medical malpractice case, Dr. Edward Lazarus and the Louisiana Patients' Compensation Fund ("PCF"), appeal the December 5, 2003 trial court judgment in favor of plaintiffs Roslyn and Murphy Davis.

On June 10, 1997, plaintiff Roslyn Davis was admitted to Touro Infirmary for an outpatient laparoscopic surgical procedure. Mrs. Davis' gynecologist, defendant Dr. Edward Lazarus, performed this procedure, which was completed without any immediate evidence of complications. Shortly after arriving in the recovery unit, Mrs. Davis began to experience breathing difficulties. She was diagnosed with a condition known as flash pulmonary edema, and was transported to the hospital's intensive care unit ("ICU"). The flash pulmonary edema was resolved by no later than 7:30 a.m. on June 11, 1997. The plaintiffs do not contend that the flash pulmonary edema was the result of any negligence or fault on the part of Dr. Lazarus.

The medical care at issue in this lawsuit began with Dr. Lazarus' visit with Mrs. Davis on the morning of June 11, 1997. When Dr. Lazarus saw Mrs. Davis at approximately 7:30 a.m., the flash pulmonary edema had cleared. She had a temperature of 100.2. A physical examination revealed that her abdomen was soft, and bowel sounds were present but hypoactive. Dr. Lazarus ordered a complete blood count ("CBC"), started Mrs. Davis on oral fluids, discharged her from the ICU and transferred her to a room in the gynecology ward of the hospital.

At approximately 2:00 p.m. that same day, Dr. Lazarus ordered a flat and erect abdominal x-ray due to a rise in Mrs. Davis' temperature. He also put Mrs. Davis on a broad-spectrum antibiotic. Later that afternoon, Dr. Lazarus viewed the film of the abdominal x-ray with the radiologist. Both thought that the x-ray showed signs of a post-operative ileus, or paralysis of the bowel. They discussed the possibility of a ruptured abdominal viscus or bowel perforation, but Dr. Lazarus did not think that was the case. Mrs. Davis' primary care physician, Dr. Febry, saw Mrs. Davis next at 5:30 p.m. He noted that she had a temperature of 102 and had vomited in *459 recovery post-extubation. Dr. Febry indicated in his notes that he would monitor Mrs. Davis closely for possible evolution of aspirational pneumonia, and that he agreed with Dr. Lazarus' decision to treat Mrs. Davis with the antibiotic, Clarapham.

Dr. Lazarus saw Mrs. Davis at 6:30 p.m. She still had a temperature of 102, and he said he knew Mrs. Davis had been complaining of pain because Dr. Febry had ordered Percocet. He performed a physical examination and found no significant change from his earlier examination. Dr. Lazarus testified that he was concerned because Mrs. Davis was not recovering as normally as he would have expected for someone who had undergone laparoscopy the day before. He ordered additional blood tests, including another CBC. He also ordered a Dulcolax suppository to see if he could get the bowel working by evacuating the rectum and lower colon.

The nursing staff called Dr. Lazarus at 7:30 p.m. that evening, and reported that Mrs. Davis' temperature had spiked to 103. He ordered another CBC, and returned to the hospital at 9:15 p.m. to examine Mrs. Davis after picking up the results of her blood work. Her white blood count was stable so Dr. Lazarus did not think Mrs. Davis' fever was being caused by infection, although he considered it a possibility. He also still considered bowel perforation a possibility at that time, in addition to other possible diagnoses. Dr. Lazarus noted at this visit that Mrs. Davis, who is a nurse, told him she felt that her pain was due to gas, and she requested a rectal tube to try to expel the gas. He gave the order for the rectal tube, and also discussed with Mrs. Davis the possibility of going back into surgery if her condition did not improve.

The next morning, June 12, 1997, Dr. Lazarus saw Mrs. Davis and found a significant change in her condition, namely, an acute abdomen. At that time, Dr. Lazarus made the decision to have a surgical consult with Dr. Ernest Cohen. Dr. Cohen suspected that the cause of the acute abdomen was peritonitis, but recommended surgery to rule out the possibility of a perforated bowel. Dr. Cohen performed surgery that afternoon, and found a perforation in the bowel. In the surgery, he made an open incision, repaired the bowel perforation, irrigated the abdomen to remove material that had entered Mrs. Davis' abdomen as a result of the bowel perforation and then closed the incision. The surgery took approximately one hour. Mrs. Davis remained hospitalized after the surgery until June 19, 1997.

Three days later, on June 22, 1997, Mrs. Davis went to the emergency room complaining of pleuritic chest pain accompanied by fever. She was admitted to the hospital with a diagnosis of atelectasis in the right lower lung fields, with small pleural effusion. In his deposition, Dr. Cohen described atelectasis as "a partial, or can be total, collapse of the lung, where it's not being filled with air." He said that this condition is not uncommon postoperatively in someone who has had a general anesthetic. Mrs. Davis was treated in the hospital with antibiotics and physical therapy until her release on June 25, 1997.

Mrs. Davis was hospitalized again on June 30, 1997 with fever and right pleural fusion. She was diagnosed with right thoracic empyema, which is pus in the chest cavity. Mrs. Davis was treated with antibiotics and underwent thoracentesis for removal of pleural fluid. She was discharged from the hospital on July 5, 1997. She returned to the hospital on July 8, 1997 to receive a blood transfusion due to anemia. Mrs. Davis was also hospitalized in September 1997 for a bowel obstruction.

Mrs. Davis and her husband, Murphy Davis, filed a petition for damages against *460 Dr. Lazarus and Sheila Fontenot, CNRA. Plaintiffs subsequently dismissed Ms. Fontenot from the lawsuit. In their petition, plaintiffs allege that Dr. Lazarus committed medical malpractice by waiting too long to obtain a surgical consult for Mrs. Davis after her laparoscopic surgery, and failing to diagnose her perforated bowel and pleural effusion. Plaintiffs allege that the delay in obtaining a surgical consult required Mrs. Davis to undergo additional medical procedures and caused her to suffer post-traumatic stress disorder. Following a jury trial, the jury returned a verdict finding that Dr. Lazarus breached the standard of care, but that his breach was not a cause of the damages complained of by plaintiffs. The trial court rendered judgment in conformity with the jury's verdict, and dismissed plaintiffs' case against Dr. Lazarus with prejudice.

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