Falkowski v. Maurus

637 So. 2d 522, 1993 WL 651358
CourtLouisiana Court of Appeal
DecidedSeptember 9, 1993
DocketCA 92 0102
StatusPublished
Cited by30 cases

This text of 637 So. 2d 522 (Falkowski v. Maurus) 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
Falkowski v. Maurus, 637 So. 2d 522, 1993 WL 651358 (La. Ct. App. 1993).

Opinion

637 So.2d 522 (1993)

Lawrence FALKOWSKI and Carolyn Falkowski
v.
Joseph L. MAURUS, The City of Baton Rouge/Parish of East Baton Rouge Through the Department of Emergency Medical Services, and the St. Paul Fire and Marine Insurance Company.

No. CA 92 0102.

Court of Appeal of Louisiana, First Circuit.

September 9, 1993.

*523 Ralph L. Fletcher, Baton Rouge, for plaintiffs-appellants Lawrence Falkowski, et ux.

Errol J. King, Baton Rouge, for intervenor-appellant Community Health Network of La., Inc.

Myron A. Walker, Jr., Baton Rouge, for defendants-appellees Joseph Maurus, Clifton Malone, City of Baton Rouge EBRP, Dept. of Emergency Medical Services, St. Paul Fire and Marine Ins.

Before EDWARDS, SHORTESS and WHIPPLE, JJ.

*524 WHIPPLE, Judge.

This appeal concerns the res nova issue of the definition of gross negligence as contained in LSA-R.S. 40:1235 et seq. and its applicability under the facts presented herein. Plaintiffs, Lawrence and Carolyn Falkowski, and intervenor, Community Health Network of Louisiana, Inc., appeal the judgment of the lower court in favor of defendants, Joseph Maurus; Clifton Malone;[1] the City of Baton Rouge/Parish of East Baton Rouge through the Department of Emergency Medical Services (EMS); and the St. Paul Fire and Marine Insurance Company. The judgment dismissed with prejudice the action of plaintiffs and intervenor. For the following reasons, we affirm.

FACTS AND PROCEDURAL HISTORY

Lawrence Falkowski was diagnosed with diabetes in January of 1988. In the early evening of August 30, 1988, Dr. Falkowski suffered an episode of hypoglycemia, or low blood sugar, while sitting at a desk in his office at Louisiana State University. Dr. Falkowski's wife, Carolyn Falkowski, discovered her husband in his office in a sleep-like state and called 911 for emergency assistance.

At approximately 5:30 p.m., emergency medical technicians (EMTs) Joseph Maurus and Clifton Malone arrived on the scene. At the time of this incident, Maurus was an EMT paramedic, and Malone was an EMT intermediate.[2] After learning that Dr. Falkowski was diabetic, the EMTs determined that his blood sugar level was 40, which was "profoundly low" and that he was responsive only to pain stimuli, a potentially life-threatening situation.

Maurus then contacted Our Lady of the Lake Hospital to obtain authority to initiate a hypoglycemia protocol. Dr. Joseph Allain, the emergency room physician on duty that evening, authorized Maurus and Malone to proceed with the established protocol for hypoglycemic patients. Dr. Allain's authorization was not given directly, but was relayed to EMT Maurus through a nurse on duty at the hospital.[3]

While Maurus was obtaining authorization to initiate the hypoglycemia protocol, Malone searched for a viable vein to initiate a venipuncture. As an EMT intermediate, one of Malone's primary functions was initiating IVs. Malone related that he had difficulty locating a suitable site to initiate an IV on Dr. Falkowski, who weighed approximately 320 pounds at the time of the incident. Malone placed a tourniquet on Dr. Falkowski's right arm, but did not see any viable veins in the antecubital fossa (the inner portion of the bended elbow). Malone then searched the left arm for a viable vein, but "saw nothing there that [he] wanted to try." Malone then went back to the right arm because he had seen a vein in the wrist area that he thought could be suitable. Malone testified he then told Maurus the vein in the right wrist was the only vein he could locate.

According to Malone and Maurus, after receiving authorization to initiate the hypoglycemia protocol, an IV was established in Dr. Falkowski's right wrist, palm side up on the ulnar nerve side. Dr. Falkowski was then given two amps of Dextrose-50, which were injected into one of the IV ports. Following the administration of the Dextrose-50, Dr. Falkowski gradually regained consciousness and at some point complained of pain at the IV site and inability to use his right hand. Dr. Falkowski testified that upon regaining consciousness, he immediately noticed swelling in the area of the IV site. Maurus eventually discontinued the IV because of Dr. Falkowski's complaints.

Dr. Falkowski was transported to Our Lady of the Lake Hospital where he was *525 examined by Dr. Allain. Dr. Allain testified that he did not recall any swelling or blistering at the site of the IV or anything unusual about Dr. Falkowski's situation at the time he arrived at the hospital.[4] According to Dr. Allain, Dr. Falkowski was alert and able to respond to questions appropriately. Dr. Falkowski testified that he complained of numbness and loss of use of his hand, but was told that these problems were temporary. Dr. Falkowski was sent home later that evening.

The pain and swelling in Dr. Falkowski's right arm increased during the night until his entire arm from the shoulder to the fingertips was double its size by the next morning. Dr. Falkowski also had no feeling or motion in the right hand. Later that day, Dr. Falkowski was examined by Dr. Ted Kemp, the partner of Dr. David Ramey, the Falkowskis' family physician. After examining Dr. Falkowski, Dr. Kemp thought that Dr. Falkowski had possibly developed a deep venous thrombosis in the subclavian area (or blood clot in a deep vein in the area right under the collarbone) as well as thrombophlebitis (an inflammation or infection in the vein and surrounding skin). Dr. Kemp admitted Dr. Falkowski to Our Lady of the Lake Hospital.

Dr. Ramey, a specialist in internal medicine, took over Dr. Falkowski's care on the day after Dr. Kemp admitted him to the hospital. Dr. Ramey released Dr. Falkowski from the hospital on September 2, 1988, having ruled out deep venous thrombosis. Based on the numbness present in the last two fingers of the right hand, Dr. Ramey concluded Dr. Falkowski had probably sustained infiltration of the Dextrose-50, a hypertonic solution which can be extremely damaging to tissues and which had been administered to him during the hypoglycemic attack two days before, on August 30, 1988.

Dr. Falkowski was eventually treated by Dr. David Kline, a neurosurgeon and chairman of the Department of Neurosurgery at LSU Medical Center, upon referral by Dr. Steven Zuckerman, the neurologist who obtained nerve conduction studies. Dr. Kline determined that Dr. Falkowski was suffering from complete distal ulnar palsy, meaning that all the functions of the ulnar nerve from the wrist down were absent. On March 15, 1989, Dr. Kline performed surgery on Dr. Falkowski, removing the non-functioning segment of the ulnar nerve and replacing it with segments of sural nerve harvested from Dr. Falkowski's leg.

Dr. Kline saw Dr. Falkowski post-operatively on April 14, 1989 and September 11, 1989, at which times his ulnar palsy was unchanged. Dr. Kline explained that regrowth of the nerve, if any occurs, is a process that takes four or five years, and opined that Dr. Falkowski had a fifty percent chance of making a significant recovery over the next several years.

At trial, held on March 25 and 26, 1991, Dr. Falkowski testified that the surgery performed by Dr. Kline had produced no effect on his right hand in terms of function although the pain and swelling were reduced to some degree. Dr. Falkowski stated that he still experiences pain and periodic swelling in his right hand. As of the time of the trial, he had not regained use of the right hand and suffered loss of use of the muscles of the thumb.

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Cite This Page — Counsel Stack

Bluebook (online)
637 So. 2d 522, 1993 WL 651358, Counsel Stack Legal Research, https://law.counselstack.com/opinion/falkowski-v-maurus-lactapp-1993.