Jones v. Bick

891 So. 2d 737, 2004 La.App. 4 Cir. 0758, 2004 La. App. LEXIS 3221, 2004 WL 3030024
CourtLouisiana Court of Appeal
DecidedDecember 15, 2004
DocketNo. 2004-CA-0758
StatusPublished
Cited by1 cases

This text of 891 So. 2d 737 (Jones v. Bick) 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
Jones v. Bick, 891 So. 2d 737, 2004 La.App. 4 Cir. 0758, 2004 La. App. LEXIS 3221, 2004 WL 3030024 (La. Ct. App. 2004).

Opinion

| MOAN BERNARD ARMSTRONG, Chief Judge.

The surviving brothers and sisters of David M. Jones, who died in March of 1998, brought this medical malpractice case against Doctors John Bick, Ricardo Febry, Nancy Lehman, Hope Cromer, Malcolm Andry and Christine Smith. The plaintiffs claimed that David Jones’ death was caused by the appellants’ negligent treatment and inappropriate administration of the drug, Clozaril. Doctors Febry and Andry filed their answer, noting that the plaintiffs’ complaint was presented to a statutory medical review panel that concluded that the doctors complied with acceptable standards of care, and pleading the statutory maximum recovery of $100,000 should plaintiffs prove liability. Doctors Bick, Lehman, Cromer and Smith, and the State of Louisiana1, filed answer claiming the benefit of the provisions of the Louisiana State Employees Medical Malpractice Act, LSA-R.S.40:1299.39 et seq. (The Public Act).

12Doctors Cromer and Smith filed a motion for summary judgment that the trial court denied on September 5, 2003.

The case was tried on the merits to the trial judge on September 15, 16 and 17, 2003. On November 10, 2003, the trial court rendered a final, second amended judgment against Dr. Bick, awarding each plaintiff $50,000 in general damages; awarding plaintiff Ruby Jones $4,264.00 for funeral expenses; dismissing with prejudice the plaintiffs’ survival action on behalf of David Jones; dismissing plaintiffs’ wrongful death and survival actions against Doctors Febry, Andry, Lehman, Cromer and Smith; and casting Dr. Bick in judgment for court costs, expert witness fees and judicial interest from the date of demand until paid. _ Plaintiffs did not appeal the judgment, but filed an answer to the appeal claiming that Doctors Cromer and Smith were hable with Dr. Bick and the State.2 The State of Louisiana, Louisiana State University Health Sciences Center (the State) and Dr. Bick, and the plaintiffs filed motions for new trial that the trial court denied on January 15, 2004, and the State and Dr. Bick subsequently filed this appeal. For the reasons that follow we amend the judgment to remove the name of Dr. John Bick and, as amended, affirm the judgment of the trial court.

During the late 1980s, Mr. Jones experienced auditory and visual hallucinations. He reported to his doctors that he heard voices and had visions of a “hit man” and a man dressed in an Army uniform. In 1990, at the age of thirty, Mr. Jones was diagnosed with severe chronic paranoid [740]*740schizophrenia. Ih 1996, |3while being treated as an outpatient at Chartres Mental Health, his sister, Ruby Jones, transferred his care to Dr. Smith in the Touro Infirmary Partial Hospitalization Program (PHP). Under this program, Mr. Jones would attend the psychiatric treatment facility daily from 9:00 a.m. until 3:00 p.m., whereupon he would return home.

From 1990 to 1997, he was treated with a variety of anti-psychotic medications, including Haldol, Novane, Risper-dal, and Zyprexa. The litigants agree that these drugs produced only mild or sporadic relief from Mr. Jones’ severe psychotic episodes. In the fall of 1997, Dr. Smith observed the lack of relief provided by Zyprexa, and recommended to Mr. Jones and to his sister, Ruby Jones, that Mr. Jones should begin a trial of Clozaril. The communication of this recommendation to Ruby Jones was consistent with her active participation in her brother’s care. His doctors considered Ms. Jones an integral part of her brother’s care and support system during the time he was a psychiatric outpatient. The expert testimony indicates that Clo-zaril is a powerful drug, with dangerous side effects, and can be considered a drug of last resort.

In early February, 1998, Dr. Smith prescribed 12.5 mg of Clozaril each day. The dosage was to increase gradually (“ti-trate”) over a six-week period to the level of 150 mg per day. According to the 1998 edition of the Physicians’ Desk Reference, a joint exhibit, this was slower than the manufacturer’s recommended rate of increase in dosage. The Touro Infirmary Pharmacy issued Mr. Jones’ first Clozaril prescription on February 6, 2004.

[4At the same time, Mr. Jones complained of back pain and was diagnosed with hypertension. The record shows that Mr. Jones was referred to internist Dr. Ricardo Febry and presented with a family history of heart attacks and strokes. Furthermore, Mr. Jones was overweight, smoked, complained of back pain and had high cholesterol. Dr. Febry began treating Mr. Jones’ hypertension and performed a cardiac workup in connection with the February, 1998 referral. An echocardio-gram demonstrated that over a six-month period Mr. Jones’ heart became enlarged because of his chronic high blood pressure. Dr. Febry’s initial patient assessment noted that this hypertension was causing damage to the heart requiring intervention and treatment.

In early March, 1998, the PHP staff noticed that despite having been on Clo-zaril for nearly a month, Mr. Jones was still highly psychotic, with possible suicidal ideations. On March 12, 1998, he was admitted as an in-patient to Touro’s psychiatric unit, where Dr. Bick supervised his psychiatric care. The purpose of the admission was to place Mr. Jones in a controlled environment where his medication could be increased to a therapeutic level of between 400 and 900 mg of Clozar-il per day without the risk of Mr. Jones harming himself or others.

The hospital record shows that on March 12 and 13, he was extremely hypertensive, and the psychiatry service referred him for an internal medicine consult to address the back pain and high blood pressure findings. Dr. Febry continued his treatment in response to the consult. Dr. Febry added Procardia to the Norvase and Lotensin Mr. Jones was taking for hypertension. These | ¿medications are members of the class of benzodiazepines, which can interact adversely with Clozaril to cause, among other side effects, sudden death. During this hospitalization, Mr. Jones experienced several of the known adverse side effects to Clozaril, those being drowsiness, weakness, incontinence, [741]*741slurred speech, depression, hypertension, hypotension, hypersalivation, back pain and altered states of consciousness.

On the evening of March 13, a Touro nurse called Dr. Febry to report that Mr. Jones’ lethargy and slurred speech could be associated with an evening dosage of Clozaril. Dr. Febry testified that this medication was within Dr. Bick’s area of expertise, but said he began at that time to question the relationship between Mr. Jones’ symptoms and his taking Clozaril. He ordered discontinuation of the Clozaril and prescribed Benadryl to address Mr. Jones’ slurred speech. At 10:45 that evening, Mr. Jones reportedly became weak and fell on his way to the bathroom.

The next morning, Dr. Febry, Dr. Bick and psychiatric resident Dr. Lehman met, whereupon Dr. Febry deferred to Dr. Bick’s decision to reinstate the Clozaril, reasoning that a psychiatrist is responsible for knowing the medications he prescribes.' The doctors decided, on Dr. Bick’s recommendation, to continue Mr. Jones’ Clozaril and to increase the dosage to a therapeutic range. Mr. Jones received Clozaril at 1:30 and 100 mg, 50 mg less than his pre-hospitalization dosage level, at 5:00 p.m. The evening of March 14 passed without further incident.

|fiOn March 15, Mr. Jones ate breakfast and took his morning medications, including a 100 mg dose of Clozaril, without reported difficulty.

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Bluebook (online)
891 So. 2d 737, 2004 La.App. 4 Cir. 0758, 2004 La. App. LEXIS 3221, 2004 WL 3030024, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jones-v-bick-lactapp-2004.