Kirby v. State ex rel. Louisiana State University Board of Supervisors

174 So. 3d 1, 2014 La.App. 1 Cir. 0017, 2014 La. App. LEXIS 2705, 2014 WL 5791567
CourtLouisiana Court of Appeal
DecidedNovember 7, 2014
DocketNo. 2014 CA 0017
StatusPublished
Cited by3 cases

This text of 174 So. 3d 1 (Kirby v. State ex rel. Louisiana State University Board of Supervisors) 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
Kirby v. State ex rel. Louisiana State University Board of Supervisors, 174 So. 3d 1, 2014 La.App. 1 Cir. 0017, 2014 La. App. LEXIS 2705, 2014 WL 5791567 (La. Ct. App. 2014).

Opinions

PETTIGREW, J.

|2In this medical malpractice action, the defendant, the State of Louisiana through the Louisiana State University Board of Supervisors, The Louisiana State University Health Sciences Center, Earl K. Long Medical Center (hereinafter, collectively referred to as “defendant” or “EKL”) appeals a judgment rendered against it based on a jury verdict finding that the internal medicine physicians and staff, as well as the general hospital administrative staff at Earl K. Long Medical Center, breached the established applicable standard of care, and that those breaches caused damages and the ultimate death of fifty-one-year-old Amy Kirby. After a thorough review of the record, we find no merit to the defendant’s assignments of error, and affirm the judgment. Likewise, we find no merit in the plaintiffs’ answer to the appeal, seeking damages for a frivolous appeal, and decline to render an award.

SUMMARY OF BACKGROUND FACTS AND PROCEDURAL HISTORY

On December 19, 1993, Ms. Kirby married the plaintiff, John Kirby, and together they had a child, plaintiff Jonathan Kirby. Ms. Kirby also had three children from a prior marriage, plaintiffs Michelle C. Norton, William Andrew Cuny, and Angela Renee Cuny. In 1994, Ms. Kirby graduated as a registered nurse from Our Lady of the Lake School of Nursing. She worked at the OLOL Medical Center in the Neurology Department, and then later worked as a home health nurse. She was forced to retire due to a back injury sustained in a 1999 automobile accident, for which she took opioid medications. Although Mr. Kirby was employed at Superior Ford, the family had personal financial difficulties and had lost its medical insurance coverage.

Ms. Kirby died at EKL on August 7, 2008, two days after being admitted for continued complaints of severe and worsening abdominal pain and constipation, for which she had previously made several recent trips to the emergency room (ER) at EKL. The medical occurrences that led up to Ms. Kirby’s death were a perforated colon at the | ¡¡cecum that allowed liquid stool into her abdominal cavity, after which she became septic, and developed DIC1 and metabolic acidosis.

The record reveals that throughout the two days leading up to her death, Ms. Kirby screamed in agony that she was rupturing from the inside, felt that she was dying, and pleaded with the EKL staff to do surgery, or something, to relieve her of the unrelenting and unbearable pressure and pain in her abdomen. Instead, the EKL staff continued the same treatment it had administered from the inception of her complaints — administering increasingly strong laxatives, enemas, and pain medication. And indeed, as she predicted, Ms. [4]*4Kirby’s colon ruptured and as a result she ultimately died.

The record also reveals that there were other tests available that were not performed, specifically, a CT of the abdomen, a colonoscopy, and/or a hy-paque/gastrografin enema, through which the EKL physicians would have been able to diagnose Ms. Kirby’s malfunctioning bowel, and decompress her expanding colon before it ruptured. Further, the record evidences that the interns and residents attending to Ms. Kirby, including them supervisors, failed to timely or adequately address Ms. Kirby’s agonizing screams due to her symptoms or modify the treatment she was being given despite that the treatment showed no signs of improving her symptoms or her condition.

EKL appeals the judgment adopting the jury verdict, which was consistent with a prior medical review panel opinion, concluding that the administrative staff and internal medicine physicians at EKL breached the standard of care owed to Ms. Kirby and that those breaches caused her injuries and death.2 The jury awarded damages in excess of $1,750,000.00, which were reduced to the medical malpractice cap of $500,000.00. The defendant did not assign error to the damage award; it is not at issue in this appeal.

^SPECIFIC FACTUAL BACKGROUND

Approximately three weeks prior to her death, Ms. Kirby was hospitalized at Lane Memorial Hospital (Lane), from July 15, 2008 to July 17, 2008, for tests and evaluation of complaints of abdominal pain and weight loss. An abdominal CT scan performed at Lane reveáled a pancreatic mass and a nearby lymph node was indicative of metastasizing pancreatic cancer. She was released from Lane on July 17, with the continued prescribed use of oxycodone for pain and with instructions to report for follow-up treatment at EKL’s Hematology/Oncology Clinic.

Ms. Kirby reported to the EKL clinic on the date of her appointment, July 24, 2008, but was told she did not have one scheduled. However, on that date, she did see a nurse practitioner who ordered some lab work and also scheduled appointments for Ms. Kirby to return to biopsy, confirm, and stage her pancreatic cancer.

However, prior to those appointments, on July 30, 2008, Ms. Kirby went to the EKL ER complaining of pain to her back, stomach, and ribs. An abdominal examination at this time revealed diffuse abdominal pain, with bowel sounds present. She reported that her last bowel movement had been the day before. Her prior lab tests indicative of cancer were confirmed; her previously scheduled appointments were confirmed and moved up to August 6, 2008; and she was discharged that same day with additional pain medication.

The next day, July 31, -2008, Ms. Kirby reported to the ER at Lane with the same complaints of ■continuing abdominal pain, now radiating to her back. An abdominal x-ray was performed that revealed scattered gas within her small and large intestines, but no evidence of acute intra-ab-dominal problems. She was administered additional narcotic medication and discharged that same day.

The following day, August 1, 2008, Ms. Kirby was still in severe abdominal distress and EMS was called to her’ home. The EMS reports reflect that she complained of pain in the left upper quadrant [5]*5of her abdomen, radiating into her mid-back. She was transported to EKL where she complained of increasing and worsening abdominal pain despite taking morphine and oxycodone. She was admitted to the hospital for observation and pain medication regulation. She was started on a fentanyl patch for the 1 ^breakthrough pain, which Ms. Kirby reported helped control her pain much better than anything had before. X-rays of her abdomen were performed that revealed,“a moderate degree of retained stool throughout the colon.” She was diagnosed with refractory narcotic-induced constipation and was placed on a bowel regimen of laxatives and stool softeners. She was discharged at approximately 3:00 p.m. on August 2, 2008, despite that she was unable to have a bowel movement while at the hospital.

However, at 10:49 p.m. that same day, EMS was again called to her home, and the responders found Ms. Kirby in a fetal position, complaining of increasing pain for the past six hours that was getting worse. She was transported back to the EKL ER, and records indicate she complained of “periumbilical” (around the belly button) abdominal pain and reported that she had not had a bowel movement in three days. She was examined again, and her abdomen was noted to be firm, distended, and tender to palpation. An x-ray revealed that she had, a large amount of retained stool in her ascending colon (indicating that.the stool was not moving as it should through the colon), but no free air, or evidence of a small bowel obstruction.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
174 So. 3d 1, 2014 La.App. 1 Cir. 0017, 2014 La. App. LEXIS 2705, 2014 WL 5791567, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kirby-v-state-ex-rel-louisiana-state-university-board-of-supervisors-lactapp-2014.