Myrick v. Hansa CA1/3

CourtCalifornia Court of Appeal
DecidedFebruary 27, 2015
DocketA139810
StatusUnpublished

This text of Myrick v. Hansa CA1/3 (Myrick v. Hansa CA1/3) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Myrick v. Hansa CA1/3, (Cal. Ct. App. 2015).

Opinion

Filed 2/27/15 Myrick v. Hansa CA1/3 NOT TO BE PUBLISHED IN OFFICIAL REPORTS California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

FIRST APPELLATE DISTRICT

DIVISION THREE

KODY PAUL MYRICK, Plaintiff and Appellant, A139810 v. (City & County of San Francisco S. NICK HANSA, Super. Ct. No. CGC-11-515329) Defendant and Appellant.

S. Nick Hansa, M.D., appeals a medical malpractice judgment against him, in favor of plaintiff Kody Paul Myrick. The claim arises from Hansa’s failure to take immediate measures to treat plaintiff’s stroke, although some irreparable damage had already occurred before Hansa assumed his care. Claims against other medical providers who provided earlier treatment were settled prior to trial. On appeal, Hansa does not challenge the jury’s finding that his treatment of plaintiff fell below the applicable standard of care, but he contends the evidence is insufficient to support the jury’s finding that his negligence caused plaintiff’s injury. He also contends the court erred in instructing the jury with regard to causation, calculation of damages, and the allocation of responsibility between him and the other medical providers. In addition, plaintiff has filed a cross-appeal challenging the trial court’s calculation of prejudgment interest. We find no error in the court’s instructions or in the sufficiency of the evidence. We conclude, however, that the court erred in the calculation of prejudgment interest.

1 Factual and Procedural Background Plaintiff’s complaint alleges a single cause of action for negligence. The following evidence was presented at trial: On Saturday, July 31, 2010, between 7:30 p.m. and 8:00 p.m., plaintiff suffered a life-threatening stroke. He was immediately taken by his father to Bakersfield Memorial Hospital (BMH). When he arrived at 8:50 p.m., the triage nurse identified his complaint as a possible stroke. The emergency room doctor, Dr. Caroline Han, ordered a CT scan. Unfortunately, the CT scan was misread by the radiologist, Dr. Bernard Maristany. Maristany identified a lacunar infarct, which is caused by small strokes, in the left thalamus but failed to identify the blood clot in the basilar artery in the back of plaintiff’s brain which, it was later determined, had caused plaintiff’s stroke. Hansa was the internist on call for BMH the night of plaintiff’s stroke. Plaintiff’s care was transferred to Hansa from Han between 11:40 p.m. and midnight. Hansa was informed of plaintiff’s symptoms and the possible stroke diagnosis. Han asked Hansa whether he would like her to call a neurologist, but Hansa said that would be done as part of plaintiff’s admission to the hospital. Hansa gave orders by telephone to have plaintiff admitted to BMH with the diagnosis of a possible stroke. Plaintiff spent the next eight hours on the ward at BMH, where nurses performed neurologic checks every two hours. Plaintiff’s symptoms fluctuated over the course of the night. Although he could not speak when he entered the emergency room, by 1:50 in the morning he was able to speak and answer questions and to move his right side on command. At 8:15 a.m. on August 1, however, plaintiff suddenly lost consciousness and control of his airway. The rapid response team was called. He was intubated and taken to the intensive care unit. As noted above, subsequent tests showed that a blood clot had traveled to plaintiff’s brain, blocking his basilar artery. After 20 days at BMH, plaintiff was transferred to Santa Clara Valley Medical Center, where he remained hospitalized for the next few months. At the time of trial, plaintiff could walk only a few steps when assisted by his parents and had difficulty speaking.

2 Considerable expert testimony was offered at trial. In summary, the expert testimony established that a stroke is a medical emergency requiring immediate evaluation and diagnosis because the window of time for successful treatment is measured in hours. “When possible stroke is raised as a possibility, . . . that mandates activation of a stroke alert and activating people who can help provide that therapy . . . [b]ecause the longer you wait, the therapy is less effective and at some point the window is completely closed for that therapy.” For example, t-PA (tissue plasminogen activator) is a clot-dissolving medication that can be given stroke patients up to four and one-half hours after the onset of symptoms. The experts agreed that plaintiff was outside the treatment window for t-PA when his care was transferred to Hansa around midnight. Another treatment option is a thrombectomy, which involves sending a device up a vessel to catch and remove the blood clot. The window for a thrombectomy is generally eight hours after the onset of symptoms. BMH is a community hospital that is not equipped to handle certain medical emergencies. In 2010, BMH had a teleneurology system in place for physicians to obtain emergency neurology evaluation of any patient who presented with a possible stroke. BMH, as a community hospital, also had a system to transfer patients to tertiary care centers if more complicated procedures such as a thrombectomy were deemed necessary. Plaintiff’s expert, Benny Gavi, M.D., testified that Hansa violated the standard of care by admitting plaintiff to BMH instead of referring him to a neurologist immediately. He also opined that if the teleneurologist had been called around midnight and consulted about plaintiff’s condition, the teleneurologist would have asked for a CT angiogram and informed the treating doctor that the patient will need to be transferred to a tertiary care center. Another expert, Dr. Steven Hetts, testified that plaintiff’s outcome would have been substantially improved if a thrombectomy had been performed the morning of August 1. The jury returned a unanimous verdict in favor of plaintiff. The jury found that Hansa was negligent, and that his negligence was a substantial factor in causing harm to plaintiff. The jury found that plaintiff’s economic and non-economic damages totaled

3 more than $12 million and allocated 40 percent of the fault to Hansa. After deducting amounts received in the prior settlements, the court entered judgment against Hansa in the principal amount of $4,596,375 plus $473,426 interest. Hansa filed a timely notice of appeal. Plaintiff cross-appealed. Discussion I. Direct Appeal 1. Substantial evidence supports the jury finding of causation. The jury was instructed that to establish his claim against Hansa, plaintiff must prove, among other elements, that Hansa’s negligence was a substantial factor in causing plaintiff’s harm. The instructions explained that “[a] substantial factor in causing harm is a factor that a reasonable person would consider to have contributed to the harm. It must be more than a remote or trivial factor. It does not have to be the only cause of the harm. [¶] Conduct is not a substantial factor in causing harm if the same harm would have occurred without that conduct.” The jury was also instructed, “A person’s negligence may combine with another factor to cause harm. If you find that Sahaphun Hansa, M.D.’s negligence was a substantial factor in causing Kody Paul Myrick’s harm, then Sahaphun Hansa, M.D. is responsible for the harm Sahaphun Hansa, M.D.

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Bluebook (online)
Myrick v. Hansa CA1/3, Counsel Stack Legal Research, https://law.counselstack.com/opinion/myrick-v-hansa-ca13-calctapp-2015.