Reginald Lewis, on Behalf of Robert Lewis, Jr. v. Cornerstone Hospital of Bossier City, LLC

CourtLouisiana Court of Appeal
DecidedSeptember 25, 2019
Docket53,056-CA
StatusPublished

This text of Reginald Lewis, on Behalf of Robert Lewis, Jr. v. Cornerstone Hospital of Bossier City, LLC (Reginald Lewis, on Behalf of Robert Lewis, Jr. v. Cornerstone Hospital of Bossier City, LLC) 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
Reginald Lewis, on Behalf of Robert Lewis, Jr. v. Cornerstone Hospital of Bossier City, LLC, (La. Ct. App. 2019).

Opinion

Judgment rendered September 25, 2019. Application for rehearing may be filed within the delay allowed by Art. 2166, La. C.C.P.

No. 53,056-CA

COURT OF APPEAL SECOND CIRCUIT STATE OF LOUISIANA

*****

REGINALD LEWIS, ON BEHALF Plaintiff-Appellant OF ROBERT LEWIS, JR.

versus

CORNERSTONE HOSPITAL OF Defendant-Appellee BOSSIER CITY, LLC

Appealed from the Twenty-Sixth Judicial District Court for the Parish of Bossier, Louisiana Trial Court No. 151,867

Honorable E. Charles Jacobs, Judge

THOMAS, SOILEAU, JACKSON, Counsel for Appellant BAKER & COLE, LLP By: Steven E. Soileau

HUDSON, POTTS, & BERNSTEIN Counsel for Appellee By: Gordon L. James Sara G. White

Before MOORE, PITMAN, and GARRETT, JJ. MOORE, J.

Reginald Lewis appeals a jury verdict that denied his claims for

medical malpractice and invasion of privacy involving his late father, Robert

Lewis (“Mr. Lewis”), as well as a judgment that denied his motion for

JNOV. The case involves treatment that Mr. Lewis received at Cornerstone

Hospital, a long-term acute care facility, from April 17 to April 30, 2015.

For the reasons expressed, we affirm.

FACTUAL BACKGROUND

The 63-year-old Mr. Lewis, a Vietnam veteran and longtime smoker,

went to the emergency room at the VA hospital in Shreveport with

complaints of speech changes, fatigue, decreased oral intake, and weight

loss. Dr. Sean Troxclair, an internist, critical care and nutrition physician,

admitted him and became his treating physician. Mr. Lewis weighed only

88 pounds, was about half the normal body mass index, and needed

aggressive nutritional support. A CT scan showed a large malignant mass in

his throat; it was cancer. He underwent surgery to remove the mass.

Doctors also inserted a feeding tube (called a “PEG”) into his abdomen to

provide nutritional access and a tracheostomy (“trach”) into his throat to

secure his airway. While at the VA, he developed a large (3 cm × 3 cm)

decubitus ulcer, Stage III, in the sacral area. The oncologist at the VA said

Mr. Lewis needed chemotherapy, but could not undergo it because he was so

underweight.

Dr. Troxclair transferred Mr. Lewis to Cornerstone on April 17 so he

could gain weight and strength, with the plan of beginning chemo and

radiation to treat the cancer. Despite his health problems, doctors at the VA described Mr. Lewis as in “good condition”; Dr. Troxclair said he was

talking, using a walker, oriented, and having no problem with the PEG or

trach. Dr. Troxclair sent dietary instructions to Cornerstone: give Mr. Lewis

Impact 1.5 at 60 ml/hour, and feed him like a 70 kg (154-lb.) man instead of

the 40-45 kg (88-99-lb.) man he was.

Mr. Lewis arrived at Cornerstone on April 17 and was admitted to the

ICU by Dr. Allan Matriano-Lim, an internist and pediatrician with privileges

there. Oddly, neither Dr. Matriano-Lim nor Cornerstone’s clinical dietician,

Valerie Calhoun, could recall ever seeing Dr. Troxclair’s dietary

instructions. However, Ms. Calhoun recalled seeing some orders from the

VA, and Dr. Matriano-Lim gave orders to feed Mr. Lewis Vital 1.5 at 60

ml/hour. (Ms. Calhoun testified that Cornerstone did not stock Impact 1.5,

so they used Vital 1.5 instead.) After two days in ICU, Mr. Lewis was

moved to the “floor.”

At this point, unfortunately, Mr. Lewis’s condition started to go

downhill. On April 19, he refused his PEG feeding, demanded solid food,

and complained to Ms. Calhoun about cramps and nausea. Thinking he

could not tolerate the high volume and protein of Vital 1.5, Ms. Calhoun

switched him to a formula called Peptamen 1.5 at 50 ml/hour, and he seemed

to respond better. However, on April 22, Dr. Matriano-Lim issued a new

order to use Impact 1.5, which they had ordered but not yet received, so they

resumed using Vital 1.5. On April 23, Mr. Lewis vomited it up, and on

April 24, he refused any more tube feeding. On April 25, an attending

physician, Dr. Jackson, found abdominal distension and ordered tube-

feeding stopped; he placed Mr. Lewis on an intravenous (“IV”) feed of

ProcalAmine at 77 ml/hour. Mr. Lewis also pulled out his trach at least 2 three times, and nurses simply replaced it, without notifying Dr. Matriano-

Lim. On April 27, nurses charted “dark liquid input” into Mr. Lewis’s

genitourinary bag, but did not chart that they notified the doctor of this,

either.

On April 28, at 3:00 am, nurses discovered that Mr. Lewis had pulled

out his PEG tube (which must have involved some effort and some pain).

Nurses removed the broken sutures, and cleaned and dressed the site; at 8:00

am, they called Dr. Matriano-Lim about this. At 8:15, he ordered them to

place a catheter in the PEG site and consult with a general surgeon, but he

did not label this STAT or urgent. No surgeon ever came, but nurses

inserted the catheter by 8:35. Cornerstone’s chief of nursing, Tamara

Grimm, felt this was acceptable since Mr. Lewis was getting IV nutrition by

then.

Cornerstone’s case manager, Connie Combs, testified that she became

“very concerned” about Mr. Lewis’s changes at this point. She faxed a

clinical update to the VA (but not directly to Dr. Troxclair), advising that the

PEG feeding had been “on hold” since April 25 because of abdominal

distension, but that Mr. Lewis was on IV ProcalAmine; he had a wound on

his backside; and he had walked 265 feet with a rolling walker. The next

day, April 29, she phoned her contact at the VA, a Ms. Sanders, to make

sure they got the message. On April 30, Dr. Troxclair finally received this

information and ordered Mr. Lewis transferred back to the VA.

On his return to the VA, Mr. Lewis was not in good shape. He was

still emaciated, was noncommunicative, had irritation around his trach and

PEG sites, and still had the decubitus ulcer. Because of his malnutrition and

distended abdomen, he was not a candidate for surgery or chemo. After 3 consultation with Reginald, Mr. Lewis’s son, Dr. Troxclair placed him on

palliative care, and he died on May 19.

During this ordeal, Reginald had been driving down from his home in

Topeka, Kansas, every week or two to see his father. He admitted the

prognosis was bad, but his dad was “a little better” by the time he was sent

to Cornerstone. In one visit, early during Mr. Lewis’s stay there, he

“seemed okay,” and even wanted to leave and go with the family to

Walmart. Reginald was alarmed when he heard how bad his dad’s situation

was on his return to the VA. At some point, Reginald called Dr. Troxclair,

who apparently vented some frustration at Cornerstone, blaming it for

allowing the patient to lose weight and get an ulcer on his backside.

According to Reginald, Dr. Troxclair told him, “We had him up, almost

jogging, ready to go to the store,” but once at Cornerstone, “he turned so

fast.” Reginald then called Ms. Combs, the case manager at Cornerstone, to

complain, particularly about the ulcer Mr. Lewis got while there.

On May 20, two Cornerstone employees, William Candler, director of

provider relations, and Lindsey Trainor, clinical liaison, went to the VA to

talk to Dr. Troxclair; according to Candler, he “had questions” and they “did

not have the answers.” They checked their records and, on May 27, went

back to the VA to advise Dr. Troxclair that Mr. Lewis already had that ulcer

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