Reid v. North Caddo Memorial Hosp.

528 So. 2d 653, 1988 La. App. LEXIS 1029, 1988 WL 43146
CourtLouisiana Court of Appeal
DecidedMay 4, 1988
Docket19588-CA
StatusPublished
Cited by8 cases

This text of 528 So. 2d 653 (Reid v. North Caddo Memorial Hosp.) 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
Reid v. North Caddo Memorial Hosp., 528 So. 2d 653, 1988 La. App. LEXIS 1029, 1988 WL 43146 (La. Ct. App. 1988).

Opinion

528 So.2d 653 (1988)

John D. REID, Appellant,
v.
NORTH CADDO MEMORIAL HOSPITAL, Appellee.

No. 19588-CA.

Court of Appeal of Louisiana, Second Circuit.

May 4, 1988.

*654 Edmund M. Thomas, Shreveport, for appellant.

Mayer, Smith & Roberts by Alex F. Smith, Jr., Shreveport, for appellee, North Caddo Memorial Hosp.

Nelson, Hammons & Johnson by John L. Hammons, Shreveport, for appellee, William R. Brown, M.D.

Before HALL, SEXTON and NORRIS, JJ.

NORRIS, Judge.

In this medical malpractice action tried before a judge plaintiff, John Reid, appeals the judgment granted in favor of defendants, Dr. William R. Brown and North Caddo Memorial Hospital. We affirm.

On Sunday, October 26, 1980 John Reid was involved in an altercation with his wife's boyfriend. According to the plaintiff the second blow he struck knocked out three of the victim's teeth and cut the little finger of his left hand. Reid sought treatment at the emergency room of North Caddo Memorial Hospital in his hometown, Vivian, Louisiana. Reid drove from south Shreveport, where the altercation took place, to Vivian in an effort to evade any legal consequences of his assault. Reid testified that when he was first admitted to the emergency room at 2:00 or 3:00 p.m. he told the head nurse that he had hurt his left little finger during a fight, having "hung it on a boy's tooth." Reid was then treated by the defendant, Dr. William R. Brown. Dr. Brown was a resident at the LSU Medical Center who "moonlighted" during weekends by providing emergency room services for the hospital. Dr. Brown testified that he had no specific recollection of treating Reid, and that he could only rely on what was written on the emergency room sheet. Reid testified that he had told Dr. Brown he injured his finger during a fight, and that he had made it clear the cut was from a tooth. Dr. Brown's notes on the emergency room record said there was a 2 centimeter (¾") laceration on the dorsum (the top side of the hand). There were also notations that the cut was sustained during a fist fight, that he questioned whether the wound was secondary to a human tooth, and that he elected his treatment on the basis of a doubtful bite history. The emergency room notes indicate that Dr. Brown X-rayed the finger, which revealed nothing abnormal, irrigated the wound with saline solution, sutured the cut closed, applied Geramycin ointment (a local antibiotic), and wrapped the wound in a sterile dressing and an ace bandage. Dr. Brown also concluded from his notes that he had instructed Reid on the signs of infection and instructed him to return to the clinic if they manifested. There was no notation of when he told Reid to see another doctor, but Dr. Brown testified that his customary practice was to tell the patient to see Dr. Haynes the next day. Reid said that he was told to see Dr. Haynes on Wednesday.

Reid testified that he returned to the emergency room later that same evening complaining of extreme pain in his arm and hand, and that Dr. Brown gave him Tylenol 3 but did not re-examine the wound. The emergency room records show that Reid was given the pain killer, but do not reflect a second visit. October 28, Tuesday night, a friend drove Reid to see Dr. Haynes at the hospital. Reid told the doctor he was in pain and how he had been injured. Reid's left little finger was infected when Dr. Haynes saw it. He treated the wound by removing the stitches, opening the wound, cleaning it, hospitalizing Reid and placing him on intravenous antibiotics. Reid was discharged from the hospital November 4. Dr. Haynes saw him again on the 7th and 10th of November. On November 10 he sent Reid to Dr. McAlister, an orthopedic specialist.

Dr. McAlister first saw Reid November 11, 1980. In his deposition (Dr. McAlister did not testify at trial) Dr. McAlister stated that Reid had suffered persistent soreness *655 and stiffness in the hand. X-rays revealed some narrowing of the joint space, which resulted in permanent injury. Dr. McAlister concluded that Reid had an active infection and septic arthritis in the joint, which needed drainage. Reid entered the hospital November 12. Dr. McAlister irrigated and debrided the joint, and inserted a closed suction tube for drainage. Reid remained in the hospital four days. On January 23, 1981 Reid was discharged from Dr. McAlister's care. Reid did not seek medical attention again until July 9, 1982 when he returned complaining that he had difficulty gripping and holding large objects. At that time he had a motion range of 0° to 40° in the MP joint, as opposed to a norm of 0° to 70° or 90°. Dr. McAlister assigned him a 40% disability rating of the little finger, or a disability rating of 4% of the whole hand.

Reid is a left-handed welder, who testified to significant lost income and difficulty with his work due to the disability.

Reid named Dr. Brown, North Caddo Memorial Hospital and their respective insurers defendants in a medical malpractice suit. At the close of the trial North Caddo Memorial Hospital was released in its individual capacity but remained party to the suit as Dr. Brown's employer. At trial the plaintiff called Dr. Ricky Jones, an expert in family medicine; Dr. Malcomb P. Russell, Director of the Huey P. Long Hospital emergency services and a clinical instructor in the Department of Medicine from Tulane; and the defendant, Dr. William R. Brown on cross examination. The defendants' experts were Dr. Brown; Dr. Norris Knight of Texarkana, a specialist in the field of orthopedic surgery; and Dr. John H. Haynes, Director of the North Caddo Memorial Hospital, a family practitioner. The deposition of Dr. Clinton G. McAlister, a Shreveport/Bossier City specialist in hand surgery was entered into evidence by the stipulation of both parties.

After hearing the evidence the trial judge concluded that the applicable standard of care for Dr. Brown was that of a general practitioner practicing in an emergency room setting. The judge found that "there are no set medical standards as to suturing of human bite wounds or administration of antibiotics," and that Dr. Brown's initial treatment of debriding the wound, suturing it, applying Geramycin ointment, wrapping the hand, explaining the symptoms of infection, and instructing Reid to see his regular doctor within a few days did not constitute malpractice. The judge also found that Dr. Brown's failure to re-examineReid's hand when he returned that night was not a breach of the standard of care owed to the plaintiff, because Dr. Brown could not have discovered the infection at that point in time even if he had re-examined the hand.

Plaintiff appeals, with four assignments of error:

(1) The lower court erred in its factual finding that the defendant, Dr. Brown debrided the wound.

(2) The lower court erred in misconstruing the testimony of the medical experts, regarding the failure to take a proper history, the failure to make a thorough examination; and therefore, determining it was a deep penetrating wound, the failure to treat the wound as contaminated, the failure to leave the wound open, the failure to irrigate it, the failure to debride it, the failure to either hospitalize the patient or instruct the patient to return within twenty-four hours for specific follow-up and the failure to treat or re-examine when the patient returned to the hospital with additional complaints.

(3) The lower court erred in [by] determining as a medical fact that when Mr. Reid returned, his symptoms could not have been symptoms of infection because infection can only manifest itself at its earliest within twenty-four hours and therefore, a failure on the part of Dr.

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Bluebook (online)
528 So. 2d 653, 1988 La. App. LEXIS 1029, 1988 WL 43146, Counsel Stack Legal Research, https://law.counselstack.com/opinion/reid-v-north-caddo-memorial-hosp-lactapp-1988.