Sibley v. BD. OF SUP'RS OF LA. ST. UNIV., ETC.

446 So. 2d 760
CourtLouisiana Court of Appeal
DecidedMay 25, 1984
Docket83-CA-0411
StatusPublished
Cited by9 cases

This text of 446 So. 2d 760 (Sibley v. BD. OF SUP'RS OF LA. ST. UNIV., ETC.) 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
Sibley v. BD. OF SUP'RS OF LA. ST. UNIV., ETC., 446 So. 2d 760 (La. Ct. App. 1984).

Opinion

446 So.2d 760 (1983)

Henry A. SIBLEY, III, Curator of Jane Elizabeth Sibley, Interdict
v.
The BOARD OF SUPERVISORS OF LOUISIANA STATE UNIVERSITY AND AGRICULTURAL AND MECHANICAL COLLEGE.

No. 83-CA-0411.

Court of Appeal of Louisiana, First Circuit.

December 30, 1983.
Rehearing Denied February 28, 1984.
Writ Granted May 25, 1984.

*761 David W. Robinson, and Steve Marks, Baton Rouge, for plaintiff-appellant.

Vincent Fornias, Baton Rouge, for defendant-appellee.

Before LOTTINGER, EDWARDS and ALFORD, JJ.

*762 EDWARDS, Judge.

Henry A. Sibley, III, brother and curator of Jane Elizabeth Sibley, sued the Board of Supervisors (the Board) of Louisiana State University and Agricultural and Mechanical College (LSU) and Louisiana Health Services, doing business as Blue Cross,[1] for injuries suffered by Ms. Sibley during her hospitalization and treatment in the psychiatric ward of the Confederate Memorial Medical Center (Confederate), owned by the State and operated by the Board as an adjunct to the Louisiana State University Medical Center (LSUMC) in Shreveport.[2]

Plaintiff successfully proved at trial that Ms. Sibley was misdiagnosed at Confederate for psychotic depression and wrongly administered certain antipsychotic drugs, called neuroleptics, over a period of five weeks in dosages and combinations which reached toxic levels in her bloodstream. Weakened and poisoned by the drugs, she eventually suffered a cardiopulmonary arrest. She survived but during the crisis, her brain was deprived of oxygen and she suffered massive permanent brain damage as a result.

The trial court rendered judgment in favor of the plaintiff, but under the provisions of LSA-R.S. 40:1299.39 limited the defendant's liability to $500,000.00. Plaintiff appeals this judgment, contending that the limitation of liability in LSA-R.S. 40:1299.39 is not applicable because of the independent "corporate" negligence of Confederate. He also argues that if LSA-R.S. 40:1299.39 is applicable, its limitation of liability provision violates Article XII, Section 10(A) of the Louisiana Constitution.

The following facts, presented in some detail, are undisputed. During the summer of 1980, Jane Sibley, 19 years old, was living in Shreveport, Louisiana, with her great-aunt and uncle and working at Willis-Knighton Hospital. She had been living with her mother and sister in Baton Rouge, and had briefly attended LSU there, but her mother's alcoholism along with other family problems had caused her to move away. She returned home for a visit over the 4th of July weekend. Something happened over that weekend which was never brought out at trial, and which apparently precipitated Ms. Sibley's subsequent mental illness. After she returned to Shreveport, within a very short time she became increasingly withdrawn and uncommunicative. Her co-workers noticed a change in her normally cheery disposition and neat appearance. Diane Andrews, her supervisor at Willis-Knighton had her examined by a hospital physician who immediately referred her to Dr. George Seiden, a private psychiatrist who practices out of Brentwood Hospital, a private mental health facility in Shreveport.

Dr. Seiden diagnosed her condition as reactive depression, an affective disorder in which changes in a person's mood are caused by external or environmental stresses, and which is distinguished from endogenous depression which results from internal or biological changes affecting one's mood or emotional state independent of any environmental stresses or stimuli. He prescribed no medication for her treatment, opting instead for psychotherapy.[3] He treated her for three weeks, from mid-July to August 7, before financial difficulties necessitated her transfer to Confederate.

On August 7, 1980, under an emergency certificate of commitment, Ms. Sibley was transferred to the psychiatric ward on the tenth floor of Confederate.[4]

*763 In the psychiatric service, two teams are responsible for treatment of the patients. Each is headed by a faculty psychiatrist responsible for supervising and training the residents, assigned to the team on a rotating monthly basis as part of their training. Each team also includes at least one social worker and a staff psychologist. Medical students are also assigned to the team as part of their education to learn about psychiatry. According to the testimony elicited at trial, the team system at LSUMC is not fundamentally different from that employed by teaching hospitals throughout the country.

Dr. Joel L. Steinberg, staff member and assistant professor of psychiatry at LSUMC, headed the team assigned to Ms. Sibley. He obtained his medical degree (M.D.) in 1974 and was appointed to the faculty in 1979. He was assisted by resident Dr. Mary Jo Fitzgerald, who obtained her M.D. on May 31, 1980, and had been assigned to the team on August 1, 1980, and by resident Dr. Mitchell Stevens, who obtained his degree in 1978, and who replaced Dr. Fitzgerald on September 1. Also assigned to the team was Susan Pintado, a medical student expecting her degree in 1982. Each of these individuals was under the direct supervision of Dr. Steinberg, who maintained throughout trial that all the dosages were administered in accordance with his directions and approval.

Dr. Seiden telephoned Dr. Fitzgerald at Confederate and related to her Ms. Sibley's problem and history. After conducting a physical and mental examination, Dr. Fitzgerald agreed with Dr. Seiden's diagnosis of depression and made the appropriate notations in the hospital record. The following day, August 8, Ms. Sibley was seen on rounds by the entire team. On the basis of what he observed to be signs of catanoia and delusions, Dr. Steinberg changed the diagnosis to "acute unspecified psychosis," with "possible schizophreniform disorder" and immediately placed her on neuroleptic therapy.

According to Dr. Frank J. Ayd, a psychiatrist and a world-renowned expert and pioneer in the field of psycho-pharmacotherapy (the treatment of disorders of the central nervous system through the use of psychotropic drugs), neuroleptic drugs (also known as major tranquilizers, antipsychotic agents and psychotropic medications), chemically affect the central nervous system, altering thought processes and producing dramatic physical effects in the body. Neuro-transmitters, or chemical agents in the brain, control and keep in balance the dopaminergic and cholinergic systems of the body. The dopaminergic system, so-named for the neuro-transmitter dopamine, controls body movements and muscle tone. The cholinergic system, named for the neuro-transmitter acetylcholine, controls the vegetative and secretory functions of the body, including digestion, perspiration, urination and exretion. All neuroleptics, regardless of their chemical group, impede the flow of dopamine from the brain, resulting in the depression of the dopaminergic system. When the dopaminergic system is chemically depressed, the patient will develop certain physical reactions or side effects from the drugs, including akinesia, akathisia, dystonia and parkinsonism. These symptoms are collectively designated as "extrapyramidal signs" (EPS), which may require additional medication, such as benadryl, to counteract.

Neuroleptic drugs upset the balance between the dopmainergic and cholinergic systems. When this happens, the body will experience an increase in cholinergic activity, which will result in an increasing, and sometimes rapid, loss of body fluids as the body attempts to compensate.

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446 So. 2d 760, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sibley-v-bd-of-suprs-of-la-st-univ-etc-lactapp-1984.