Sloan ex rel. Sloan v. Providence Health System-Oregon

386 P.3d 203, 282 Or. App. 301, 2016 Ore. App. LEXIS 1451
CourtCourt of Appeals of Oregon
DecidedNovember 16, 2016
Docket094049L2; A152989
StatusPublished
Cited by3 cases

This text of 386 P.3d 203 (Sloan ex rel. Sloan v. Providence Health System-Oregon) is published on Counsel Stack Legal Research, covering Court of Appeals of Oregon primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sloan ex rel. Sloan v. Providence Health System-Oregon, 386 P.3d 203, 282 Or. App. 301, 2016 Ore. App. LEXIS 1451 (Or. Ct. App. 2016).

Opinion

TOOKEY, J.

Plaintiff brought this wrongful death action as personal representative of his father’s estate, alleging that defendants Providence Health System-Oregon (Providence) and Apogee Medical Group, P.C. (Apogee) negligently caused the death of his father, Jack Sloan. Plaintiff appeals the judgment entered against him after the jury found Apogee negligent, but did not find Apogee’s negligence to be the cause of Sloan’s death.1 Plaintiff argues that the trial court erred in failing to give two of plaintiffs requested jury instructions. Plaintiff also assigns error to the denial of his motion for a new trial. Because we conclude that the trial court erred in failing to provide one of the proposed instructions, we reverse and remand with respect to plaintiffs claim against Apogee.2

I. STANDARD OF REVIEW AND STATEMENT OF FACTS

In reviewing whether the trial court erred in failing to give the requested instructions, we view the evidence in the light most favorable to the establishment of the facts necessary to require the giving of those instructions. Hernandez v. Barbo Machinery Co., 327 Or 99, 101 n 1, 957 P2d 147 (1998).

On November 3, 2007, at about 3:00 a.m., Sloan, then 85 years old, fell in his bathroom after having blacked out for a moment. Sloan took a cab to the emergency room of a hospital, owned and operated by Providence, to receive treatment. He explained to the medical personnel that he had fallen and was experiencing chest pain and pain in what the medical personnel described as Sloan’s “right flank” area, on the right side of Sloan’s back, below his rib cage and above his hip bone. The emergency room medical personnel determined that Sloan had atrial fibrillation and began treating that condition. An x-ray was taken of Sloan’s [304]*304chest with a portable x-ray machine, and both the radiologist and the emergency room doctor found no rib fractures on the x-ray image. However, at trial, plaintiffs medical experts testified that the portable x-ray image showed, albeit subtly, that Sloan had at least one, and maybe five, displaced rib fractures, as well as some fluid in his right chest cavity.

Sloan was admitted to the hospital and treated for atrial fibrillation, anemia, and risk of stroke by Doctors Jasti and Naoom, both of whom were hospitalists3 employed by Apogee to work in Providence’s hospital. Sloan’s blood levels dropped significantly during his stay at the hospital, and the hospitalists treated the drop in Sloan’s blood levels with a transfusion of two liters of blood, and performed an endoscopy and colonoscopy to determine the source of blood loss. The tests did not show the source of Sloan’s blood loss, and the hospitalists ordered no further tests to determine the source of the problem.

Throughout Sloan’s hospital stay, he complained of pain in his right flank area. Other than giving pain medication, the hospitalists did not diagnose or treat Sloan’s complaint of pain. Sloan often needed oxygen for breathing, and nurses reported diminished sounds in both lobes of Sloan’s lungs. Plaintiffs medical experts testified that Sloan’s blood loss, complaints of “right flank” pain, his need for oxygen, and the nurses’ reports of diminished sounds in the lobes of the lungs, all indicated that Sloan had rib fractures and bleeding in his chest cavity. The medical experts further testified that other diagnostic imaging equipment available at the hospital would have given the hospitalists a much sharper and more reliable image of Sloan’s chest than the portable x-ray image taken in the emergency room. The hospitalists, however, did not order any further diagnostic imaging.

On November 7, the hospitalists discharged Sloan to a skilled nursing facility, Avamere Three Fountains (Three Fountains), where medical personnel understood from the hospital records that Sloan was at risk of syncope, or loss [305]*305of consciousness, was anemic with the cause unknown, had high blood pressure and atrial fibrillation, and was “generally deconditioned” from having been in a hospital bed for several days. Sloan remained at Three Fountains until November 19. He was able to breathe, supported, on and off, by two liters of oxygen per minute, until the morning of November 17, when Sloan’s oxygen saturation levels decreased to 70 percent. By November 19, with the support of four liters of oxygen per minute, Sloan’s oxygen saturation levels had declined to 58 percent and his breathing was shallow and irregular. Three Fountains sent Sloan to the emergency room for treatment.

A chest x-ray taken at the emergency room on November 19 indicated that Sloan had a hemothorax, which is an accumulation of blood in the lung cavity. The emergency room doctor drained approximately 1100 milliliters of bloody fluid from the lung cavity, and a second x-ray on that day showed that Sloan’s right lung had collapsed from a hemothorax, that Sloan had three to five displaced rib fractures, and that at least two of those rib fractures had caused bleeding into the chest cavity. Sloan died shortly thereafter.

After an autopsy, the medical examiner determined that the cause of Sloan’s death was “respiratory failure due to right hemothorax, which is blood in the chest cavity, and right lung collapse due to multiple rib fractures due to a domestic fall.” Dr. Thorson, who treated Sloan on November 19 in the emergency room, testified at trial that the same rib fractures that existed on November 3 were likely the cause of the hemothorax on November 19.

At trial, plaintiffs theory of liability was that Sloan came to the hospital with rib fractures and bleeding in his chest cavity, which Providence’s medical personnel and Apogee’s hospitalists were negligent in failing to diagnose and treat, and that their failure caused Sloan’s death. Pertinent to this appeal, plaintiff alleged in his fourth amended complaint that Apogee was negligent “in one or more” of the following particulars:

“(a) In failing to ascertain the presence of multiple rib fractures;
[306]*306“(b) In failing to recommend or order or obtain additional imaging studies to adequately rule in or rule out the presence of multiple rib fractures;
“(c) In failing to treat Mr. Sloan for multiple rib fractures;
“(d) In failing to ascertain the likely source of blood loss during Mr. Sloan’s hospitalization;
“(e) In discharging Mr. Sloan without ascertaining the likely source of bleeding;
“(f) In assuming that Mr. Sloan suffered only a bruise on his right flank from his fall.”

Apogee’s main theory of defense was that “something happened” to Sloan, beginning November 17, while Sloan was in Three Fountains’ care. That unknown event, Apogee argued, caused Sloan’s death. To support its theory, Apogee offered evidence that when Sloan left Apogee’s care, Sloan had no displaced rib fractures and no bleeding in his chest cavity and that, upon arriving at Three Fountains, Sloan could breathe at normal rates without supplemental oxygen, had clear breath sounds in his lungs, had no cough or shortness of breath, and denied any chest pain.

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

Related

Appleyard v. Port of Portland
492 P.3d 71 (Court of Appeals of Oregon, 2021)
O'Kain v. Landress
450 P.3d 508 (Court of Appeals of Oregon, 2019)
Sloan v. Providence Health System-Oregon
437 P.3d 1097 (Oregon Supreme Court, 2019)

Cite This Page — Counsel Stack

Bluebook (online)
386 P.3d 203, 282 Or. App. 301, 2016 Ore. App. LEXIS 1451, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sloan-ex-rel-sloan-v-providence-health-system-oregon-orctapp-2016.