Thoulion v. Jeanfreau

794 So. 2d 936, 2001 WL 710276
CourtLouisiana Court of Appeal
DecidedJune 20, 2001
DocketNos. 2000-CA-1045, 2000-CA-1046
StatusPublished
Cited by5 cases

This text of 794 So. 2d 936 (Thoulion v. Jeanfreau) 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
Thoulion v. Jeanfreau, 794 So. 2d 936, 2001 WL 710276 (La. Ct. App. 2001).

Opinion

hMAX N. TOBIAS, JR, Judge.

This appeal involves a wrongful death and survival action that alleges medical malpractice and loss of a chance of survival [938]*938claims arising from the death of Mrs. Joy-celyn Springer. The defendants, Robert D. Jeanfreau, M.D., Wallace E. Jeanfreau, M.D., and their insurer, Louisiana Medical Mutual Insurance Company, appeal from a trial court judgment rendered in favor of the plaintiffs, Cynthia Springer Thoulion, Dondnel Springer Shephard, Joy Springer Machado1 and Federick J. Springer, III, individually and as Executor of the Estate of Frederick J. Springer, Jr.2 The Louisiana Patient’s Compensation Fund (the “Fund”), an intervenor, also appeals.

Dr. Robert Jeanfreau, a board certified internist, testified that he first saw Mrs. Springer on 13 June 1990. She had a family history of lung cancer and coronary artery disease (“CAD”). Her father died from a myocardial infarction (“MI”) at age 57, and her sister had a MI and coronary artery bypass graft surgery at age 57. Mrs. Springer had been diagnosed with Raynaud’s syndrome three years earlier and treated with Procardia. Her chief complaint was an ulcer on her left fourth finger for two weeks. Dr. Jeanfreau noted that she had “tight” skin on her fingers and telangiectasia on her hands. At the time, she had no pulmonary or gastrointestinal symptoms. Dr. Jeanfreau diagnosed possible CREST3 syndrome and prescribed Procardia, 10 mg twice a day. The CREST syndrome diagnosis Dwas confirmed by Mrs. Springer’s positive anti-centromere antibody and 9 July 1990 evaluations by Reginald D. Sanders, M.D., a rheumatologist.

On 20 June 1990, Mrs. Springer called Dr. Robert Jeanfreau, complaining that her hand was not better. Dr. Jeanfreau increased the Procardia dosage to 20 mg twice a day. Three days later he prescribed Augmentin, an antibiotic, for an infection in Mrs. Springer’s left ring finger. The following week, on 28 June 1990, he again increased the Procardia dosage to 20 mg three times a day for the hand pain. On 8 August 1990, Dr. Robert Jeanfreau started Mrs. Springer on Persantine, 50 mg twice a day.

Dr. Robert Jeanfreau testified that he next saw Mrs. Springer on 29 August 1990. She complained of retrosternal pain after eating for two weeks, which occurred after most meals, and told him elevating the head of her bed provided some relief. Mrs. Springer also complained of shortness of breath with exertion for several months. According to Dr. Jeanfreau, the pulmonary complications from CREST explained the shortness of breath. A chest x-ray showed no fibrosis, but Dr. Jean-freau explained that microscopic pulmonary fibrosis is not always evident on an x-ray of a patient with CREST syndrome. An electrocardiogram (“EKG”) was normal. Dr. Jeanfreau diagnosed Mrs. Springer as having “reflux esophagitis” and possible “pulmonary fibrosis.” Because she had stopped taking all the previously prescribed medications, Dr. Jean-freau prescribed Procardia XL, 60 mg once a day, Persantine, 50 mg twice a day, and aspirin, one a day. He also prescribed Nitrol 2% ointment for her finger tips.

On 24 September 1990, Dr. Robert Jean-freau had Mrs. Springer undergo an eso-phagram and upper GI series, both of which were normal, and pulmonary [939]*939| ¡Junction studies (“PFS”). The PFS indicated that her lung volumes were “mildly reduced. Airflow is reduced at the level of the small airway and improves after bron-chodilator administration.” Her defusion deficiency was 44% of the predicted value. According to Dr. Jeanfreau, the PFS results confirmed that Mrs. Springer had mild restrictive lung disease, which accounted for her shortness of breath. On 9 November 1990, Mrs. Springer called Dr. Jeanfreau complaining of a “dry cough” and he prescribed Robitussin DM.

Dr. Robert Jeanfreau next saw Mrs. Springer on 16 November 1990 who had complaints of swelling and pain in her right wrist. At the time, she also complained of exertional chest discomfort for several months. Because the chest discomfort had not increased in frequency or duration, Dr. Jeanfreau attributed it to the restrictive lung disease and shortness of breath on exertion related to CREST syndrome. His noted diagnosis was “CREST syndrome,” possible “gout,” and “hyperur-icemia.” He prescribed Feldene, one every day.

Dr. Wallace Jeanfreau, a board certified internist, testified that he saw Mrs. Springer for the first time on 8 January 1991 because Dr. Robert Jeanfreau was on active military duty overseas. Before he evaluated Mrs. Springer, he reviewed Dr. Robert Jeanfreau’s notes and was aware of Mrs. Springer’s prior complaints of ret-rosternal pain, exertional chest pain, and shortness of breath. In his opinion, these complaints were CREST related. At the time, Mrs. Springer complained of a cold, sinus, and hacking cough. She had a low grade fever and an ulcer on her left third finger. She had no complaints of chest pain, and a chest x-ray was negative for pneumonia. Dr. Jeanfreau prescribed Bactrim, an antibiotic, and continued Mrs. Springer’s other medications.

|4In mid-April 1991, Mrs. Springer called Dr. Wallace Jeanfreau with complaints of emotional stress, and he prescribed Valium. On 29 April 1991, she saw him with complaints of an inguinal rash. Dr. Jean-freau noted that her lungs were clear, her physical examination was otherwise unchanged, and she was under emotional stress. He testified that Mrs. Springer had no complaints of chest pain.

Dr. Wallace Jeanfreau testified that he saw Mrs. Springer for a third time on 2 July 1991. She informed him that she had eaten two waffles that morning, and about 10:30 a.m. began experiencing abdominal cramps, nausea, vomiting, and later diarrhea and weakness. The episode recurred 30 minutes later. Mrs. Springer told Dr. Jeanfreau that she experienced a sharp chest pain after vomiting. She also informed him that she had been under a great deal of emotional stress due to her children’s marital problems. Dr. Jean-freau conducted a physical exam, which indicated normal vital signs and was unremarkable. He diagnosed gastroenteritis from food poisoning.

Dr. Wallace Jeanfreau testified that at the 2 July 1991 office visit he had Mrs. Springer undergo an EKG while experiencing chest soreness to rule out a heart attack. The EKG disclosed a sinus rhythm, normal axis, and questionable poor “R” wave progression across the anterior chest leads. While these EKG findings differed from the August 1990 EKG results, Dr. Jeanfreau opined that the latest EKG showed no changes suggestive of either acute infarction or ischemia, and attributed the poor “R” wave progression to improper lead placement. Dr. Jean-freau diagnosed Mrs. Springer with viral gastroenteritis, prescribed Tigan for nausea and vomiting, and continued her other medications. He noted “Schedule stress test in the future” and instructed Mrs. [940]*940Springer to return to the office within a | Bmonth to schedule an exercise stress test to complete his evaluation. He explained to her that the stress test was needed to determine whether or not there was the presence of coronary ischemia and circulatory problems to the heart. According to Dr. Jeanfreau, Mrs. Springer understood the necessity of undergoing the stress test. At the time, he found no urgency to do a stress test because her EKG was normal, other than the poor “R” wave progression, which he had attributed to improper lead placement. Mrs. Springer did return in a month and did not undergo an exercise stress test.

Mrs.

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Bluebook (online)
794 So. 2d 936, 2001 WL 710276, Counsel Stack Legal Research, https://law.counselstack.com/opinion/thoulion-v-jeanfreau-lactapp-2001.