Watson v. Brazeel

833 So. 2d 1276, 2002 WL 31829485
CourtLouisiana Court of Appeal
DecidedDecember 18, 2002
Docket36,499-CA
StatusPublished
Cited by7 cases

This text of 833 So. 2d 1276 (Watson v. Brazeel) 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
Watson v. Brazeel, 833 So. 2d 1276, 2002 WL 31829485 (La. Ct. App. 2002).

Opinion

833 So.2d 1276 (2002)

Andrew WATSON, et al, Plaintiffs-Appellants,
v.
Dr. Steven BRAZEEL and The Medical Protective Company, Defendants-Appellees.

No. 36,499-CA.

Court of Appeal of Louisiana, Second Circuit.

December 18, 2002.

*1277 Jay A. Pucheu, Marksville, for Appellants.

Crawford & Anzelmo, by Brian E. Crawford, Monroe, Jefferson B. Joyce, Baton Rouge, for Appellees.

Before BROWN, WILLIAMS, GASKINS, CARAWAY and DREW, JJ.

BROWN, C.J.

On November 17, 1995, plaintiff, Andrew Watson, suffered a laceration on top of his foot when it was caught in a garbage press at work. The wound was superficial and of almost no depth—at best one centimeter. Mr. Watson went to St. Francis Medical Center OccuMed Clinic and was seen by Kalisa Ramsey, a nurse practitioner, and Dr. Steven Brazeel. Mr. Watson claims that the wound was not properly cleaned, became infected and required surgery. Approximately one month later, surgery was performed by Dr. Brian Bulloch, an orthopedic surgeon, who removed debris or foreign particles from the wound that could be easily seen by the eye. Dr. Bulloch concluded that this debris was from the work injury.

Mr. Watson was given intravenous (IV) antibiotics while hospitalized. On December 20, 1995, he was released from the hospital and was administered IV antibiotic therapy by home health care. He was readmitted to the hospital when he became nauseated and suffered temporary kidney failure as a result of a reaction to the antibiotics. This condition required dialysis, but the problem was eventually resolved.

A medical review panel found that the initial treatment of the wound by all concerned was appropriate; however, the panel found that there were substantial issues of fact concerning the administration of the antibiotics.

On January 26, 1998, plaintiffs, Andrew and Jacquelyn Watson, filed suit against Dr. Brazeel and his insurer, The Medical *1278 Protective Company, Ms. Ramsey, Dr. Bulloch, and St. Francis Medical Center. The parties reached a settlement as to the plaintiffs' claims arising from the administration of the IV antibiotics. The matter proceeded to trial only against Dr. Brazeel and his insurer. It was stipulated that the only issue remaining concerned the initial treatment of the injury and that any damages awarded would be from that date, November 17, 1995, until Mr. Watson's readmission to the hospital due to the drug reaction on December 28, 1995. The parties also stipulated that Mr. Watson's medical expenses for this period totaled $23,001.25.

Questioning the credibility of Mr. Watson, the trial court found in favor of defendants. We reverse.

Discussion

There is no dispute in this case as to the applicable standard of care. Dr. Brazeel testified that the standard of care would include inspecting the wound, opening the laceration and checking for foreign bodies and debris. It would also include irrigating the wound with peroxide, saline, water, or any combination of those substances. Dr. Brazeel agreed that ultimately, he was responsible for seeing that the standard of care was implemented.

Ms. Ramsey testified that another nurse in the clinic was to clean the wound with peroxide and saline. Ms. Ramsey stated that she thought the wound had been cleaned because Mr. Watson's foot was wet when she entered the room. However, she did not personally clean the foot nor did she see anyone else do so. Further, Ms. Ramsey testified that, although a tetanus shot was ordered for Mr. Watson, she does not know if it was actually given. Ms. Ramsey stated that she spread the wound slightly apart and examined it. She denied seeing any debris in the wound. She claimed that after Dr. Brazeel determined that sutures were not necessary, an antibiotic ointment was applied to the laceration. Ms. Ramsey testified that she instructed Mr. Watson to wash his foot with warm, soapy water every day and to apply antibiotic ointment three times per day.

Ms. Ramsey stated that she had no reason to believe that the standard plan was not followed. She said, "I have to feel confident that the people who work for me and with me in the clinic would have no reason to not execute my plan. That had never happened in the past." No one testified that these cleaning procedures were done, nor were any such procedures noted or charted in the medical record.

Ms. Ramsey detailed five follow-up visits in November and December 1995 by Mr. Watson in which there was a yellowish discharge from the wound with swelling and continued complaints of pain.

Mr. Watson testified that when he initially went to OccuMed, no one spread the wound open to look for debris. He said that his foot was merely twisted back and forth. Ms. Ramsey then poured a brown liquid, Betadine, over it. He denied being given a tetanus shot and stated that he was not instructed to wash the foot or to apply ointment. He further stated that he did not receive any written instructions regarding wound care. According to Mr. Watson, he was told not to get the foot wet. He returned for follow-up visits because his foot continued to swell. He claims that he was not given any instructions about cleaning the foot until his third visit.

The defense attempted to impeach Mr. Watson with deposition testimony in which he stated that some liquid was poured over his foot. Mr. Watson did not dispute that statement, but reiterated that the only liquid used was Betadine. He consistently *1279 testified that the foot was not cleaned with any other substance.[1]

Dr. Brazeel said that when he initially saw Mr. Watson, he only looked at the wound to determine if it needed sutures. Dr. Brazeel testified that he did not clean the wound and did not see anyone else clean it. He stated that, "The instructions were clearly given to clean the wound with peroxide.... I would assume that those things occurred." He also acknowledged that there was no documentation in the medical record that the wound was cleaned. He assumed that Ms. Ramsey had done an adequate examination of the foot.

Dr. Bulloch's surgical report shows that there were large amounts of black debris inside the wound. He removed from the wound 20 to 40 particles that were between one and two millimeters in size. This "small blackish appearing material" was confirmed in the pathology report to be foreign matter. This material caused aggravation of the soft tissue and bone in Mr. Watson's foot. Dr. Bulloch believed that this matter was from the time of the initial injury.

Dr. Desormeaux, an internal medicine specialist, testified by deposition on behalf of the plaintiffs. He stated that the medical chart in this case did not provide thorough documentation. He noted that irrigation of the wound and a tetanus shot were ordered, but there is no showing that the orders were carried out. Further, there was no description of how thoroughly the wound was examined. According to Dr. Desormeaux, the record indicates that the wound was to be cleaned with peroxide. However, he stated that the standard of care is to flush the laceration with copious amounts of saline, not just peroxide. Dr. Desormeaux said that there is no documentation in the medical record to substantiate the nature and extent of the treatment received by Mr. Watson. He testified that it could not be proved from the medical record that the wound was cleaned and thus, he opined that Mr. Watson received substandard care. Dr. Desormeaux stated that Dr. Brazeel was ultimately responsible for seeing that all necessary treatment was rendered to Mr. Watson.

Dr.

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Bluebook (online)
833 So. 2d 1276, 2002 WL 31829485, Counsel Stack Legal Research, https://law.counselstack.com/opinion/watson-v-brazeel-lactapp-2002.