membranes. She assessed him as “emer- gent” - the most urgent category at anonymous hospital - and admitted him to the emergency department. At 9:55 a.m., the infant was assessed by a nurse in the emergency department. She noted no acute distress, clear breath sounds, crying and that the skin was warm and dry.
This nurse then placed the
infant’s chart in a rack of charts awaiting a physician’s review.
The infant was not seen by anonymous emergency physician until 30 minutes later.
Plaintiffs reported that the infant
had refused a bottle at 10:10 a.m. Physi- cian examined the infant and noted that he looked dusky and felt cool, his pupil were small, rales were noted to the left chest, the abdomen was soft and the in- fant appeared cyanotic. Physician ordered a pediatrician paged stat. At 10:32 two anonymous pediatricians
arrived. Physicians began examining the infant and taking a history from plain- tiffs. During this time, IV access was being attempted. At approximately 10:40 a.m., the infant went into respiratory ar- rest.
care unit at Johns Hopkins Hospital was contacted by telephone for a consultation. At approximately 11:06 a.m., the infant went into cardiac arrest. According to the medical records, at no time was the infant’s blood glucose level tested. At 11:25 a.m., a small dose of glucose was administered via a femoral IV. At 11:30 a.m., the in- fant was pronounced dead.
Allegations of Liability: According to the State of Maryland Post Mortem Exami- nation Report, the infant died suddenly and unexpectedly possibly due to a long chain fatty acid disorder. Plaintiffs’ ex- perts believed that the precise cause of death was hypoxia induced bradyasystolic cardiac arrest secondary to esophageal in- tubation and hypoglycemia. Unknown to anyone at the time, infant suffered from a rare metabolic disorder, a very long chain fatty acid disorder (VLCAD). VLCAD prevents the body from converting fat cells into sugar. If left untreated, it eventually causes massive organ failure beginning usually with the lungs and heart. How- ever, metabolic disorders such as VLCAD, when diagnosed and treated properly, can be managed and are not life-threatening. According to plaintiffs’ experts, there was an unreasonable delay in having the in- fant examined and treated by a physician in the emergency room and this delay deprived the physicians of the opportu-
Summer 2001
nity to approach the infant’s care in a more organized fashion and to treat and resus- citate him successfully.
Injures and Damages: Death of 5-week- old infant
Plaintiff ’s Experts: Frank Baker, M.D. (Emergency Medicine) Oakbrook, Illi- nois; Gerald Paulson, M.D. (Pediatrics) Washington, D.C.; Holmes Morton, M.D. (Metabolic and Genetic Diseases) Strasburg, Pennsylvania;
Ira Chasnoff,
M.D. (Pediatrician) Chicago, Illinois; Constance Settlemeyer, R.N. (Nursing and Hospital Nursing Staff) Arnold, Pennsylvania; William Nellis (Hospital Quality Assurance) Woodstock, Con- necticut
Verdict/Settlement: Case settled for an undisclosed amount shortly before trial.
Plaintiff ’s Counsel: Edward L. Norwind (MTLA Member) and Albert H. Lechner (MTLA Member) Karp, Frosh, Lapidus, Wigodsky & Norwind, P.A., Rockville, MD
________
Anonymous Plaintiff v. Anonymous Hospital in the District of Columbia, Medical Groups, and Physicians A District of Columbia Court
Facts: The plaintiff’s husband, age 44, visited his family physician and was diag-
(Continued on page 42)
Anonymous physicians intubated the infant and begin resuscitation efforts. At 10:50 a.m., the pediatric intensive
Trial Reporter
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