The Supreme Court of the State of Washington (“Washington Supreme Court”) issued its written opinion on December 11, 2014 in a case in which it reinstated a Washington medical malpractice verdict in favor of the plaintiff that had been vacated by the trial judge and affirmed by the lower appellate court. The Washington medical malpractice jury had found in favor of the plaintiff and awarded $583,000 in damages against the defendant hospital.
The Washington Supreme Court stated that the primary issue it had to decide was whether the trial court properly granted the defendant hospital’s post-verdict motion for judgment as a matter of law where the plaintiff presented expert testimony establishing that following his lengthy heart surgery, the surgeons in charge of his postoperative recovery failed to meet their standard of care, which required appropriately monitoring him for compartment syndrome, a known possible complication following such surgery, and also failed to direct members of the hospital’s care team to monitor the plaintiff for developing compartment syndrome.
The Underlying Facts
On December 21, 2006, the plaintiff underwent a complex six-hour cardiac surgery after which he was under the primary care of various surgeons until his release from the hospital. The cardiac surgery was successful but the plaintiff experienced a difficult recovery from the surgery, including developing pneumonia and a blood infection, and he required intubation between December 23 and December 26.
By December 29, the plaintiff’s medical records indicated that the plaintiff’s left calf was swollen, red, and painful to the touch, and that his ability to bend his joints in both ankles was weak, particularly on his left leg. It was suspected by two physicians that the plaintiff had cellulitis, a bacterial infection typically treated with antibiotics, even though the plaintiff was already on antibiotics for the earlier blood infection.
By December 31, the plaintiff could not fully flex his left foot and dragged his left toe when he walked during physical therapy sessions. One of the physicians suspected that the plaintiff had compartment syndrome, which is a known complication from lengthy surgical procedures, the typical symptoms of which include hardness, swelling, numbness, tingling, pallor, loss of neurological function, lack of pulse, and severe pain (the plaintiff did not have severe pain but he was heavily medicated for pain throughout his recovery from surgery). A compartment pressure test on December 31 indicated that the plaintiff had compartment syndrome.
The plaintiff had surgery to address his compartment syndrome but by then it was too late – he suffered necrosis, muscle and other cell death within the compartment that resulted in permanent injury to his left leg. The plaintiff brought a medical malpractice case against the hospital and various physicians, alleging that their medical negligence led to his injuries.
The difficulty facing the plaintiff was that the defendant hospital provided medical care on a team basis that included surgeons, physician assistants, nurses, students, and other hospital staff who made rounds more than once a day. Therefore, it was not entirely clear who, specifically, was responsible for providing care and treatment to the plaintiff at particular times, and who in fact provided medical care and treatment while the plaintiff was in the hospital recovering from his surgery.
After the Washington medical malpractice jury returned its verdict against the defendant hospital, the trial court, in response to a motion filed by the defendant hospital, entered judgment in favor of the defendant hospital, finding that the plaintiff had failed to prove breach of the standard of care on the part of any particular employee of the defendant hospital.
In reviewing the trial court’s entry of judgment in favor of the defendant hospital, the Washington Supreme Court stated, “A plaintiff seeking damages for medical malpractice must prove that his or her “injury resulted from the failure of a health care provider to follow the accepted standard of care.” RCW 7.70.030(1). The statutory definition of “health care provider” includes physicians, physician assistants, nurses, and any “entity” employing such persons, including hospitals or an employee or agent thereof acting in the course and scope of his or her employment. RCW 7.70.020(1), (3). The plaintiff must prove that the health care provider “failed to exercise that degree of care, skill, and learning expected of a reasonably prudent health care provider at that time in the profession or class to which he or she belongs.” RCW 7 .70.040(1 ). The plaintiff also must prove proximate cause. RCW 7.70.040(2). The applicable standard of care and proximate causation generally must be established by expert testimony.”
The Washington Supreme Court noted that two of the plaintiff’s medical experts provided testimony during trial upon which the jury could have concluded that any one or all three of the surgeons breached the standard of care in that they failed to adequately monitor the plaintiff for the known possible complication of compartment syndrome, resulting in the late diagnosis of the onset of compartment syndrome, which resulted in injury to the plaintiff, and that there was no dispute that the negligence of a single employee of the defendant hospital rendered the hospital liable for such negligence. Therefore, the Washington Supreme Court held, “based on the evidence concerning the surgeons’ omissions, reversal of the trial court and reinstatement of the jury verdict is warranted.” (“The statutory definition of “health care provider” is nonexclusive, extending to “[a]n entity” “employing one or more” individual health care providers. RCW 7.70.020(3). The hospital is specifically identified as one such entity, and it would logically seem that a hospital medical team collaborating in providing treatment to an individual patient in accordance with hospital policies could constitute yet another type of “entity.””)
The Washington Supreme Court concluded, “Considering the inferences and the evidence presented in [the plaintiff’s] favor, [the plaintiff] met his burden under chapter 7.70 RCW to show that identified health care providers employed by [the defendant hospital] failed to meet the applicable standard of care in monitoring his postoperation recovery for compartment syndrome, resulting in the untimely diagnosis of that syndrome and proximately causing injury to [the plaintiff] by failure to timely treat that complication. Accordingly, we reverse the Court of Appeals and remand to the trial court with direction to reinstate the jury verdict in favor of [the plaintiff].”
Source Grove v. PeaceHealth St. Joseph Hospital, et al., No. 89902-9.
If you have been injured as a result of medical negligence in a hospital in Washington State or in a hospital in another U.S. state, you should promptly seek the legal advice of a Washington medical malpractice attorney (or a medical malpractice attorney in your state) who may investigate your hospital malpractice claim for you and represent you in a hospital medical malpractice case, if appropriate.
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