Tuesday, June 26, 2001
Panel Advises County to Pay $1.3 Million to Settle Medical Malpractice Claims
By a MetNews Staff Writer
The Los Angeles County Claims Board yesterday recommended settling three lawsuits for a total of nearly $1.3 million in three lawsuits, including an award of $135,000 to the children of a women who died from multiple organ failure and infections she developed after taking a prescribed steroid.
Citing the failure of medical personnel to properly monitor Debra Day’s use of the steroid after a scheduled surgery did not take place, attorneys for the county recommended settling the suit.
Day, 43, died a month and a half after she visited County-USC Medical Center for an evaluation of her continuous neck pain on Sept. 16, 1998. An autopsy attributed Day’s death to an abscess in the liver, a fungal infection of the upper gastrointestinal tract, an overwhelming infection in the blood stream and adrenal insufficiency, which were attributed to Day’s use of steroids.
Day was prescribed the anti-inflammatory steroid Decadron, which can suppress the body’s immune system and make it susceptible to infection, to reduce neck swelling in preparation for cervical spine surgery.
A pre-operation evaluation at County-USC Medical Center two weeks later revealed an elevated level of total white blood cells, indicating possible infection.
Surgery was not scheduled because of the infection, but Day was not told to stop taking the steroid.
On Oct. 18, 1998, Day went to the emergency room at Olive View/UCLA Medical Center with complaints of diarrhea, a sore throat, an inability to swallow solid food. She was diagnosed with a fungal mouth infection, which medical personnel attributed to the Decadron. She was given an anti-fungal throat medication and told to come back if she developed a fever, chills, or nausea.
Just four days later Day returned to the emergency room with a fever and chills, a rapid heartbeat and an abnormally low blood pressure.
Day also complained about not having been able to consume solid food for several weeks. A liver function test was performed and a possible fungal infection was detected. Day was given an additional antifungal medication and was discharged the following week despite continued abnormal results in a repeat liver function test.
Day returned to the emergency room two days later complaining of acute shortness of breath and a choking pain. While medical personnel suspected Day was suffering from a bacteria infection, she was not given antibiotics until the following day.
On Oct. 29 an analysis of Day’s blood confirmed the presence of two bacterial organisms, requiring her to be given several antibiotics. Despite the medication, her condition continued to deteriorate requiring a breathing tube to be inserted in her nose and the use of a ventilator.
She suffered multiple organ failure on Oct. 30 and the following day her family terminated life support.
The settlement awards Day’s children $41,300 each for loss of care, comfort, and companionship along with a sum to cover attorneys’ fees and cost of litigation.
The Claims Board also voted to award $245,000 and lifetime acute medical care in a medical negligence suit to Maria Hernandez who suffered a brain hemorrhage as a result of medical personnel failing to manage her high blood pressure while she was being treated at County-USC.
Hernandez, 32, underwent an emergency Cesarean section to deliver her daughter at County-USC on Jan. 24, 1998, when medical personnel suspected she suffered from pregnancy induced hypertension.
PIH can pose a serious threat to both mother and child.
Hernandez’s daughter was delivered without incident. Hernandez remained hospitalized in order to prevent complications stemming from PIH, which can include bleeding within the brain and insufficient blood supply.
An order was made to monitor Hernandez’s blood pressure below a threshold level by giving her medication to control blood pressure through an IV every hour. The order, however, did not specify whether the medication was to be given if only one of the two specified thresholds were exceeded or when both levels were exceeded.
According to the report prepared by county counsel, threshold levels were exceeded without any medication being administered to control the blood pressure level for as long as five and a half hours at a time on Jan. 28.
After five and a half hours without any medication, Hernandez was given a blood pressure-controlling medication. Because her blood pressure continued to be extremely high, Hernandez was give medication intravenously an hour and a half later.
Later that afternoon Hernandez complained of blurred vision and an imaging study revealed that she had experienced a large intracerebral hemorrhage in the back of the brain which experts say began to occur minutes before the second medication was administered.
The Claims Board also approved accepting $425,869 in the settlement of two county lawsuits against the state Medi-Cal program.
Both lawsuits challenged the denial of Treatment Authorization Requests concerning a total of 1,279 days of care provided to Medi-Cal patients at County-USC Medical Center and Harbor-UCLA Medical Center.
The recommendations will be reviewed by the County Board of Supervisors in the coming weeks, Assistant County Counsel Lou Aguilar said.
Copyright 2001, Metropolitan News Company