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Clelland v. Haas12/22/2000
This is an appeal from a judgment dismissing plaintiff's medical malpractice action based on a jury's finding that defendant did not breach the standard of care in his discharge instructions, evaluation, diagnosis and treatment of plaintiff.
FACTUAL BACKGROUND
On the morning of Friday, October 13, 1995, plaintiff, Brenda Clelland, went to the emergency room at St. Tammany Parish Hospital complaining of a sudden onset of severe mid-abdominal pain. In the history taken by the triage nurse, plaintiff complained of nausea, but she denied vomiting or diarrhea. Additionally, plaintiff told the triage nurse that on the way to the hospital, the pain would intensify when plaintiff's vehicle would go over bumps in the road.
Plaintiff gave a similar history to defendant, Dr. Michael Haas, the treating emergency room physician; however, plaintiff denied experiencing nausea and described her pain as general lower abdominal pain. Plaintiff also revealed a history of ovarian cysts to Dr. Haas. Plaintiff's vital signs were normal and she did not have fever. Dr. Haas performed a physical examination of plaintiff. This examination revealed that plaintiff was not experiencing rebound tenderness or rigidity in her abdomen, symptoms that, if present, would have indicated appendicitis. Dr. Haas ordered a chemical blood analysis, which revealed an elevated white blood cell count of 14,000, and thus the probable existence of infection. Based on the history given by plaintiff and the physical examination findings, Dr. Haas ordered a pelvic ultrasound, which he hoped would reveal any uterine or other female organ problems, in addition to any abdominal problems. According to Dr. Haas, a pelvic ultrasound examines the lower abdomen, which includes the appendix. Dr. Haas did not order an abdominal ultrasound because that would have checked for problems in the upper abdomen such as the gallbladder, liver and spleen, all areas that did not concern Dr. Haas in light of the plaintiff's history and physical examination results. At some point during the evaluation of plaintiff, Dr. Haas injected plaintiff with Toradol, an analgesic, to lessen the inflammation and "knock" down plaintiff's pain without clouding Dr. Haas's evaluation of plaintiff.
Dr. Don Saucier, the doctor interpreting the ultrasound, detected a pocket of fluid in the posterior cul-de-sac, which Dr. Saucier attributed to a ruptured ovarian cyst. Dr. Saucier also noted the absence of cysts within the left ovary, which cysts had been present in the past.
Within two hours of her admission to the emergency room, plaintiff's pain had subsided. Based on the history, physical exam, test results and the subsidence of plaintiff's pain, Dr. Haas concluded that plaintiff was probably suffering from a ruptured ovarian cyst, which pain should fully subside in a couple of days. Accordingly, Dr. Haas discharged the plaintiff with written instructions to follow up with her private doctor on the following Monday, October 16. Dr. Haas also gave plaintiff two prescriptions, one for an analgesic, to take the edge off the pain, and one for an antibiotic. Although not supported in the written discharge instructions, Dr. Haas contended that he verbally told plaintiff to return to the emergency room or call her doctor if her symptoms returned or worsened.
Plaintiff did not feel as bad on Saturday as she had felt on Friday. However, early Sunday morning, October 15, plaintiff awoke with a high fever, diarrhea, nausea and intense pain in her lower right abdomen. When Tylenol failed to relieve the fever or the pain, plaintiff returned to the emergency room on Sunday morning, where she was examined by Dr. Joan Curtis. Upon taking plai
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