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Piro v. Chandler

11/1/2000

In this medical malpractice action, the jury determined that the defendant, Bossier Medical Center ("BMC"), did not breach the standard of care in the treatment of Salvatore Piro, who died on July 31, 1995 while a patient at BMC.


On appeal, Bernard Piro, the plaintiff and son of the deceased, argues that the jury erred in finding no breach of the standard of care. We agree and find that the jury was clearly wrong in finding no breach of the standard of care by BMC. Accordingly, we reverse the judgment of the trial court dismissing the plaintiff's action and remand for further proceedings on the merits of this claim.


FACTS


On the morning of July 13, 1995, Salvatore Piro, age 81, was admitted to BMC by Dr. Janet L. Morehouse, who was the on-call physician for Mr. Piro's treating physician, Dr. John Chandler. Admission to BMC was necessary because Mr. Piro, who had a long history of hiatal hernia and hypertension, was exhibiting symptoms of upper gastrointestinal bleeding. Upon admission to BMC, Mr. Piro underwent an esophagogastroduodenoscopy, or endoscopy, to locate the site of the gastrointestinal bleeding. The endoscopy revealed a Mallory Weiss tear and a large duodenal bulb ulcer. Mr. Piro required transfusion of four units of packed cells to replace blood lost from the bleeding.


Following the endoscopy, Mr. Piro was transferred to a room. At about 3:30 p.m., Dr. Morehouse issued orders for Procardia, a medication used to decrease blood pressure, to be given to Mr. Piro up to every four hours if his blood pressure rose above 160/95, meaning a systolic measure greater than 160 and a diastolic measure greater than 95.


Medical records indicate that Mr. Piro's blood pressure was taken around 4:00 p.m., at which time his blood pressure was 173/100. However, Procardia was not given to Mr. Piro until approximately 7:45 p.m. when his blood pressure was taken again and shown to be 170/100. Medical records also indicate that by 12:00 a.m. in the morning of July 14, 1993, nurses conducting the shift assessments could not arouse Mr. Piro. According to patient progress notes, Mr. Piro was exhibiting "strident sounding" respirations accompanied by "thick, mucousy rasping in throat." His skin was noted to be "pale and dusky." Dr. Morehouse was called to the hospital, breathing treatments were begun, and Mr. Piro was subsequently transferred to the intensive care unit ("ICU"). Dr. Morehouse suspected that Mr. Piro had suffered a stroke. A scan taken on July 14, 1995 revealed no evidence of hemorrhage or infarction.


However, her suspicion was confirmed by a scan taken on July 16, 1995, which showed an infarct involving the pons area of the brain, primarily on the right side. By July 18, 1995, the pontine infarct had extended to the mid and upper portion of the pons and there was an additional early small infarct involving the mid portion of the left temporal lobe. Mr. Piro remained in ICU and died on July 31, 1995. BMC's discharge summary attributes cause of death to "irreversible cerebral damage due to numerous cerebral infarctions."


On January 27, 1999, following an adverse medical review panel decision, Bernard Piro filed the instant medical malpractice action naming as defendants BMC, Dr. Chandler, and Dr. James Kim, a neurologist who treated Mr. Piro after he suffered the stroke. The claim against Dr. Kim was dismissed after the trial court granted summary judgment in his favor; Dr. Chandler settled with the plaintiff. The matter proceeded to trial on the claim remaining against BMC. The plaintiff's theory at trial was that Mr. Piro lost a chance of survival due to the actions of BMC's nursing staff, particularly in the failure to

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