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Piro v. Chandler2/28/2001
tin v. East Jefferson General Hospital, supra. Where a patient dies, the plaintiff does not have to meet the "unreasonable burden" of proving the patient would have lived if proper treatment had been given. Instead, the plaintiff need only prove that the patient was denied a chance of survival because of the improper treatment. Martin v. East Jefferson General Hospital, supra; Smith v. State, Through Dept. of Health and Human Resources Admin., 523 So.2d 815 (La. 1988); Hastings v. Baton Rouge General Hospital, 498 So.2d 713 (La. 1986); and Gordon v. Willis Knighton Medical Center, supra.
The record establishes that Mr. Piro, age 81, entered BMC on July 13, 1995, exhibiting symptoms of vomiting and gastrointestinal bleeding. He underwent an endoscopy, and he received a transfusion of four units of packed cells. Mr. Piro was expected to remain in the hospital for three to five days. The breach occurred after Mr. Piro was admitted to a room following the endoscopy. As explained previously, Mr. Piro was not given medication in accordance with his physician's orders until almost four hours after his blood pressure was found to be elevated. However, after Mr. Piro received the medication, his blood pressure returned to normal ranges. During the early evening hours, Mr. Piro exhibited symptoms of nausea, spitting, and sleepiness. Mr. Piro choked and spit out medication given to him. Orders were issued allowing him to have ice chips only and medication was administered to him to address the nausea. Dr. Janet Morehouse, Mr. Piro's treating physician at the time, was not alarmed at his condition. She testified that sleepiness following an endoscopy was not unusual. She further testified that she was not alarmed by complaints of nausea. She explained that it would not be unusual for a patient, who has had a tube down his throat and who has undergone some sedation, to experience throat irritation with choking and spitting up. She also testified that the appearance of paleness and poor turgor would also not be unexpected in a patient of Mr. Piro's age who has undergone an endoscopy. Unfortunately, Mr. Piro's condition deteriorated when he suffered a stroke sometime during the late evening hours. By 12:00 a.m., on the morning of July 14, 1995, Mr. Pior was exhibiting "strident sounding" respirations and "thick, mucousy rasping" in his throat. He was transferred to ICU after Dr. Morehouse came to believe that he had suffered a stroke.
What must be determined from these facts is whether the breach, namely, the failure to administer the Procardia as ordered by Dr. Morehouse, increased Mr. Piro's likelihood of suffering a stroke and therefore decreased his chances of survival. Testimony established that high blood pressure or hypertension is a known risk factor for stroke. Testimony also established that, at the time in question, Procardia was administered as ordered by Dr. Morehouse to quickly reduce blood pressure and thereby decrease the risk of stroke. However, the testimony further established that Mr. Piro suffered a thrombotic stroke, which is not commonly associated with hypertension.
Dr. E.J. Mayeaux, a practitioner of family medicine and a member of the medical review panel in this case, testified on behalf of the plaintiff. On direct examination, Dr. Mayeaux agreed that the breach of the standard of care would increase the risk of stroke and decrease Mr. Piro's chance of survival. On cross examination, Dr. Mayeaux referred to other possible risk factors for stroke, such as stress due to loss of blood and the endoscopy procedure. Dr. Mayeaux also explained the difference between a homorrhagic and a thrombotic stroke. According to Dr. Mayeaux, a hemorrhagic stroke involves the breaking of a bloo
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