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Johannesen v. Salem Hospital12/26/2003
Argued and submitted January 10, 2003.
Peremptory writ to issue.
Balmer, J., concurred and filed an opinion in which Gillette, J., joined.
In this original mandamus proceeding, we are called upon to apply the legal standards governing a trial court's decision on a motion under ORS 18.535 (2001) to amend a complaint to add a punitive damages claim in a medical malpractice action. In the case from which this proceeding arises, the trial court denied plaintiff's motion to amend his complaint on the ground that he had not presented "clear and convincing" evidence that defendants had acted with malice. Because we conclude that the trial court did not apply the proper test in making that determination and that plaintiff's motion satisfied the statutory requirements for amendment of the complaint, plaintiff is entitled to a peremptory writ of mandamus.
The underlying action arises out of the medical treatment of Salina Johannesen ("Johannesen"), plaintiff's now-deceased wife. Although plaintiff named other defendants to the action, the only claim at issue in this proceeding is the claim against Salem Hospital ("defendant") as the employer of the nurses who treated Johannesen. We recount the actions of Johannesen's doctors at some length, however, because the facts regarding overall medical care help to explain plaintiff's contention that the nursing staff should have intervened on Johannesen's behalf.
We present the evidence submitted in support of the motion to amend in the light most favorable to the plaintiff. See ORS 18.535(3) (directed verdict standard applies). Johannesen consulted Dr. West for prenatal care. During her pregnancy, she developed preeclampsia/pregnancy-induced hypertension, a potentially fatal condition. Delivery of the child is the only definitive treatment for severe preeclampsia. After Johannesen developed symptoms of preeclampsia, West left the office for about two weeks, entrusting Johannesen's care to a nurse practitioner who had limited experience with preeclampsia. During West's absence, Johannesen's condition worsened.
Upon his return, West arranged for Johannesen to be hospitalized. She was admitted on November 8, 1999, with evidence of severe pregnancy-induced hypertension. Later that day, West transferred Johannesen out of the hospital's Labor and Delivery Unit and into the Postpartum Unit, which decreased the amount of monitoring she would receive. Johannesen suffered high blood pressure accompanied by headaches, visual disturbances, and epigastric pain, which are signs of end organ injury. West treated her with antacids and a pain killer. West did not order medication to reduce the chances of seizure until November 10, and he did not order any medication to control her blood pressure until she had lapsed into a coma.
On November 10, 1999, West decided to induce labor and attempt a vaginal delivery. He did not disclose to Johannesen that she was at risk for a fatal brain hemorrhage during the six to eight hours that he planned to allow for labor. Johannesen was transferred back to the Labor and Delivery Unit at 5:35 a.m. on November 10. Johannesen had a severe headache, such severe visual disturbance that she was unable to see, and epigastric pain. Dr. Anderson, the anesthesiologist, saw her twice that morning. After Johannesen labored all morning without success, West transferred her to the operating room for a caesarean section at approximately 12:50 p.m. She fit all the definitional criteria of coma before the first incision was made. The doctors performed the delivery without seeking a neurological consultation. When plaintiff asked why his wife was "sleeping," Anderson told him that his wife
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