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Garcia v. San Antonio Community Hospital11/6/2002
Plaintiff appeals awards of summary judgment in favor of San Antonio Community Hospital (hospital), and C. David Huang, and C. David Huang, M.D., Inc. (collectively doctor), in a medical malpractice action arising from the failure to discover and treat a bowel obstruction in a timely manner. After reviewing the expert declarations and other evidence submitted in support of and in opposition to the summary judgment motions, we affirm as to the hospital, but reverse as to the doctor, finding that there are relevant factual disputes.
Statement of Facts
Plaintiff was born in defendant hospital on March 30, 1993, at 1:20 p.m. Defendant doctor, plaintiff's pediatrician, examined plaintiff around 9:00 p.m. that evening. Later that night, the doctor circumcised plaintiff and formulated discharge instructions. Plaintiff was discharged the next day around 1:30 p.m. without being seen again by the doctor.
While in the hospital, plaintiff never passed stool. Almost every five hours a nurse recorded plaintiff's failure to pass stool on a chart titled "24-Hour Newborn Care Note," but the nurses never told the doctor about it. At that time, written hospital guidelines required nurses to " otify pediatrician if infant does not stool in 24 hours."
Upon discharge, a nurse told plaintiff's mother to contact the doctor if plaintiff failed to pass stool within a day. The next day, on April 1, plaintiff's mother contacted the doctor and told him that plaintiff still had not passed stool. Without examining plaintiff, the doctor told the mother to give plaintiff a laxative. On April 3, plaintiff's mother again contacted the doctor, complaining that plaintiff had still not passed stool, was irritable, and had a decreased appetite. Still without examining plaintiff, the doctor told the mother to give plaintiff Mylicon to relieve gas.
On April 5, plaintiff's mother brought him in to see the doctor. By that time, plaintiff was pale and jaundiced and his abdomen was distended. Plaintiff was diagnosed with an obstructed and perforated bowel, and transferred to another hospital for surgery. He remained in the hospital until July.
After being released from the hospital, plaintiff was diagnosed with Hirschprung's disease, a disease with a genetic component that disrupts cellular formation of the bowels, thereby requiring surgical intervention. Plaintiff underwent corrective surgery and currently complains of occasional fecal incontinence.
In March 2001, plaintiff filed the instant medical malpractice complaint and the hospital moved for summary judgment. The hospital's expert opined that the hospital's nurses satisfied the standard of care by accurately charting plaintiff's symptoms, telling the mother to contact the doctor if plaintiff still had not passed stool by the next day, and discharging plaintiff in accordance with the doctor's instructions. The hospital's expert noted that the standard of care does not require the nurses to personally inform the doctor of the failure to pass stool because that information was readily discernible from the chart. The expert also opined that the hospital's conduct did not cause any injuries because Hirschprung's disease was a congenital condition.
Plaintiff's expert countered that the nurses' conduct breached the applicable standard of care because they violated their own policies by failing to notify the doctor about plaintiff's failure to pass stool. Furthermore, plaintiff's expert opined that this conduct caused damage because it prevented the doctor from being alerted to a potential problem and responding appropriately.
The doctor filed a separate summary judgment motion. Th
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