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SMITH v. SCHULTE8/18/1995
Woodrow Smith, as administrator of his deceased wife's estate, appeals from a judgment reducing to $1,276,873 a jury's $4,500,000 punitive damages award in his wrongful
death action against William J. Schulte, M.D., and Pulmonary Associates of Mobile, P.A. ("PAM"). Schulte and PAM cross appeal from that judgment.
On September 28, 1989, Annie Jo Smith was involved in an automobile accident in which she suffered contusions to the upper body and multiple fractures, including fractures of the ribs and hip. She was admitted to Knollwood Park Hospital in Mobile, where she was surgically treated for the fractured hip and was placed in the intensive care unit. Because she was breathing with difficulty, she was given supplemental oxygen externally, specifically, by an oxygen "mask," at a volume of 40%.
Throughout the night and the next day, her breathing difficulties increased progressively, and "pulmonologists" with PAM were summoned to consult and participate in her treatment. By 7:30 a.m., September 30, when she was first attended by Dr. Schulte, Mrs. Smith's breathing difficulties had not lessened, despite the fact that her supplemental oxygen supply had been increased to a concentration of 100%. Moreover, test results suggested that she had begun suffering from "adult respiratory distress syndrome" ("ARDS"), pneumonia, and one or more additional infections.
Dr. Schulte concluded that her respiratory condition required mechanical oxygenation โ an internally inserted "endotracheal tube" connected to a mechanical "ventilator." Between 9:05 a.m. and 9:15 a.m., he inserted an endotracheal tube through a passageway in her throat. As she was being "intubated" in this manner, Mrs. Smith became "combative." Doctor Schulte then ordered the administration of Pavulon, a drug that, within 30 seconds of administration, paralyzes striated muscles and renders all voluntary muscular activity โ including breathing โ impossible.
Coincident with the cessation of her voluntary movement, Mrs. Smith's blood pressure began falling; it continued to fall until 9:15 a.m., by which time she had lost all blood pressure and experienced a "cardiac arrest." After Dr. Schulte and accompanying medical personnel had initiated cardiopulmonary rescusitation and other measures calculated to revive her, Dr. Schulte noticed "gastric contents in the tube"; that fact revealed that the endotracheal tube had, in fact, passed through Mrs. Smith's esophagus into her stomach instead of into her lungs. Subsequently, a new endotracheal tube was properly inserted; however, Mrs. Smith, who had by that time lost consciousness, never revived.
She died four days later, October 4, 1989. An autopsy revealed that the "immediate cause of death" was "anoxic encephalopathy, cerebral edema with brain stem herniation." More colloquially stated, Mrs. Smith had suffered a period of oxygen deprivation that caused her brain to swell out of its cavity and force its way "down into the spinal canal."
On April 19, 1990, Woodrow Smith, as administrator of his wife's estate, sued Dr. Schulte and PAM. The complaint alleged that Dr. Schulte had "passed the [endotracheal] tube into the esophagus, [and had left the] tube for a period of time so that it produced brain death and cardiac arrest," followed by "the wrongful, premature" death of Mrs. Smith. The cause was tried to a jury, which, on April 6, 1993, returned a verdict for Mr. Smith in the amount of $4,500,000.
On April 23, 1993, Dr. Schulte and PAM filed a motion requesting reduction of the verdict to $1,000,000, with consumer-price-index adjustments, the amount of the damages limitation set forth in Ala. Code 1975, ยง 6-5-547. On Nove
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