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Gasiorowski v. Hose12/15/1994
FIDEL, Judge
On the morning of April 1, 1988, defendant Aron Hose, M.D., an anesthesiologist on call at Thunderbird Samaritan Hospital, administered an epidural anesthetic to plaintiff Veronica Gasiorowski, a twenty-two year old expectant mother who had entered the hospital to deliver her first child. Plaintiff claims in this medical malpractice lawsuit that Dr. Hose threaded the epidural catheter too far into her spinal canal, impinged on the S-1 nerve root, and triggered dystonia, a cramping, spasmodic condition that has left her wheelchair bound. Dr. Hose and co-defendant Samaritan Health Services, the owner of Thunderbird Samaritan, respond that Dr. Hose properly administered the epidural anesthetic, deny that he caused or precipitated plaintiff's condition, and allege either that plaintiff does not suffer dystonia at all or that her condition is psychosomatic and wholly unrelated to her treatment by Dr. Hose.
The case was tried to a jury, which returned a verdict in favor of defendants. We reverse because the trial court wrongly suppressed evidence that, fourteen months after plaintiff's injury , Thunderbird Samaritan suspended Dr. Hose's epidural and on-call privileges in response to several episodes of "difficulty threading the epidural catheter." We hold that plaintiff should have been permitted to use this evidence to probe and counter the testimony of Dr. Hose, who was presented to the jury as a qualified expert on the proper administration of epidural anesthetic and who testified that he had treated the plaintiff in full compliance with the standard of care.
We also hold that, because a defense expert testified that dystonia primarily afflicts persons with an unusual predisposing susceptibility, the trial Judge erred by denying plaintiff's request for an "eggshell plaintiff" instruction -- an instruction that an accident victim's predisposing susceptibility does not relieve a negligent actor of responsibility for whatever injuries his negligence precipitates.
I.
Ms. Gasiorowski had no back complaints when she arrived at Thunderbird Samaritan, and she walked the halls of the delivery ward in the early hours of her labor. As Dr. Hose administered epidural anesthetic, she claims to have felt a burning sensation under her left foot and toes. Plaintiff and Dr. Hose dispute whether she reported this sensation while undergoing the injection, but she later complained to nurses of shooting pains in her left leg and foot and attributed their onset to the injection. According to hospital records, Ms. Gasiorowski experienced progressive left leg swelling and cramping for the remainder of her hospital stay, as well as curling of the foot. During the next several months, cramping, pain, and spasms spread to her lower back, buttocks, right leg, and right foot.
To administer epidural anesthetic, the physician inserts a hollow needle between the patient's vertebrae -- in this case the 3rd and 4th lumbar vertebrae -- far enough for the tip to penetrate the epidural space within the spinal canal. Through the needle, the physician inserts a catheter into the epidural space, gauging the proper distance by six black dots spaced a centimeter apart along the catheter. The catheter is a soft floppy tube, braced by a thin metal wire called a stylet to ease its passage through the needle. After insertion, the physician then withdraws the needle and stylet, leaving the catheter in place to permit ongoing doses of anesthesia.
Dr. Hose testified that his method of placing the catheter was to insert it until none of its black dots could be seen -roughly two centimeters past the last black dot -- and then to gradually withdraw the catheter until
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