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GLENN v. CARLSTROM12/18/1996
Plaintiff, Amy Glenn, appeals from an adverse judgment in a medical malpractice action against Dr. Thomas Carlstrom, Dr. David Boarini, and Iowa Methodist Medical Center. She asserts that the trial court erred during the course of the proceedings with respect to several of its legal rulings. We consider each of her contentions and, for reasons discussed herein, affirm the judgment of the district court.
Plaintiff was born on May 25, 1970, with spina bifida, or an open spine. She had surgery at birth to close the lesion on her back. In 1978 she underwent bladder reflux surgery. Following a moped accident in 1984, plaintiff began to experience lower back pain and lower extremity fatigue. In an attempt to alleviate these problems, she underwent a tethered-cord spine surgery in 1985. In January 1987, she had a bladder augmentation procedure and, in the Fall of 1988, had orthopedic surgery to lower her instep.
In 1990 plaintiff began to experience lower back pain again. She was referred to Dr. [556 NW2d Page 802]
Carlstrom, a Des Moines neurosurgeon, by her pediatrician Dr. Spevak. Dr. Carlstrom examined her on November 12, 1990. He diagnosed a tethered spinal cord and recommended another surgery to release the tethered cord. Surgery was initially scheduled for January 1991 but was moved forward to December 21, 1990, to accommodate plaintiff's wedding plans and because Dr. Carlstrom was being called up for active service during the Persian Gulf War. On December 20, 1990, Dr. Spevak performed a preoperative history and physical examination and cleared her for surgery. Dr. Carlstrom performed the surgery on December 21.
Dr. Carlstrom visited plaintiff after the surgery on the night of December 21 and again on December 22 and 24. Dr. Spevak visited plaintiff every day, sometimes twice or three times a day. Dr. Carlstrom had arranged for his associates Dr. Boarini and Dr. Hayne to continue with plaintiff's postoperative care during his absence. Dr. Boarini saw the plaintiff on December 25, 29, 30, and 31. Dr. Hayne saw her on December 27 and 28. She was discharged from IMMC on December 31.
Plaintiff continued to experience severe pain, especially when walking. Dr. Boarini referred her to physical therapy. During this period, she was also seen by Dr. Spevak and Dr. Hayne. Dr. Carlstrom returned from the Gulf War in late March and examined plaintiff on April 2, 1991. He ordered further tests including an MRI, EMG, and x-rays. Plaintiff saw Dr. Carlstrom again on April 23, and he recommended her to Dr. DuBois, a neurologist who was interested in pain problems and helping patients deal with that pain. Dr. DuBois examined plaintiff on April 24 and again on May 9. She was readmitted to the hospital by Dr. Spevak due to the intense pain she was experiencing.
Dr. Carlstrom examined plaintiff in the hospital on May 20, 1991. She was then receiving twenty milligrams of morphine intravenously every hour. Dr. Carlstrom discussed with her his concern that she was receiving an excessively high dosage of morphine. According to Dr. Carlstrom the standard dose he gives a postoperative adult is between six and eight milligrams every three to four hours. After he left the room, a nurse told him, "She doesn't want to see you. She doesn't want you in her room anymore." Dr. Carlstrom did not believe that he had been "fired" and, according to his trial testimony, was never told by plaintiff or her mother that he had been fired. In fact, at the request of Dr. Spevak, Dr. Carlstrom continued to see plaintiff every day the rest of the hospitalization — May 21, 22, 23 and 24. During this period of time, at plaintiff's mother's request, Dr. Carlstrom attempted to arrange a v
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