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ELLIS v. NILES10/31/1994
Michael Anthony Ellis filed medical malpractice actions against Dr. Jack Niles, Jr. and Dr. Raymond Bynoe alleging he received negligent treatment while under the care of the Richland Memorial Trauma Team for a serious neck injury
I.
Ellis was injured in a single car accident the morning of October 3, 1988. The paramedics who arrived at the scene found Ellis's car upside down, with Ellis outside the car. The paramedics, assuming Ellis had suffered a spinal injury, placed a collar on him to secure his neck, and rolled him onto a spine board to maintain spinal alignment. Fully immobilized, Ellis was transported from the accident scene to Richland Memorial Hospital, a designated Level I Trauma Center. The paramedics radioed ahead to notify the trauma team of their arrival. According to Ellis, Richland Memorial thereby held itself out as providing personnel uniquely qualified in A.T.L.S., or Advanced Trauma Life Support.
There was evidence Ellis was not paralyzed at the time he arrived at the hospital. One of the paramedics noted Ellis had some movement in all four extremities. A nurse recalled Ellis was fighting and moving about on the stretcher when he first arrived, and Ellis ultimately had to be placed in arm and leg restraints. Furthermore, Dr. Weidner, a member of the trauma team, conducted a rectal examination on Ellis when he first arrived, and noted he had rectal tone, an indication of neurological response. As of October 4, 1988, however, Ellis was paralyzed, save for the ability to move his left arm slightly.
The trauma team treating Ellis consisted of Dr. Moore, a sixth year resident in trauma surgery, who headed the team, Dr. Pettigrew, a junior resident, Dr. Weidner, a junior resident and several nurses. Dr. Moore also called in Dr. Oliver, an anesthesiologist who was not a member of the trauma team. Dr. Oliver unsuccessfully attempted to nasotracheally intubate Ellis. Dr. Moore and Dr. Oliver then made a number of attempts to orotracheally intubate Ellis before they finally performed a cricothyroidotomy. At the time they were attempting
Dr. Bynoe was at the hospital October 3, 1988, and his name appears on an x-ray request. Dr. Bynoe did not examine or treat Ellis. However, he knew that Ellis had a cervical spine injury, and was informed by Dr. Moore by telephone that the team was about to attempt to establish an airway. Bynoe told Moore to proceed with the management of Ellis. In addition, Bynoe looked in on the team after the cricothyroidotomy had been performed. Dr. Niles was working in the emergency room on the day in question and recalled looking in on the team at various intervals. His name is reflected on the medical records, but he did not participate in the treatment of Ellis. However, Dr. Niles did see the attending physicians attempting to orotracheally intubate Ellis.
The hospital prepared a document entitled "The Trauma Team" which provides for a chain of command within the team, starting with the general surgeon/traumatologist as team leader, followed by the senior emergency department physician, the chief surgical resident, the senior surgical resident, other residents, the trauma nurses, and finally the scribe. (The most senior physician on the team treating Ellis was Dr. Moore, as chief surgical resident.) This document was apparently prepared in connection with the hospital's efforts to become certified as a Level 1 Trauma Center.
Ellis offered A.T.L.S. course materials indicating attempts at orotracheal intubation is contra-indicated for a patient suspected of having a cervical spine injury. Ellis maintains his paralysis is the result of the attempts at orotracheal intubation. Although Drs. Bynoe and Niles wer
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