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Grayson v. State9/15/1992
The opinion of the court was delivered by: GARRETT, Judge.
Appellants' decedent, Randall Grayson (Randall), was their ten-year old son. He was admitted to Appellee Children's Hospital of Oklahoma for surgery for the repair and reconstruction of his skull (craniosynostosis). Surgery was performed by Dr. Reynolds, Dr. Hisey, and Dr. Pollay. Dr. Reynolds and Dr. Hisey are Appellees. Dr. Pollay is not a party to this appeal. Dr. Greg Williams, who also treated Randall, died prior to the trial. An "Order Permitting Substitution of Deceased Party" was entered by the trial court, substituting the Estate of Greg Williams as party defendant, in place of Greg Williams, Deceased.
Randall was placed in the Intensive Care Unit (ICU) after surgery, and orders were given that he could receive Codeine for pain, and Phenergan for sedation and vomiting, and these medications were given to Randall. During the evening, R.N. Nancy Roche (Nurse Roche) contacted Dr. Williams by telephone because of Randall's continued vomiting. Dr. Williams authorized the use of additional Phenergan in suppository form, if needed, and Randall was given this medication at 9:30 p.m. He continued vomiting and became unresponsive to painful stimuli. Two CT scans were taken, and neurological examinations were performed. Although Randall had been responsive, and restless, within a short time he was not breathing. CPR was given, but he never regained consciousness. He died shortly thereafter, at 2:15 a.m. on June 17, 1988.
Appellants brought this action against the Appellee Hospital and Appellee physicians for wrongful death and medical malpractice, contending he died from an overdose of Phenergan and codeine in combination.
Appellants presented their evidence at the trial. This appeal arises from the trial court's orders sustaining Appellees' demurrers to Appellants' evidence and the order overruling Appellants' motion for new trial.
In Appellants' first proposition of error, they contend their evidence was sufficient to show negligence on the part of the Appellee Hospital and Appellee Physicians. In support of their contention, they cite cases from other jurisdictions and argue that dosages of medication in excess of those recommended by the manufacturer in a package insert are evidence of a deviation from accepted standards of medical care. They also contend that the failure of Nurse Roche to inform Dr. Williams of previous orders for, and administration of, Phenergan and codeine constitutes a lack of ordinary care understandable to a layman, so that expert testimony is not required. Appellees respond that this exception to the general rule [that testimony of an expert witness is required] applies only where the negligence is so grossly apparent that laymen would have no difficulty in recognizing it. See Turney v. Anspaugh, 581 P.2d 1301 (Okl. 1978); Boxberger v. Martin, 552 P.2d 370 (Okl. 1976).
Courts in other jurisdictions are split on the issue of whether giving dosages of medications in excess of the manufacturer's label is prima facie evidence of negligence. The parties have not cited an Oklahoma case, and we know of none, which addresses this precise issue. Among the courts which have addressed this issue are the Utah Supreme Court in Ramon By and Through Ramon v. Farr, 770 P.2d 131 (Utah 1989); and the District Court of Appeals in Salgo v. Leland Stanford Jr. University Bd. of Trustees, 154 Cal. App.2d 560, 317 P.2d 170 (1957). We find the reasoning in Ramon and Salgo persuasive. The Ramon court held at page 135:
Rather, we think the better rule is that manufacturers' inserts and parallel P.D.R.
Page 1 2 3 4 Oklahoma Personal Injury Attorneys
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