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Redel v. Capital Region Medical Center5/10/2005
Opinion Vote: AFFIRMED IN PART; REVERSED AND REMANDED IN PART.
Mooney, P.J., and Hoff, J., concur.
Opinion:
Capital Region Medical Center ("Hospital") appeals the judgment entered upon a jury's verdict in favor of Vincent Redel ("Patient") and Rita Redel ("Wife") (collectively "Plaintiffs") for Hospital's medical negligence. We affirm in part and reverse and remand in part.
On October 26, 1998, Patient underwent bilateral knee replacement surgery, or surgery replacing both of his knees, at St. Mary's Hospital in Jefferson City, Missouri. Upon completion of the surgery, Patient's orthopedic surgeon, Dr. Timothy Galbraith, ordered Patient to receive physical therapy, including therapy through the use of a continuous passive motion ("CPM") machine. A CPM machine moves the knee joint through a predetermined range of motion without requiring the patient to use any leg muscles to do the work. Application of the CPM machine was intended to prevent Patient's knees from becoming stiff due to lack of movement following surgery.
During the five days Patient remained at St. Mary's after surgery, Patient made steady progress in his recovery, and by October 30 he had 110 degrees of flexion in both knees and could walk with minimal assistance. Patient was discharged from St. Mary's on October 30 and transferred to Hospital for continued rehabilitative treatment. When Patient arrived at Hospital, he initially was able to ambulate twenty feet with minimal assistance and had almost normal ankle strength. However, the oxygen level in Patient's blood began to drop that night, rendering Patient hypoxic. Hospital admitted him into the intensive care unit ("ICU"). While in the ICU, Patient was anemic and suffering from an abnormally high heart rate. Patient was also confused, disoriented and agitated, was unable to recognize Dr. Galbraith, and was eager to get out of the ICU and go home.
Beginning at 7:00 in the evening on October 31, Nurse Cynthia Mote took charge of Patient. According to Dr. Galbraith's notes regarding Patient, Patient was to receive CPM therapy. Nurse Mote was not familiar with administering CPM therapy and asked for assistance from Nurse Jennifer Moyer. At some point, Nurse Mote asked Patient whether he would allow her to administer CPM therapy and he refused. According to Wife, sometime in the morning of November 1, Nurse Mote explained to her that Patient had to undergo CPM therapy and had Nurse Moyer help apply the first CPM machine to one of Patient's legs. After Nurse Moyer left the room, Nurse Mote had trouble putting the second CPM machine on Patient's other leg, so Wife helped her. With both machines moving his legs, Patient was confused and disoriented. He kept moving around, tossing and pulling himself by the bed handles, and flipping the machines so that they were knocked out of alignment. The machines continued to move his legs.
Dr. Galbraith arrived at Hospital while Patient was strapped into the CPM machines lying sideways rather than on his back. He took the machines off of Patient and stated that he was concerned that Patient was so confused he likely could not express the degree of pain he was in. He was also disappointed that Hospital personnel failed to follow his verbal orders to watch Patient closely because of his disorientation and to only place Patient in one CPM machine at a time.
About two hours after the CPM incident, physical therapist Mary Rakestraw discovered that Patient had "drop foot," a condition meaning that Patient lost all dorsiflexion in both ankles so that he could no longer lift either of his feet up by the ankle. Shortly after his discharge from Hospital, Patient
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