Washington v. Washington Hosp Center

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Washington v. Washington Hosp Center by Mind Map: Washington v. Washington Hosp Center

1. Facts

1.1. Parties

1.1.1. Alma D. Washington, plaintiff, on behalf of daughter LaVerne Thompson

1.1.2. Washington Hospital Center, defendent

1.2. Where

1.2.1. District of Columbia Court of Appeals

1.3. What happened

1.3.1. Thompson (the plaintiff's daughter) suffered catastrophic, permanent brain damage during elective surgery because her breathing tube was inserted incorrectly

1.3.1.1. Nurse anesthetist Elizabeth Adland, under supervision of physician anesthesiologist Dr. Sheryl Walker, inserted the tube in the wrong place

1.3.1.2. The physician performing the surgery, Dr. Nathan Bobrow, noticed the patient's blood turning purple, indicative of lack of sufficient oxygen

1.3.1.2.1. Nurse Adland rechecked the patient's vital signs and found nothing amiss

1.3.1.3. Thompson went into cardiac arrest and suffered irreversible brain damage and is in persistent vegetative state

1.4. Procedural History

1.4.1. Jury awarded Ms. Thompson $4.586 M, and her husband $63 K

1.4.1.1. Suit against surgeon Bobrow dismissed

1.4.1.2. The nurse-anesthetist and anesthesiologist were volunatrily dismissed as they had been settled outside of court

1.4.1.3. Washington Hospital appealed, stating that (1) plaintiff failed to establish standard of care and that (2) as a result, the trial court erred in failing to grant a motion for judgement notwithstanding the verdict.

2. Issue Before the Court

2.1. whether Washington Hospital failed to meet the appropriate standard of care by failing to supply carbon dioxide monitors

2.1.1. would a reasonably prudent tertiary care hospital at the time of the injury (1987) have been expected to supply carbon dioxide monitors to patients receiving anesthesia for surgery?

3. Application

3.1. The court ruled that Washington Hospital had failed to meet the applicable standard of care and upheld the trial court's decision

3.1.1. Expert testimony from the plaintiff's expert, as well as testimony by Washington Hospital Center's own chairman of anesthesiology, provided sufficient evidence for the jury to conclude that a tertiary care hospital's standard of care should include a carbon dioxide monitoring system

4. Conclusion

4.1. Upheld in full

5. Rule of Law

5.1. Common law (negligence through medical malpractice, burden of proof to establish standard of care)

6. Impact of the decision

6.1. Koonce v. Merit Oil Co. of District of Columbia, Inc.

6.1.1. Handling of damages when plaintiff is suing more than one defendant (in Washington v. Washington Hospital System (WHC), WHC claimed a credit should have been applied to the jury verdict to account for Ms. Washington's settlement outside of court with the hospitals co-defendants (the nurse-anesthetist and anesthesiologist).  The court denied that claim).

6.2. Hill v. Medlantic Health Care Group

6.2.1. Qualifications for what expert testimony can be used to introduce/establish standard of care.  The court in Hill v. Medlantic Health Care found the expert testimony did not meet the qualification of being based on more than just the expert's opinion or experience (in Washington v. Washington Hospital Center, the court allowed the expert testimony as it was based on opinion as well as literature from prominent medical publications).

6.3. Travers v. District of Columbia

6.3.1. In negligence through medical malpractice cases, as established in Washington v. Washington Hospital Center, the plaintiff has the burden of proving the following:  (1) the applicable standard of care, (2) that defendant deviated from that standard, and (3) that defendant's deviation was the cause of plaintiff's injury.

6.4. Whether standard of care is defined by comparing at the local or national level (in Washington v. Washington Hospital Center, the court found that tertiary care hospitals should be compared to peers nationally).

6.5. Ray v. American National Red Cross

7. Relevance to business professional

7.1. Highlights need to maintain up-to-date with the facilities, equipment, and practices used by one's peers to shield from potential liability for failing to meet appropriate standard of care

8. Impact to business practices

8.1. Need to maintain compliance with acceptable standard of care

8.1.1. Need to maintain awareness of constantly changing standards used by comparable hospitals

8.1.2. Need to encourage and enforce policies that support the purchasing and acquisition of equipment deemed necessary to maintain compliance with appropriate standard of care