Washington v. Washington Hosp. Center

Get Started. It's Free
or sign up with your email address
Washington v. Washington Hosp. Center by Mind Map: Washington v. Washington Hosp. Center



1.1.1. Plaintiff-LaVerne Alice Thompson

1.1.2. Defendant-Washington Hospital Center


1.2.1. LaVerne Alice Thompson went to the Washington Hospital Center for an abortion and tubal ligation under general anesthesia on November 7, 1987.  She was a healthy, 36 year old woman.

1.2.2. A ventilation tube was inserted into Ms. Thompson's esophagus rather than her trachea and as a result air was pumped into her stomach vs. her lungs.

1.2.3. Dr. Nathan Bobrow (surgeon) noticed that Ms. Thompson's blood was dark which would indicate that her tissues were not receiving sufficient oxygen.  Dr. Bobrow requested that Nurse Adland check Ms. Thompson's vital signs but she reported them stable.  Dr. Bobrow continued with the procedure.

1.2.4. During the tubal ligation procedure Ms. Thompson's heart rate dropped and she suffered a cardiac arrest.  While Ms. Thompson was resuscitated the lack of oxygen resulted in catastrophic brain injuries.  Ms. Thompson is in a persistent vegetative state and is totally incapacitated leaving her in an "awake but unaware"  condition for the rest of her life.


2.1. Prove Medical Negligence on the part of Washington Hospital Center.

2.1.1. To establish the applicable standard of care in a medical negligence action a patient must provide expert testimony establishing that a physician or hospital deviated from a national standard causing injuries to the patient to avoid jury findings based on speculation or conjecture. The plaintiff was arguing that the failure of Washington Hospital Center to have a carbon monoxide monitor in the operating room which would have notified the surgeon that the patient was receiving insufficient oxygen during the surgery and this resulted in her catastrophic brain injury.  Washington Hospital Center deviated from the standard of care because many of the hospitals in the area had the carbon monoxide monitors installed at the time of Ms. Thompson's surgery.


3.1. In a medical malpractice suit it is the responsibility of the patient to establish the applicable standard of care and proof that the defendant deviated from that standard and caused harm.

3.1.1. Ms. Thompson would need to prove that Washington Hospital Center's conduct was different from that of hospitals nationwide.

3.1.2. The plaintiffs called Dr. Stephen Steen as their expert witness.  Dr. Steen needed to demonstrate that Washington Hospital Center was negligent by not providing a carbon monoxide monitor which he states is the standard of care in other hospitals at the time of Ms. Thompson's surgery.  Dr. Steen testified that it was strongly encouraged but not mandatory that all hospitals  have carbon monoxide monitors in the operating rooms.

3.1.3. Washington Hospital Center called their own expert witness, Dr. John Tinker from the University of Iowa.  Dr. Tinker testified that the the hospital he worked for had installed carbon dioxide monitors in every operating room by early 1986 and that by 1987 many hospitals were in the process of converting to carbon dioxide monitors.

3.1.4. Washington Hospital Center called their own Chairman of the Department of Anesthesiology, Dr. Dermot A. Murray.  Dr. Murray testified that he submitted a requisition form for carbon monoxide monitors in December 1986/January 1987 in order to monitor the administration of anesthesia in the operating rooms.  His requisition stated that the hospital would "fail to meet the national standard of care" if the monitors were not installed.  Dr. Murray testified that the monitors would be fully operational in July 1987.


4.1. While Dr. Steen testified that it was strongly encouraged for hospitals to have carbon monoxide monitors in operating rooms it was not mandated and this would be the practice that was needed to establish that it was the standard of care.

4.1.1. At the time of Ms. Thompson's surgery having a carbon monoxide detecter in the operating room was an "emerging" or "developing" standard of care, not an established practice.  By Dr. Murray testifying about his requisition to have carbon monoxide monitors installed in the operating room it shows Washington Hospital Center's intent to adopt the emerging standard of care.  However, Dr. Murray testified that the carbon monoxide monitors were to be installed by July 1987 which would have been four months prior to Ms. Thompson's surgery. The judge, Henry F. Grene, J. entered judgement on the verdict for the plaintiff against the hospital.  The plaintiff successfully proved medical negligence by Washington Hospital Center by not having a carbon monoxide monitor in the operating room that was performing surgery with general anesthesia.  While Dr. Murray testified that he requested that the monitors to be installed the fact of the matter was that they had not been installed and as a result Ms. Thompson's suffering from insufficient oxygen was not caught in time in order to avoid her injuries.


5.1. All hospitals would be affected by the ruling on this case.  It would encourage all hospitals in a given area to ensure that they are adopting any emerging standards of care as quickly as possible so that they are fully functioning once an emerging standard becomes mandated.  Failure to adopt an emerging standard of care may result in a medical malpractice suit if a patient is harmed during a medical procedure and the emerging standard of care would have prevented the injury.