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Marsh v. Arnot Ogden Medical Center

    Citation

    Brief Fact Summary. Leslie E. Marshall (the decedent whose estate is represented by the executor “Marsh”) (Plaintiff) was a patient in a hospital operated by Arnot Ogden Medical Center (referred to hereafter as “AOMC”) (Defendant) when Jane Doe (Defendant), a registered nurse employed by AOMC (Defendant), injected him by mistake with an insulin-reducing medication that had not been prescribed for him which then caused his death.  Plaintiff sued AOMC (Defendant) and other defendants claiming negligence and medical malpractice and sought punitive damages.

    Synopsis of Rule of Law. To survive summary judgment and recover punitive damages, the plaintiff in a medical malpractice suit must establish issues of fact that can be tried regarding a “reckless indifference equivalent to willful or intentional misdoing” or a “wanton and reckless disregard of a plaintiff’s rights.” 

    Facts. Leslie E. Marshall (the decedent whose estate is represented by the executor “Marsh”) (Plaintiff) was a patient in a hospital operated by Arnot Ogden Medical Center (referred to hereafter as “AOMC”) (Defendant) when Jane Doe (Defendant), a registered nurse employed by AOMC (Defendant), injected him by mistake with an insulin-reducing medication that had not been prescribed for him which then caused his death.  The attending physician, Dr. Abderhalden-Friend (Defendant), instructed Doe (Defendant) to monitor the glucose level of decedent every two hours and to call her at home if decedent’s level fell below 120.  The next testings revealed that decedent’s glucose level was 132 at 8:15 p.m. and 107 at 10:15 p.m.  After receiving the second test result, the attending doctor allegedly instructed the glucose testing be stopped until the next morning.  After the decedent was tested at 6:15 a.m. the next morning and showed a glucose level of 15, he died shortly afterwards.  Plaintiff alleged that just before the decedent was injected with the medication, decedent’s daughter specifically warned that the decedent was not a diabetic and did not use insulin.  Doe (Defendant) went ahead and injected the medication without determining decedent’s identity and without confirming that a doctor had ordered the medication for this patient.  It was later determined that the cause of death was insulin overdose due to the medication error.  Afterwards, Plaintiff filed suit against AOMC (D), Doe (Defendant), and Dr. Abderhalden-Friend (Defendant) for negligence and medical malpractice seeking punitive damages, among other things.  The Defendants’ motion for partial summary judgment dismissing the punitive damages claim against them was granted by the trial court.  Plaintiff appealed.

    Issue. To survive summary judgment and recover punitive damages, must the plaintiff in a medical malpractice suit establish issues of fact that can be tried regarding a “reckless indifference equivalent to willful or intentional misdoing” or a “wanton and reckless disregard of a plaintiff’s rights?” 

    Held. (Garry, J.)  Yes.  To survive summary judgment and recover punitive damages, the plaintiff in a medical malpractice suit must establish issues of fact that can be tried regarding a “reckless indifference equivalent to willful or intentional misdoing” or a “wanton and reckless disregard of a plaintiff’s rights.”  A showing of malice or wrongful intent is not necessary.
      As to Dr. Abderhalden-Friend (Defendant), the attending physician, the complaint alleges that even though she knew of the medication error, decedent’s medical condition and the particular risks posed to him by the wrong medication, she did not come to the hospital to examine decedent, but afterwards, by telephone, instructed AOMC (Defendant) staff to stop monitoring his glucose level until the next morning, with no orders given to monitor Plaintiff’s condition in the meantime.  In Plaintiff’s view, Abderhalden-Friend (Defendant) abandoned decedent when he needed emergency treatment, which justifies punitive damages.  If these claims are proven, it is possible that her conduct may be found to have been “grossly inappropriate given [her] actual knowledge of decedent’s condition.”  Therefore, considering the allegations in a light that is most favorable to plaintiff, the stated claim is legally sufficient to overcome the motion to dismiss.  Reversed.
      As to the motion for partial summary judgment by Doe (Defendant) and AOMC (Defendant), the essential inquiry is whether there is controversy over factual issues.  A summary determination in favor of a defendant is only called for on this issue if it can be said, as a matter of law, that punitive damages are not available to a plaintiff in a medical malpractice action.  Doe (Defendant) argues against Plaintiff’s claim that the daughter of the decedent warned Defendant specifically that decedent did not take insulin.  There are issues of fact presented regarding whether Doe’s (Defendant) action in administering the medication, in spite of the alleged warning by the daughter, went beyond simple carelessness and showed a reckless indifference regarding the medical care of the decedent which would justify an award of punitive damages in this case.  In addition, Plaintiff alleges—and the medical records verify—that decedent’s medical chart at AOMC (D) had not been updated to reflect the mistaken administration of medicine by Doe (Defendant) until four months after his death.  Willful failure to disclose relevant medical information may be enough to support punitive damages if the actions were taken to avoid a malpractice claim; neither Defendant has yet to explain the delay, and there has been no pretrial discovery.  As shown in this case, dismissal of a claim for punitive damages is premature when the party opposing the motion has not had a sufficient opportunity to conduct discovery into issues the moving party has knowledge of.
      Lastly, the record reveals that the federal Department of Health and Human Services (DHSS) conducted a medication error review after the incident and determined that Doe (Defendant) was responsible for giving the wrong medication which caused decedents death, and also for the error two months earlier where she mistakenly placed ear drops in a patient’s eye.  DHHS found that AOMC (Defendant) did not have methodology in place to identify patterns of repeated medication errors by specific staff members, had not discussed trends for medication errors at quarterly quality assurance meetings, and therefore, as required by state statute, had failed to ensure that its residents were free of any significant errors in medication.  When a medical facility fails to provide appropriate safety precautions and training, which demonstrates a conscious disregard for patient safety, there is a basis for a punitive damages award.  Therefore, Plaintiff has established that there are three triable issues of fact regarding whether Defendants Doe and AOMC may be found liable for punitive damages, and their motion for partial summary judgment should have been denied.  Reversed.

    Discussion. In any motion for summary judgment, it must be clear there are no triable issues of fact so that nothing is in dispute and the trail court can make a determination based on uncontested facts in the case.  In Marsh, the trial court moved too quickly when they prevented the chance to prove the elements necessary for an award of punitive damages.  Critically, malice is not required, as only a showing of “reckless indifference” or “wanton and reckless disregard” had to be proven.  This case makes clear that the issue is a question for the trier of fact based on the evidence presented, and generally not appropriate for a pretrial determination.


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