Case Number: CI 002-2410

Judge: Donald Grincewicz

Court: Circuit Court, Orange County, Florida

Plaintiff's Attorney:

Defendant's Attorney:

Vance Dawson and Juan Ruiz of Rissman, Wiesberg, Orlando, Florida

Description:

Medical Malpractice-Wrongful Death of a 10-year-old son-On April 14,2001, Nathan stepped on a nail. The next day, Easter Sunday, his Mom took him to the ER. Two days later when his pain persisted his Mom took him back to the ER. The ER doctor referred him to an orthopedic surgeon who admitted Nathan to Florida Hospital on April 18,2001. The Orthopedist cleaned out the wound under general anesthesia and consulted with Defendants Desai and Otegbeye for antibiotic management. The defendants prescribed Gentamicin, Zosyn and the pain reliver, Motrin. All three are nephrotoxic. Gentamicin specifically requires blood tests initially and every 5-7 days to ensure that the levels of Gentamicin are in the safe,therapeutic range and that the child's kidneys are working properly. In this case the defendants prescribed excessive doses of Gentamicin and carelessly combined it with two, additional, kidney poisoning drugs. This made careful monitoring even more important.

On April 25, 2001, Nathan was discharged without any repeat Gentamicin levels or kidney function studies. In addition, at that time, no orders were written for repeat labs as required by the standard of care. Nathan was sent home to receive 22 more days of IV antibiotics, round the clock, and Motrin as needed.

On May 5, 2001, Nathan became sick with fever, diarrhea, and vomiting. His Mom reported these symptoms to defendant Desai on May 6th. However, Dr Desai told his Mom it was just the flu and if Nathan was not better by tomorrow to call his office. According to the standard of care, this phone call and information mandated that Nathan be seen immediately and the blood tests performed. These symptoms can lead to dehydration which causes the Gentamicin levels to rise dramatically and puts the child at great risk for Gentamicin poisoning and kidney failure.

The following day Nathan's Mom called the defendants' office as instructed, but the defendant's office never returned her call. The next day, Nathan's Mom took Nathan to the Apopka Family Clinic to have some healthcare provider see her son. That healthcare provider was concerned enough to call Dr. Otegbeye and inform him about his patient. Dr. Otegbeye told the Apopka Clinic that Nathan should be admitted to the hospital that day. However, he did not think it important enough to instruct that healthcare provider to send Nathan over immediately or on an urgent basis. As a result, approximately nine hours passed before Nathan arrived at Florida Hospital. Nathan's Mom had shared with the Apopka Clinic that she had two other children and would have to arrange for someone to take care of them before going to the hospital. Not having been given any additional information from Defendant Otegbeye, the Apopka clinic had no objection to the Mom's reasonable statement that she needed to provide for her other two children.

On arrival at Florida Hospital, Defendant Otegbeye ordered blood tests on a stat basis. Those tests should have been back within 30-60 minutes. Nonetheless, Otegbeye went home and failed to check on the blood work for more than four hours. In fact, he was still home more than four hours later when a nurse called him with results showing that Nathan was in acute kidney failure and that his Gentamicin levels were grossly elevated. Even then, Otegbeye failed to speak to a kidney specialist and caused a significant delay in the start of the necessary kidney dialysis.

As a result of a complication of the necessary dialysis,Nathan developed dialysis disequilibrium syndrome. DDS caused Nathan's brain to swell, herniate and require life support. On Mother's Day, May 13, 2001, Nathan's Mom agreed to removing her son from life support and he died at age 10. Nathan never finished the 5th Grade.

Defendants tried to blame Nathan's Mom and several other healthcare providers in order to avoid responsibility for Nathan's death. Defendants also claimed that no standards exist when it comes to monitoring Gentamicin levels and that Defendants were free to monitor levels whenever they saw fit. Despite the fact that Nathan had not had Gentamicin levels or kidney function tests performed for more than 16 days when Nathan became sick and defendants were notified, Defendants did not believe Nathan was sick enough to deserve the required blood tests. Fatal to this position, however, were defendants' admissions that (1)children can appear completely normal and have excessive Gentamicin levels; and, (2) dehydration can cause a change in Gentamicin levels. In essence, defendants provided no reasonable justification for their actions. Finally, Defendant Otegbeye made clear to the jury that he did not believe that doctors "necessarily" have a duty to save children's lives.

Outcome: Plaintiff's verdict $30 Million. The jury awarded $4 Million for past pain and suffering and mental anguish and $26 Million for future pain and suffering and mental anguish.

Plaintiff's Experts:

Dr. Daniel Levin, MD, Hanover, New Hampshire and Dr. Alison Brent, St. Petersberg, Florida

Defendant's Experts:

Dr. Albert Saltiel, St. Petersberg, Florida