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Cromer v. Children’s Hosp. Med. Ctr. of Akron – Foreseeability in Medical Negligence

When a child is sick or in pain, we trust medical professionals to use their absolute best judgment in ensuring the child receives appropriate care and ultimately gets well. hospitalwaitingroom

However, sometimes this does not happen. When doctors and other health care providers fail to adhere to the appropriate standard of care under the circumstances, their action may constitute medical negligence or medical malpractice.

It’s a unique area of law with heightened burdens of proof, tighter statutes of limitations and more requirements for plaintiffs. All of this means the legal team must be experienced and prepared to mount a strong case.One of the elements that may be necessary to address is the aspect of foreseeability. That is, to what extent could or should the physician have anticipated a possible negative outcome, and to what extent did he or she prepare for or take those outcomes into consideration.

In the recent case of Cromer v. Children’s Hosp. Med. Ctr. of Akron, foreseeability was a central issue at trial, and one that became the subject of later appeals. While foreseeability is generally relevant to a determination of whether a doctor exercised reasonable care in understanding or determining risk of harm associated with certain treatments, the Ohio Supreme Court ruled it’s not necessary to include this fact in a jury instruction when it’s not disputed the doctor conducted a risk-benefit analysis prior to initiating treatment. However, the fact that such instruction was given did not unfairly prejudice plaintiff, justices ruled.

According to court records, a child was admitted for treatment at a children’s hospital after his parents brought him to the emergency room in January 2007. He received treatment for an ear infection a week earlier, but had since grown very ill. He had an elevated pulse and breathing rate, and doctors, considering his condition urgent, and diagnosed him as suffering from shock. It was ordered the child undergo oxygen therapy and receive intravenous fluids and antibiotics. He was also given a shot of epinephrine to raise his falling blood pressure.

Later that night, as the child was being transferred to the pediatric intensive care unit (PICU), his condition worsened. At that time, the attending physician inserted a central venous access catheter into his femoral vein to instantly deliver medication. Another catheter was inserted into his femoral artery to monitor his blood pressure. Doctors also inserted a tube into the boy’s tracea to lessen the burden on the heart and allow for ventilation. His condition improved for a time, but then rapidly declined. His blood pressure dropped, he went into cardiac arrest and died.

His parents, in filing a lawsuit against the hospital for medical malpractice, secured the expert witness testimony of a doctor who testified that while the interventions and treatments were appropriate, the timing of those actions – particularly intubation – was not proper. Specifically, she indicated such actions should have been done sooner, and opined hospital staffers deviated from the acceptable standard of care by not intubating the boy two hours earlier.

While she agreed doctors weighed the risks of immediate and delayed intubation, she held their clinical judgments were unreasonable given the circumstances.

This position was countered by the expert witness testifying on behalf of the hospital, who stated that while shock is life-threatening if not properly treated, immediate intubation could potentially cause cardiac arrest. Another expert witness for defense noted the sedation required to complete the procedure could cause a patient – particularly a child – to “bottom out completely.”

All this evidence was presented at trial. After closing arguments, jury instructions were given that included language detailing the element of foreseeability of harm. Plaintiffs objected to this, but the judge overruled.

Jurors sided with the hospital, finding the doctor’s actions did not breach the applicable standard of care.

On appeal, plaintiffs argued the foreseeability language in the jury instruction was improper. The court of appeals agreed and reversed.

However, the state supreme court again reversed, finding that while such language was unnecessary, it did not harm plaintiff’s case.

Such cases can be extremely complex and highly technical, which is why our Fort Myers medical malpractice lawyers urge anyone contemplating such action to consult with a well-established legal firm.

If you have been injured, contact the Hollander Law Firm at (888) 751-7770 for a free and confidential consultation. There is no fee unless we win.

Additional Resources:

Cromer v. Children’s Hosp. Med. Ctr. of Akron, Jan. 27, 2015, Ohio Supreme Court

More Blog Entries:

Florida Hospitals Stung by Federal Penalties for Patient Injury, Jan. 21, 2015, Fort Myers Medical Malpractice Lawyer Blog