Hildebrand v. Karen Donaldson, MD & Desert Hospital

Tamara Hildebrand, Koles mother, brought Kole in to Desert Hospital to be evaluated for an elevated temperature (to 105 degrees); irritability and not eating. Dr. Donaldson believed this was due to a viral illness, prescribed Ibuprofen, and sent Kole home. Over the next four days, Kole continued to spike high fevers, despite the Ibuprofen. His temperature never fell below 101 degrees. For the next two weeks Kole continued to be seen by Dr. Donaldson, who eventually prescribed Prelone, a steroid. Eventually Kole developed seizures and was admitted to Loma Linda Medical Center with a diagnosis of acquired cerebral palsy. Plaintiff contended that the continued prescription of Prelone, a steroid, reduced the severity of the symptoms and masked the infection with in Koles system. As a result of this negligence, Koles infection went untreated and eventually developed into spinal meningitis causing brain damage, seizures and blindness. A complex case involving Desert Hospital and two doctors. One doctor settled for $600,000.00 before trial. Jury awarded economic damages of $2,750,000.00 and non-economic damages of $1,250,000 (reduced to $250,000 under MICRA) with a future economic value of approximately $20,000,000.00 (medical and wage loss).

Plaintiff's Medical Expert Witnesses:
Joel Ward, M.D. Pediatric Infectious Disease, Harbor-UCLA Medical Center
1124 West Carson Street,Torrance, CA 90502 (310) 222-2346
Irvin Kaufman, M.D. Pediatrics
4638 Alhambra Street, San Diego, CA 92107 (619) 576-5841
Paul Schultz, M.D. Pediatric Neurology, Childrens Hospital and Health Center
3030 Childrens Way, Suite 202, San Diego CA, 92123 (619) 576-5819
Sharon Kawai, M.D. Pediatric Physiatrist, St. Jude Medical Center
101 E. Valencia, Fullerton, California (714) 871-3280
Cheryl Run

Defendant's Medical Expert Witnesses:
For Karen Donaldson, MD:
John Harry Samson, M.D. Pediatrics, Pediatric Medical Center
2921, Redondo Ave., Long Beach, CA 90806 (562)426-5551
Glenn W. Fowler, M.D. Psychiatrics and Neurology, Childrens Hospital of Orange County
455 South Main Street, Orange, CA 92668 (714)532-8626

For Desert Hospital:
William Kneeland, M.D. Pediatric Neurology
959 Las Tablas Road, Suite A, Templeton, CA 93465

Defendant Insurance: Karen Donaldson, M.D. - Freedmont Desert Hospital: Self insured up to 2 Million Dollarsl

Date, Time and Place of Incident(s)
The facts that gave rise to the injuries occurred over a two week period starting October 2, 1995 and ending October 17, 1995.

Facts and Background:  
Defendant DR. DONALDSON was the Hildebrands pediatrician, having treated KOLE since birth. On October 2, 1995, TAMARA HILDEBRAND, KOLEs mother, brought KOLE in to be evaluated for an elevated temperature (to 105 degrees) irritability and not eating. DR. DONALDSON believed this was due to a viral illness, prescribed Ibuprofen, and sent KOLE home. Over the next four days, KOLE continued to spike high fevers, despite the Ibuprofen. His temperature never fell below 101 degrees. On October 6, 1995, TAMARA called DR. DONALDSONs office and was referred to defendant Dr. David Lewis, who was covering for DR. DONALDSON. Dr. Lewis noted KOLEs persistently elevated fevers to 105 degrees, and that he had developed a cough. Dr. Lewis diagnosed laryngotracheobronchitis and prescribed Prelone, a steriod. Despite the defendants prescriptions of both Ibuprofen and steroids, KOLE continued to have fevers.Concerned, and at Dr. Lewis direction, TAMARA returned to DR.DONALDSONs office on October 10, 1995. During that visit, DR. DONALDSON noted KOLEs persistent fever, but no other symptoms. DR. DONALDSON prescribed continue symptomatic treatment and provided TAMARA with Prelone samples. Between October 10, 1995 and October 16, 1995, TAMARA administered both Ibuprofen and Prelone. KOLE did not improve. During the evening of October 15, 1995, his condition worsened. On October 16, 1995, without an appointment, TAMARA brought KOLE to DR. DONALDSONs office. They waited approximately one hour until DR. DONALDSON arrived, during which time KOLE vomited, in the presence of DR. DONALDSONs staff. By that time, KOLE was moaning, extremely irritable and holding his head. DR. DONALDSON noted KOLE would fall asleep in TAMARAs arms when not disturbed. After examining KOLE, DR. DONALDSON prescribed antibiotics.Following that visit, TAMARA took KOLE home. Over the next several hours, KOLEs lethargy increased. By early evening, TAMARA and her husband, MICHAEL, noted KOLE was difficult to arouse and his eyes would deviate to the side of his head. In response, MICHAEL telephoned DR. DONALDSON's office and was told defendant DR. J. SCOTT WERNER was on call for DR. DONALDSON. The Hildebrands were advised by DR. WERNER to meet him at the defendant DESERT HOSPITAL Emergency Department.

DR. WERNER was not present when the Hildebrands arrived at the DESERT HOSPITAL with KOLE. They waited approximately one hour in the waiting room before KOLE was brought back to an examining room. Upon seeing KOLE's condition, the Emergency Department physician, Dr. Leandra Lynch, performed a lumbar puncture. Highly suspicious KOLE had meningitis, Dr. Lynch ordered antibiotics. Soon after that KOLE had his first seizure.

DR. WERNER arrived at approximately 11:00 p.m., and assumed care for KOLE. DR. WERNER began treatment for KOLE's seizure and elected to keep him at DESERT HOSPITAL. He admitted him to a general pediatric floor. For the next 10 hours, KOLE continued to have virtually uninterrupted seizure activity. Unable to control KOLE's seizures, on October 17, 1995 at approximately 7:30 a.m., DR. WERNER contacted Loma Linda Medical Center, and requested KOLE be life-flighted to their Pediatric Intensive Care Unit.

Upon admission to Loma Linda Medical Center, KOLE was given medication which stopped his seizures. KOLE remained hospitalized for the next three weeks and was discharged with a diagnosis of acquired Cerebral Palsy.

Plaintiff's Contentions, Allegations:
Plaintiff contended that Dr. Donaldson was negligent in failing to administer a blood test on either October 10 or October 16. Further, plaintiff contended that the continued prescription of Prelone, a steroid, reduced the severity of the symptoms and masked the infection with in Kole's system. As a result of this negligence, Kole's infection went untreated and eventually developed into spinal meningitis causing brain damage, seizures and blindness.

As to Desert Hospital, plaintiff contended that it was below the standard of care for the nursing staff to inform Dr. Werner that they could provide constant care and constant visual observation of Kole on their general pediatric unit. Further, the nursing staff provided inadequate monitoring and charting. Due to these inadequacies, Dr. Werner was not informed of the severity of Kole's seizures. Plaintiff contended that it was below the standard of care for the nursing staff to not inform Dr. Werner that they would not be able to provide the care Kole required. As a result, Kole was not transferred to a Pediatric Intensive Care Unit until the following morning. Kole suffered damage to his brain due to seizure activity that occurred through the night. This damage could have been controlled had Kole been transferred to a pediatric intensive care unit.

Injuries and/or Damages:
As a result of the negligence, Kole suffers from developmental delay, seizure disorder, ataxic cerebral palsy, cortical blindness.

Defense:
Dr. Donaldson contended that her treatment did not fall below the standard of care in that there was no symptoms that indicated that a severe infection or meningitis was present. Dr. Donaldson further contended that she did not prescribe Kole Prelone on October 10, 1995. Desert Hospital contended that the care of the nursing staff of Desert Hospital did not fall below the standard of care. They further contended that the seizure activity that occurred while Kole was at Desert Hospital did not cause any part of his brain damage.

Specials:
Past Medical: $254,352, Future Medical: $7,606,789( present value), Future Lost Earnings: $414,325 (present value), Out of Pocket: $126,220

Demand:
To Dr. Donaldson: C.C.P. Section 998 offer to compromise for $1,000,000.
To Desert Hospital: C.C.P. Section 998 offer to compromise for $2,000,000

Settlement Amounts: Dr. Werner settled out of the case before trial for $600,000.00

Verdict or Award:
Economic: $2,750,000, Noneconomic: $1,250,000, reduced to $250,000 under MICRA,
Future Economic Value: Approximately $20,000,000.00 medical and wage loss

Other Verdict Details:
January 21, 1998. Defendant negligence, Desert hospital: 35 percent. Dr. Donaldson: 35 percent

Length of Trial: 21 Days

Jury: 3.5 day deliberation

Attorney for client: Kevin F. Quinn and Leo R. Bartolotta

Attorney for defendant:
For Karen Donaldson, M.D.: H. Gilbert Jones Firm, Lewis, DAmato, Brisbois & Bisgaard
For Desert Hospital: Ralph Helton Firm: Helton and Associates