JOAN BARRON Star-Tribune capital bureau | Posted: Tuesday, April 13, 2004 12:00 am
CHEYENNE - The Wyoming Supreme Court ordered a new trial Monday in a medical malpractice case that confused the jury.
The Supreme Court handed down a split 4-1 ruling in a lawsuit filed by Ivan P. and Jennifer Armstrong against Tanya L. Hrabal, M.D. and Emergency Medical Physicians P.C.
The majority opinion said Laramie County District Judge Nicholas Kalokathis was wrong when he precluded the Armstrong's emergency medicine expert from giving his opinions on the standard of care for treatment while allowing the defendant's expert to give his opinion.
On Feb. 5, 1999, one of the Armstrong's children was diagnosed at a private medical clinic as suffering from influenza. As a precaution, the Armstrong family members were prescribed an anti-influenza medication.
On Feb. 25, Armstrong awoke with head and body aches and nausea and received a second dose of anti-influenza medication at the clinic.
Three days later he went to the emergency room of United Medical Center in Cheyenne.
He was seen by Dr. Hrabal who concluded Armstrong had influenza and ordered fluids for his dehydration.
On March 2, 1999, Armstrong was admitted to the hospital with dizziness, fever, vomiting and diarrhea.
During the afternoon of March 3, 1999, Armstrong got worse. Philip Sharp, M.D., an infectious disease specialist who was called in for a consultation, concluded Armstrong was suffering from sepsis. He ordered broad coverage antibiotics and body fluid culture. The next day the culture proved positive for bacterial infection.
Subsequent tests reveal that Armstrong had endocarditis, an infection of the heart valve. He underwent surgery to replace his aortic valve with a prosthetic valve.
The endocarditis was caused by the bacteria staphylococcus aureus.
One of the Armstrong's expert witnesses was Gary M. Green, M.D., board certified in internal medicine and infectious disease. Green, who formerly practiced in Casper, was to establish the standard of care for infectious disease care in the emergency room.
The attorney for the defendants objected to Green's testimony on grounds Green is not certified in emergency medicine. Kalokathis agreed.
But the defendant's expert, Dennis L. Stevens, M.D., was allowed to testify on the standard of care even though he had no training in emergency medicine since his internship.
During deliberations, the jury submitted a note to the judge, saying, "We have a problem with 'What is standard of care?"' All the doctors testified differently, the note said.
The jury ruled in favor of the defendants.
"We cannot find such error to have been harmless, given the jury's stated confusion as to the standard of care," said the majority opinion written by Justice Barton Voigt.
Dissenting, Justice Larry Lehman wrote that while he agrees it was improper for the district court to exclude Green's standard of care testimony, it was not prejudicial to the Armstrongs.