In its wide-ranging opinion filed on June 16, 2015, the Supreme Court of Appeals of West Virginia (“West Virginia Supreme Court”) upheld and affirmed a West Virginia medical malpractice jury’s verdict in favor of the plaintiff that included an award of punitive damages in the amount of $500,000 against the defendant doctor.
The jury had awarded the plaintiff $500,000 in noneconomic damages and $500,000 in punitive damages, which was reduced to $810,000 to reflect the off-set from the non-economic damages awarded by the jury for the amounts of all pre-trial settlements.
The Underlying Facts
The 65-year-old decedent had a history of chronic health problems that included obstructive sleep apnea, COPD, and chronic hypercapnia that caused him to retain excess carbon dioxide (CO2) in his blood and to become confused and agitated.
In October 2008 and in March and June 2010, the decedent was admitted to the hospital with acute respiratory distress caused by excess CO2 retention that caused decreased mental and respiratory function. During the June 2010 admission, the defendant doctor was listed as the decedent’s attending physician. The decedent was successfully treated and discharged to home with a BiPAP portable ventilator to use at home to treat his hypercapnia.
On September 3, 2010, the decedent returned to the hospital with an exacerbation of the same chronic lung problems for which he had been treated during his June 2010 visit. The defendant doctor was again listed as the decedent’s attending physician. The Admission History and Physical on admission to the hospital noted the decedent’s allergies that included Seroquel, Ativan, and Aldactone (during a previous hospitalization, the decedent became excessively sedated when he was given 50 mg of Seroquel and therefore was determined to have an adverse reaction to the medication – sedation was hazardous to his lung function and mental function).
Nonetheless, the decedent was given two different anti-psychotic sedatives during his September 2010 admission because of his confusion and altered mental state, including Seroquel that was ordered by the chief resident despite the admitting records noting the decedent’s prior adverse reaction to Seroquel. After the administration of Seroquel, the decedent became more disoriented, agitated, and combative, and subsequently became very sedated. The defendant doctor signed off on the chief resident’s order for the administration of Seroquel and she took no further action.
The following day, a neurological consult was ordered due to the decedent’s altered mental status, and the neurologist ordered that the decedent be administered 25 mg of Seroquel that afternoon. The decedent remained sedated most of the day and night of September 4, 2010, and never fully awakened.
Although the decedent’s initial ABG’s revealed that he had excessively high CO2 levels in his blood, no follow-up ABG studies were ordered to continue to monitor his CO2 levels once he was admitted. The record further reflected that a pulmonologist was not consulted at any point during the decedent’s admission.
Although the decedent required a BiPAP when he slept, the record revealed that a BiPAP was not ordered until 10:00 pm on September 4, 2010, despite the fact that he was heavily sedated during the course of his hospital stay. During the early morning hours of September 5, 2010, the decedent developed tachyarrhythmia, QRS widening, bradycardia, and asystole, and he died at 7:00 am.
The personal representative of the decedent’s estate filed the West Virginia medical malpractice lawsuit that alleged that the defendant doctor and others deviated from the standard of care by prescribing and administering excessive doses of Haldol and Seroquel to the decedent, ignoring documented allergies, contraindications, and black box label warnings, and by willfully and recklessly failing to take any measure to investigate or rectify the reasons for the decedent’s prolonged state of unconsciousness, which proximately caused his death. The allegations of medical malpractice against the defendant doctor further alleged that the defendant doctor became aware that the decedent had been given Seroquel by other physicians but failed to take any countermeasures.
After the defendant doctor lost at trial, she appealed the jury’s verdict, raising many issues, including the appropriateness of an award of punitive damages by the jury.
The West Virginia Supreme Court held that upon its review of all of the evidence presented at trial, there was sufficient testimony presented for a jury to be convinced that willful, wanton and reckless conduct occurred warranting punitive damages, stating that the punitive damages definition of malice has grown to include not only mean spirited conduct, but also extremely negligent conduct that is likely to cause serious harm.
The West Virginia Supreme Court held that the plaintiff had presented sufficient evidence that the defendant doctor’s care of the decedent was dangerous, and at the very least highly reckless.
Source Delilah Stephens, M.D. v. Charles Rakes, Personal Representative of the Estate of Gary Rakes, No. 13-1079.
If you were harmed as a result of medical negligence in West Virginia, you should promptly find a West Virginia medical malpractice lawyer who may investigate your medical malpractice claim for you and represent you in a West Virginia medical malpractice case, if appropriate.
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