Hollywood Medical Center, Inc. v. Alfred
2012 Fla. App. LEXIS 1328
| Fla. Dist. Ct. App. | 2012Background
- May 18, 1996: Ursuline Alfred experiences a seizure and is taken by emergency services to Hollywood Medical Center (HMC).
- Alfred arrives at HMC emergency department around 8:08 p.m. with impaired vital signs and a very low Glasgow Coma Scale (3).
- Nurse Ackerly and ER staff assess Alfred; Dr. Schillinger orders treatment including valium to prevent further seizure; vital signs are unstable (pulse 40s, BP 49/?, shallow respiration).
- Between 8:20 and 8:22 p.m., Alfred receives Atropine, epinephrine, and an unsuccessful intubation attempt, followed by Anectine (paralytic) to facilitate intubation; she then goes into full cardiac arrest and dies at 8:40 p.m.
- Expert testimony indicated that immediate intubation and respirator support could have rendered Alfred survivable; pulmonary embolism suspected as cause of death by cardiology expert. Nurses’ alleged breaches included mislabeling level of care, delayed vitals, and failure to question valium administration with a low heart rate, but causation by nursing conduct was not shown.
- The trial court denied the hospital’s directed verdict motion; the jury found both the ER physician and hospital negligent. On appeal, the court reversed and remanded for judgment in favor of the hospital, due to lack of causation evidence for nursing negligence.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Proximate causation by nursing conduct | Alfred argued nurses’ deviations from standard care breached duties and caused death. | Hospital argued nursing breaches did not causally affect outcome; physician's acts governed causation. | No causation shown for nursing negligence; reversal for entry of judgment for hospital. |
Key Cases Cited
- Gooding v. Univ. Hosp. Bldg., Inc., 445 So.2d 1015 (Fla. 1984) (requires evidence that breach more likely than not affected the outcome (causation))
- Cox v. St. Josephs Hosp., 71 So.3d 795 (Fla. 2011) (distinguishable; expert testimony must be grounded in medical facts, not speculative; jury should decide disputed evidence)
- Henry v. Hoelke, 82 So.3d 962 (Fla. 4th DCA 2011) (de novo review of directed verdict standard)
- Tarpon Springs Hosp. Found., Inc. v. Reth, 40 So.3d 823 (Fla. 2d DCA 2010) (references directed verdict standard and standard of review)