Nurse testified she was with pt. at time of cardiac arrest.

ON JUNE 1,1995, JESSE JOHNSON SUFFERED A CARDIOPULMONARY ARREST AND WAS TRANSPORTED TO LOYOLA UNIVERSITY MEDICAL CENTER. He was admitted to the Cardiac Care Unit (CCU) under the care of Dr. Diane Wallis, a board-certified cardiologist and critical-care specialist. Dr. Wallis maintained that tests revealed evidence of renal compromise. The patient was removed from the ventilator on June 2, 1995. That same day, Dr. Wallis scheduled a cardiac catheterization for Monday, June 5. The patient said he would rather die than be on dialysis. In addition, Dr. Wallis maintained that an angiogram was not done before the patient was transferred to the medical floor on June 4, because they wanted to let him stabilize and to look into the kidney situation. On June 4, 1995, Dr. Wallis ordered the patient's admission to a general medical floor, without continuous telemetry or oxygen monitoring. Dr. Davis' plan at the time was to have a renal consultant talk to the patient to reassure him that his fear behind his refusal to consent was exaggerated. Dr. Carroll saw the patient on the morning of June 5, 1995. He ordered a dobutamine stress test to evaluate the patient's cardiac status. The test would allow doctors to determine whether an angiogram was necessary. That night, the patient suffered another cardiopulmonary arrest. Reports by two staff physicians indicated that the patient was "found" unresponsive in his chair, with a heart rate of less than 30 beats per minute. However, Sandra Walshon, who was the patient's nurse for the night, maintained that at 9 p.m., the patient called her into his room and complained of shortness of breath. As Nurse Walshon was applying oxygen, the patient became diaphoretic. Acode team arrived. Nurse Walshon was present when the patient went into cardiopulmonary arrest. The patient was resuscitated, but did not regain consciousness. After the patient was stabilized, Dr. Lewis performed an emergent catheterization and angiogram (after consent forms were signed by the patient's wife and daughter). However, a neurology assessment showed that the patient suffered from prolonged oxygen deprivation resulting in irreversible brain damage. The patient never regained consciousness and was dependent on a ventilator until his death several months later. The administrator of the patient's estate brought suit against the hospital and doctors. After a jury trial, the jury returned a verdict for the plaintiff for $1,412,000. The trial judge granted the defendants' motion for Judgment Notwithstanding the Verdict (JNOV). The plaintiff appealed.

THE APPELLATE COURT OF ILLINOIS REVERSED THE TRIAL COURT'S GRANT OF JNOV FOR THE DEFENDANTS AND REINSTATED THE JUDGEMENT FOR THE PLAINTIFF IN THE AMOUNT OF $1,412,000 DOLLARS. The court held, inter alia, that the defendants were not entitled to JNOV since the only question presented to the jury was whether the defendants were negligent when they failed to adequately monitor the patient since the plaintiff's expert medical witness testified that the failure was the proximate cause of the patient's injuries.

THE ONLY ISSUE PRESENTED TO THE JURY WAS WHETHER OR NOT THE DEFENDANTS WERE NEGLIGENT. The precise point of the issue was whether the defendants were negligent when they "failed to maintain Jesse Johnson in a Cardiac Care Unit or telemetry unit with continuous EKG and 02 Sat. monitoring." The jury returned a verdict in favor of the plaintiff against Dr. Carroll, and vicariously against the hospital. However, the jury found in favor of Dr. Wallis, the other cardiologist. The trial court entered JNOV in the defendants' favor on the basis that the plaintiff failed to prove proximate cause. The trial court cited the rule that proximate cause in a medical malpractice case must be established through expert testimony. Although the trial court had determined during the trial that the expert retained by the plaintiff, Dr. Ian Newmark ,could not present his opinion about the need for and timing of cardiac catheterization or bypass surgery, he should have been permitted to do so over the defendants' objection. However, the trial court erroneously ruled that because Dr. Newmark, a pulmonologist and critical-care specialist, was not qualified to testify as to the appropriateness of cardiac catheterization and bypass surgery, his opinion that intervention through catheterization and surgery would have prolonged the patient's life was merely speculation. In this regard the trial court erred when it concluded that the evidence of proximate cause was insufficient to sustain the jury verdict in favor of the plaintiff and against Dr. Carroll, and the hospital. However, the Supreme Court of Texas was convinced that there was sufficient evidence introduced by the plaintiff to allow the jury to find that the failure to maintain the patient in the Cardiac Care Unit was the cause of the patient's death, as Dr. Newmark testified. Had the patient remained in the CCU where his condition was continuously monitored by telemetry systems, the patient would have received the care he so desperately needed much sooner than he did and thus, would have survived. Johnson v. Loyola University Medical Center, Iw080404185 (03/31/08)--IL

Meet the Editor & Publisher: A. David Tammelleo, JD, is a nationally recognized authority on health care law. Practicing law for over 40 years, he concentrates in health care law with the Rhode Island firm of A. David Tammelleo & Associates. He has presented seminars on medical, nursing and hospital law throughout the United States. In addition to his writings as Editor of Medical Law's, Nursing Law's & Hospital Law's Regan Reports, his legal articles have been published in the most prestigious health law journals. A prolific writer, his thousands of articles, as well as his achievements as an attorney and lecturer, have won him recognition in Martindale-Hubbell's Bar Register of Preeminent Lawyers, Marquis Who's Who in American Law, Who's Who in America and Who's Who in the World.