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| Disposition:
(Settlement/Arbitration/Trial) |
Trial |
Date: |
11/6/1991 |
Type of Case: |
Medical Malpractice |
Allegation(s): |
Death of a Child |
Result: |
$1,200,000 |
Case Name: |
Norby v. Children's Hospital, James Mathewson,
M.D., Judith Isherwood, JNS Nursing Service |
Facts: |
The decedent, 13-month-old Marikar Norby, suffered from Wolff-Parkinson-White syndrome and was on Digoxin to help control her symptoms of arrhythmia.
In August 1988, Marikar suffered an episode of supraventricular tachycardia. At that time Dr. Mathewson removed Marikar from the Linoxin and started her on Norpace. Norpace is a drug known to reduce cardiac output, with recognized therapeutic blood levels of between 2 and 5, and toxicity at 7 or above. Marikar's initial blood level measured 2. Her dosage was then increased at the time of her discharge.
Marikar was seen three more times before her final hospitalization. The first time was on September 1, 1988. At that time she had a recurrence of a rapid heart beat and her Norpace intake was increased. On September 6, 1988, Marikar's cardiovascular status was found to be stable. Based on her Norpace level, the dosage of the medication went unchanged at that time. Marikar was then seen on October 25, 1988. Her Norpace level and cardiovascular status were both normal.
On November 16, 1988, Marikar's elevated heart rate returned and she was admitted to the hospital. Dr. Mathewson noted that her previous Norpace levels had been in the low end of the therapeutic range. He then increased her dosage of Norpace and also placed her on Inderal. A second dosage was then administered seven hours later. Soon after, a widening of the QRS complex was noticed. The widening indicated a potential Norpace toxicity. Dr. Mathewson concluded that it was "artifact" and gave no new orders.
On November 17th, at 7:00 a.m., chest x-rays revealed cardiomegally with evidence of interstitial edema and some degree of congestive heart failure. (Congestive heart failure as a result of decreased cardiac output can also be an indication of potential Norpace toxicity.) At 5:00 p.m., Marikar was given more Norpace and an increased dosage of Inderal. She was then discharged at 5:30.
Within 2-1/2 hours, Marikar was into respiratory arrest. She was taken to Sharp Hospital where her Norpace level was measured at 8.9. She was then transferred to Children's Hospital where her Norpace level rose to 14.6. Marikar died at approximately 12:30 p.m. on November 18, 1988.
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| Injury/Injuries: |
Wrongful death. Emotional distress of parents.
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| Contentions: |
Plaintiffs contended that Dr. Mathewson should have checked Marikar's blood levels before removing her from the Digoxin and then placing her on Norpace. The plaintiffs also contended that the dosage of Norpace was excessive and placed the decedent at great risk to incur Norpace toxicity. Additionally, the plaintiffs contended that the use of Inderal in combination with the Norpace was innappropriate as both of these medications worked to decrease kidney and cardiac output, which ultimately led to Marikar's death.
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| Special Notes: |
The jury
was out three days after a ten-day trial.
Plaintiff's verdict was against defendant
James Mathewson, M.D. only.
The jury verdict was reduced to $250,000
for general damages (the statutory cap
on emotional distress damages per MICRA)
plus costs.
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