Two feeding tubes punctured lungs, causing wrongful death. $1.5M, reduced by MICRA. Los Angeles County.

Summary

Nurse injures patient in placement of feeding tubes.

The Case

  • Case Name: Nahid Lahiji v. Providence Little Co of Mary Medical Center-Torrance, John Flynn RN, and Roman Culjat MD
  • Court and Case Number: Los Angeles Superior Court / BC 580105
  • Date of Verdict or Judgment: Monday, March 16, 2020
  • Date Action was Filed: Tuesday, April 28, 2015
  • Type of Case: Medical Malpractice, Wrongful Death
  • Judge or Arbitrator(s): Hon. Helen Zukin
  • Plaintiffs:
    Nahid Lahiji individually and as Heir to Mansoor Lahiji, Decedent
  • Defendants:
    Providence Little Company of Mary Medical Center-Torrance; John Flynn, RN; and Roman Culjat, MD.
  • Type of Result: Jury Verdict

The Result

  • Gross Verdict or Award: $1,520,645.31
  • Net Verdict or Award: $270,645.31
  • Award as to each Defendant:

    60% apportionment to Providence Little Co of Mary Medical Center-Torrance.

    40% apportionment to John Flynn, RN.

    Jury found no liability but against Roman Culjat M.D.

  • Economic Damages:

    Funeral/burial expenses: $20,645.31

  • Non-Economic Damages:

    Wrongful death: $1,500,000 – reduced per Civil Code Section 3333.2 (MICRA) to $250,000

  • Trial or Arbitration Time: 10 days .
  • Jury Deliberation Time: 8 hours.
  • Jury Polls: 12-0 on liability as to defendants Providence Little Co of Mary Medical Center-Torrance and John Flynn RN; 9-3 on liability as to defendant Roman Culjat MD; 11-1 on damages.
  • Post Trial Motions & Post-Verdict Settlements: Memorandum of costs by plaintiff including four years of prejudgment interest and expert witness fees pending per CCP Section 998 .

The Attorneys

  • Attorney for the Plaintiff:

    Law Offices of Nora Hovsepian by Nora Hovsepian, Encino.

    Schlichter & Shonack LLP by Jamie Keeton, El Segundo.

  • Attorney for the Defendant:

    Parrett & Elsberry by James Parrett and Alison Vitacolonna, Irvine. (For Providence Little Co of Mary Medical Center-Torrance and John Flynn RN.)

    Reback, McAndrews & Blessey by Robert Reback, Manhattan Beach. (For Roman Culjat M.D.)

The Experts

  • Plaintiff’s Medical Expert(s):
    Paul Merrel, RN, nursing.
    Thomas McIlraith, M.D.,hospital medicine.
    James Leo, M.D., critical care/internal medicine.
  • Defendant's Medical Expert(s):
    William Klein, M.D., pulmonology/critical care/internal medicine, for hospital and nurse  defendants.
    Andrew Wachtel, M.D., pulmonology/critical care/internal medicine, for Dr. Culjat. 
     

Facts and Background

  • Facts and Background:

    Plaintiff’s decedent Mansoor Lahiji, aged 73, died on Oct 2, 2014 at Providence Little Co of Mary Medical Center-Torrance as a result of bilateral pneumothoraces caused by the negligent placement of two small bore “Dobhoff” feeding tubes by John Flynn, RN; first puncturing his right lung, then being removed and misplaced again through his left lung. These bilateral lung injuries caused him to lose the ability to breathe, directly leading to cardiopulmonary arrest and an entirely preventable death.

  • Plaintiff's Contentions:

    As to defendant Providence Little Co of Mary Medical Center-Torrance, plaintiff contended (1) that the hospital’s written policies and procedures were vague and ambiguous and gave nurses too much leeway in making clinical decisions regarding the placement, removal and reinsertion of feeding tubes; (2) that the hospital’s own staff competency checklists proved that John Flynn, RN lacked competency in the placement of small bore feeding tubes; (3) that despite the known lack of competency, the hospital allowed John Flynn, RN to place small bore feeding tubes, thereby subjecting plaintiff’s decedent to an unreasonable risk of foreseeable harm.

    NOTE: As the result of an administrative complaint filed by plaintiff’s family, the California Dept of Public Health issued a Statement of Deficiencies against the hospital and required a Plan of Correction in July 2019 whereby the hospital changed its policies to preclude nurses from placing small bore feeding tubes and requiring that only MDs may do so. This evidence was excluded at trial per defendant’s motion in limine.

    As to defendant John Flynn RN, plaintiff contended that he was negligent in failing to disclose his lack of competency in placing small bore feeding tubes, negligent in his placement of two feeding tubes first through the patient’s right lung and then his left lung, negligent in failing to request a medical order before replacing, removing them reinserting the feeding tubes, and failing to recognize red-flag warning signs that the patient lacked a cough/gag reflex which would have alerted him to the misplacement of the feeding tubes.

    As to defendant Roman Culjat, M.D.,plaintiff contended that he was negligent in issuing vague and ambiguous orders to nursing staff concerning the feeding tubes, failing to be on-site or ensuring a hand off of the patient to another hospitalist, and failing to timely respond to numerous answering-service pages while being on call.

  • Defendant's Contentions:

    Defendants Providence Little Co of Mary Medical Center-Torrance and John Flynn, RN contended that they were not negligent and that the life expectancy of plaintiff’s decedent in the absence of the lung injuries caused by the misplaced feeding tubes was less than one to two months.

    Defendant Roman Culjat, M.D. contended that he was not negligent, that he was not timely informed by nursing staff that there was a misplacement of the feeding tubes, and that he responded appropriately to the answering-service pages once he received notice of the patient’s lung injuries while he was appropriately on call as the hospitalist.

Injuries and Other Damages

  • Physical Injuries claimed by Plaintiff:

    Wrongful death of plaintiff’s husband.

  • Funeral/burial expenses of $20,645.31

Demands and Offers

  • Plaintiff §998 Demand: $199,999

Additional Notes

Plaintiff demand at trial from jury: $2,020,645.31.
 
Defendant hospital settlement offer during trial: $225,000.