For the week of June 16, 1999 thru June 23, 1999
Jury awards $30 million in malpractice case
Dr. Coriell exonerated
By GREG MOORE
The Kirkland family.
An eight-woman jury in federal court in Boise on Monday awarded almost $30 million to the plaintiffs in a medical malpractice suit over care received from nurses at the Wood River Medical Center and from two local doctors.
Attorneys involved in the case said the award is probably several times higher than any other medical malpractice award in Idaho history, and may be the largest personal injury award ever in the state.
The Wood River Medical Center will be responsible for about $3.5 million of the $29.7-million award. The hospitals portion is covered by insurance.
Former Carey residents Sandy and Quinn Kirkland contended that irreversible brain damage to their son, Bryce, was caused by an amniocentesis that punctured a fetal blood vessel. The resulting intrauterine bleeding was not discovered for 16 hours.
After a month-long trial, the jury allocated 75 percent of the responsibility for the damage to Dr. Ross Donald, a Ketchum obstetrician who performed the amniocentesis, and 25 percent to the hospital, whose nurses monitored Sandy afterward. Dr. Randall Coriell of Hailey, Sandys primary physician, was exonerated.
The Kirklands had asked for almost $12 million in economic damages and $17.5 million for pain and suffering on the part of themselves and their son.
Of the total jury award, $18.5 million was for non-economic damages. The award is complicated by the fact that Idaho law limits non-economic damages against each defendant to about $550,000 unless the jury finds the defendant to have engaged in reckless conduct. The Kirklands attorneys spent considerable time trying to convince the jury that the hospital and Dr. Donald had acted recklessly. Jurors agreed with that contention in the case of Dr. Donald, but found the medical center to have been merely negligent.
The case involved a triangle of adversity, with the plaintiffs in one corner, Dr. Donald and the hospital in a second and Dr. Coriell in the third. Much of Dr. Donalds and Dr. Coriells testimony contradicted the other.
"The jury clearly believed what Dr. Coriell had to say," plaintiffs attorney Paul Luvera said in an interview. "Theres no other way to interpret the verdict."
In an interview, a juror confirmed that she had found Dr. Coriell to be more credible.
Dr. Coriell was the last party in the trial to present his case. He told jurors that he had asked Dr. Donald whether he had inserted the needle through Sandys placenta to reach a pocket of amniotic fluid and that Dr. Donald had told him, "No."
Dr. Donald had earlier testified that Dr. Coriell never asked him that question.
Dr. Coriells case was bolstered by testimony from Dr. Ty Erickson, an obstetrician in Idaho Falls., who told jurors that Dr. Donald never should have performed the amniocentesis in the first place.
"I believe that in performing a trans-placental amniocentesis in trying to decide whether the patient stays in the hospital or goes home, the risks exceed the benefits," Dr. Erickson said.
Dr. Erickson also faulted Dr. Donald for not telling Dr. Coriell that he had gone through the placenta and that he had obtained a small amount of blood on the needle.
"The baton gets dropped and that leads to substandard care and to the untoward outcome," Erickson said.
In an interview following the trial, Dr. Coriell said that though he was surprised by the size of the award, he thought the verdict "was fairly representative of the evidence."
"Im happy the plaintiffs were taken care of," he said.
Despite a mountain of complex and often contradictory testimony and evidence, the jury deliberated only four hours.
In an interview, Dr. Donald called it "incomprehensible" that the jury had found him 75 percent responsible after the hospital had admitted liability during the trial for its nurses failure to read the fetal heart monitors printouts.
Of the verdict, a juror said that she had placed much of the blame on Dr. Donald because he had not notified Dr. Coriell or the nurses that he had done a trans-placental amniocentesis. If he had, she said, they probably would have been more careful in monitoring Sandy.
Dr. Donald said that even though he feels wronged by the verdict, "Good things come out of a lot of different strange situations, and I believe that some good things will come to the community from this." He predicted that local medical specialists will be less willing to act as consultants for family-practice doctors, but will instead want to take over the entire care of any patient they treat.
"The quality of care is now going to be elevated to the quality of care of the specialists," Dr. Donald said.
Dr. Donald predicted that the trial outcome will "probably have some sort of economic effect" on his practice, but that he and his colleagues will continue to have a very busy practice.
According to trial testimony, the damage to Bryces brain accumulated during the night of Aug. 16-17, 1995 after Sandy had left Dr. Donald and returned to the medical centers Hailey campus. Though Sandy was hooked to a fetal heart monitor intermittently during that time, no one noticed the disturbingly flat line the monitor was tracing.
"I think that what happened here was unconscionable," plaintiffs attorney Paul Luvera told the jury during his closing argument. "This was so unnecessary."
The case went as far as it did only because of a refusal by the hospitals and Dr. Donalds insurance companies to settle it.
According to Dr. Donald, the Farmers Insurance Group policy that covers both the medical center and the doctors who practice there has a damage limit of $10 million. Donald said that when the extent of Bryces brain damage became evident shortly after his birth in August 1995, he and the hospital asked Farmers to pay the Kirklands any claim up to the coverage limit. Luvera confirmed that Farmers had "multiple opportunities " to settle. Negotiations continued through the trial.
"We did not want to do this," Dr. Donald said of the trial. "The hospital did not want to put us through it nor did we want to put Sandy and Quinn through it." However, he added, the insurance companies insisted on trying the case, counting on a low award in conservative Idaho.
"They thought they could get a better deal," he said. "They didnt care about us. They didnt care about the Kirklands."
The insurance situation was complicated by layers of companies that provide "excess" coverage to Farmers over various ceilings, up to the $10 million total. Resistance to settling the case appears to have come from one of those companies, American International Group, whose exposure, according to Dr. Donald, kicks in at $5 million.
In a May 20 letter, Farmers representative Ron Spriggs told Dr. Donalds personal attorney that "as of today, AIG has not authorized settlement negotiations above the $5 million offered."
The hospitals and Dr. Donalds attorney in the case, Steve Tolman, could not be reached for comment yesterday on his next move. However, the size of the award and squabbles with the insurance companies make further legal activity almost inevitable.
"I suspect you have not heard the end of this story," Luvera said.
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