The Appellate Court of Illinois, First Judicial District (“Appellate Court”) affirmed a defense verdict in an Illinois Medical Malpractice case in its opinion filed on December 2, 2016. The parents of a minor child who died following her pacemaker replacement surgery at the defendant hospital alleged that negligent medical treatment after the surgery caused her death.

The Alleged Underlying Facts

The plaintiffs’ daughter was born in 2010 with a chromosomal abnormality that resulted in several anatomical defects, including an inverted heart structure and dextrocardia, a condition in which the heart is located in the right rather than in the left chest. The child also had an atrioventricular block, a condition in which the impulses from the upper chambers of the heart are blocked from the lower chambers. To fix the block, the child underwent surgery when she was six days old to implant a pacemaker.

Two years later, the plaintiffs’ daughter needed a new pacemaker. On February 10, 2012, the plaintiffs’ daughter had surgery at the defendant hospital to replace the old pacemaker with a new one. During the surgery, a small laceration occurred on the surface of her heart. The laceration was sutured with a single stitch. Prior to closing the skin, the surgeons placed a tube in her chest to drain fluid. At the conclusion of the surgery, the child was stable and the surgeons advised the parents that the procedure had been successful.

The child was transferred to the pediatric intensive care unit (“PICU”) at 2 p.m. A few hours later, she became agitated and a nurse gave her a small dose of Versed, a sedative narcotic, to help her relax, as well as a fentanyl drip to help with any pain. About 8:20 p.m., another nurse reported that the child appeared fussy and uncomfortable. That nurse administered a second small dose of Versed.

About 8:35 p.m., the second nurse noticed that the child’s breathing had become shallow and irregular and immediately called the first nurse to the room to assess any changes in the child’s condition. The nurses began giving the child oxygen at approximately 8:45 p.m. and called a code identifying an emergent situation with the patient.

The code team arrived in less than a minute and the nurses administered medications and blood, performed compressions and tests, and protected the child’s airway. Over the next two hours, approximately 10 to 15 nurses, residents, and physicians conducted tests and worked to diagnose the child’s adverse symptoms and resolve the problem.

Blood was drawn around 9:30 p.m. to evaluate the child’s blood gas levels. The blood draw was tested three times: the first test showed levels so low they were unreadable and the next two tests showed abnormally low levels (extremely low hemoglobin levels could be one indication of internal bleeding). The treating physicians, however, believed the test results were inaccurate and most likely the result of a sampling error.

A chest x-ray, ultrasound, and echocardiogram were done, and the physicians determined that the images from those tests ruled out the possibility of internal bleeding. When a doctor checked the child’s discharge tube and a nurse felt her stomach, the chest tube output was low and her chest was soft. Those findings corroborated the results of the image tests, which indicated no evidence of internal bleeding or fluid or blood around the heart. The doctors decided not to perform a pericardiocentesis because there was no indication of fluid that needed to be withdrawn. The doctors also decided not to place her on an extracorporeal membrane oxygenation (ECMO) machine because staff had already been performing chest compressions for over 40 minutes and the machine would have had little chance of being effective by the time a team was mobilized. The medical staff continued with resuscitation efforts until it became clear those efforts were futile. The child was declared dead at 10:46 p.m. on February 10, 2012.

The Parents’ Medical Malpractice Action

The child’s parents filed an Illinois Medical Malpractice lawsuit against the hospital. The Illinois medical malpractice jury trial commenced in October 2014. Over five weeks, the jury heard testimony from multiple experts from both sides, as well as testimony from the nurses and doctors who had provided care to the child.

The plaintiffs’ medical experts testified during trial that the standard of care required the doctors to surgically re-explore the child to stop or prevent internal bleeding or cardiac tamponade, perform a pericardiocentesis to remove excess fluid from her chest, perform a portable chest x-ray to ensure the endotracheal tube remained in the correct place, and have an ECMO machine readily available.

The defendant hospital’s medical experts testified during trial that the treatment rendered to the child was appropriate under the circumstances because there was no evidence of excess fluid in her chest or proof of cardiac tamponade and, consequently, the other measures suggested by the plaintiffs’ experts would not have helped.

The Illinois medical malpractice jury returned a defense verdict and the plaintiffs appealed, arguing that a new trial is warranted because the jury’s verdict for the defendant hospital on their medical negligence claim was against the manifest weight of the evidence.

The Appellate Court stated that a verdict is against the manifest weight of the evidence where the opposite conclusion is clearly evident or where the findings of the jury are unreasonable, arbitrary, and not based upon any of the evidence: a reviewing court may not simply re-weigh the evidence and substitute its judgment for that of the jury and the weight to be assigned to an expert opinion is for the jury to determine in light of the expert’s credentials and the factual basis of his opinion.

The Appellate Court held that its review of the record establishes that the defendant hospital presented more than enough evidence to establish that a verdict in its favor would be a reasonable conclusion.

Source Eid v. Loyola University Medical Center, 2016 IL App (1st) 143967.

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