The Court of Appeals of Georgia held in its opinion dated July 1, 2021: “given Dr. Peng’s willingness to prescribe anticoagulant therapies, his appreciation of the decedent’s pre-existing risk factors for DVT, and his understanding of the “significant” DVT risk associated with immobility, it would be reasonable to conclude – as Dr. DeMarini did in his deposition testimony – that nursing reports concerning the decedent’s immobility would have prompted Dr. Peng to administer anticoagulant medication, which would have significantly reduced the decedent’s risk of a DVT.”

The Underlying Facts

In February 2014, Rhonda Orr (“decedent”), had surgery to repair the quadriceps tendon in her right knee. The decedent eventually developed an infection in her knee and was readmitted to the hospital for additional surgical procedures. On June 25, 2014, she was admitted to Northeast Atlanta Health and Rehabilitation Center (“NAHR”) by her attending physician, Sam Qingshuang Peng, M.D., for further recovery and convalescence. On July 16, 2014, the decedent became unresponsive after experiencing shortness of breath and a decrease in her oxygen saturation. She was transported to the hospital and died that same day.

The Georgia Medical Malpractice wrongful death complaint alleged that the decedent’s cause of death was a pulmonary thromboembolus (“PE”) resulting from a dislodged deep vein thrombosis (“DVT”). According to the complaint, Dr. Peng failed to recognize that the decedent’s mobility was comprised while at NAHR, putting her at risk for a DVT, and failed to provide proper prophylaxis against the development of a DVT by prescribing an oral or injectable anticoagulant medication. With respect to NAHR, which is the sole defendant who was a party to the appeal, the complaint similarly alleged that the nurses at the facility failed to appreciate the decedent’s risk of DVT, failed to report the decedent’s immobility to the relevant physicians, and failed to institute a DVT prophylaxis protocol. Attached to the complaint was an affidavit of Richard Bonfiglio, M.D., who opined, in relevant part, that the decedent’s care by the NAHR nursing staff “fell below the minimum care and treatment required of nurses generally, under like conditions or similar circumstances.” Later, Orr supported her claims by offering deposition testimony from three medical providers, Dr. Bonfiglio, Thomas DeMarini, M.D., and Nurse Ethel Willis, RN, BSN, MSN.

While the Georgia Court of Appeals affirmed the trial court’s decision that two of the three experts designated by the plaintiff were unqualified for various reasons, the Georgia Court of Appeals nonetheless stated: “Looking at Dr. Peng’s deposition in a light most favorable to Orr, the physician understood that immobility was “a pretty significant factor” in considering DVT risk, but Dr. Peng was seemingly unaware that the decedent had, as Dr. Thomas DeMarini testified, become immobile and bed bound. Dr. DeMarini testified in his deposition that it was incumbent upon the nurses at NAHR to relay the decedent’s immobility to Dr. Peng … whether proper communication concerning the decedent’s mobility would have altered Dr. Peng’s course of treatment also presents a fact question. Dr. Peng’s testimony suggests that, depending on the circumstances, he would prescribe anticoagulants and described the decision as a “clinical call.””

The Court of Appeals of Georgia concluded: “In the end, while there may be questions concerning Dr. Peng’s role in the decedent’s death – questions that are not before this Court and that we need not decide – “proximate cause is generally an issue for the jury, and there may be more than one proximate cause of an injury in cases involving the concurrent negligence of several actors.”

Source Orr v. SSC Atlanta Operating Company, LLC d/b/a Northeast Atlanta Health and Rehabilitation Center, A21A0578.

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