Fresno Jury Finds Hospital Negligent in Patient's Death



Press Release

Fresno, CA, March 16, 2005 - Yesterday afternoon, a unanimous jury ruled that Sierra Kings District Hospital in Reedley was negligent in the medical care that it provided to 20 year old Usbaldo Nieto, and that the hospital's negligence was a substantial factor in causing his death. The Superior Court Jury in Fresno also found that Sierra Kings had violated both state and federal "anti-dumping" laws, and that those violations also contributed to Usbaldo's death. The jury awarded $400,000 in damages to Usbaldo's mother, Eva Alvarado, who lives in Sultana.

On September 10, 2003, Usbaldo was sitting with his girlfriend under a tree in Mueller Park in Reedley. A large limb fell on Usbaldo, striking his pelvis. An ambulance arrived within two minutes and transported Usbaldo to the nearest emergency room, at Sierra Kings. When Usbaldo arrived at Sierra Kings at approximately 7:00 p.m., he was in extreme pain, and was complaining of being very thirsty. He was also cold, pale, and restless. The emergency room physician testified at trial that he knew at 7:05 that Usbaldo had either a hip or a pelvic fracture, and that he would have to be transferred, since there were no surgeons at Sierra Kings. Nonetheless, he did nothing to initiate the transfer of the patient at that time.

By 7:30 p.m., the emergency room doctor noted that Usbaldo's stomach was becoming firm. He testified at trial that he knew at that point that Usbaldo had internal bleeding. At 7:55 p.m., Usbaldo was so thirsty that he pulled out his I.V. and attempted to drink it. Yet, the physician did not order blood for Usbaldo.

Usbaldo was transferred to University Medical Center in Fresno at approximately 9:45 p.m.; three hours after his ambulance had arrived at Sierra Kings. A witness for UMC testified that Sierra Kings did not call to request a transfer until 9:00 p.m.

During the trial, concerns were raised regarding the medications that were prescribed for Usbaldo. The emergency room physician admitted in deposition, and hospital records confirm, that Usbaldo was given 100 milligrams of Etomidate, which is more than five times the recommended dosage. At trial, the physician testified that he was "baffled" by the records, and admitted that it was far too much to give any patient. He also admitted that giving a patient too much of this drug can damage the organs. One defense expert admitted that giving this much Etomidate fell below the physician's standard of care. Another defense expert referred to it as an "overdose." After giving this drug to Usbaldo at 9:00 p.m., his blood pressure dropped five minutes later, from 104/49 to 40/32.

When Usbaldo's blood pressure plunged, the physician prescribed two "pressors," drugs that squeeze the muscles around the arteries. The physician admitted at trial that this causes a person who is bleeding internally to bleed even more. When the Sierra Kings physician spoke to two doctors from UMC, both of the UMC doctors told him to stop the delivery of these drugs, and to give the patient "aggressive blood and crystalloid fluid resuscitation." Hospital records show that Usbaldo did not receive blood until 9:35 p.m., more than two hours after the emergency room physician testified that he knew Usbaldo had internal bleeding.

Usbaldo died shortly before midnight that evening at UMC.

At trial, Usbaldo's mother argued that the hospital was negligent, and that the hospital did not properly care for her son prior to his transfer to UMC. All twelve jurors agreed. "Far too often these things are swept under the rug, and we thought it was important for this story to be told," said Arturo J. Gonzalez from Morrison & Foerster in San Francisco. "A young man died because he was not properly cared for. That should never happen. We are pleased that the jury understood that the hospital was liable."

The jury awarded $25,000 to Ms. Alvarado for lost income that Usbaldo would have contributed to the household, and $375,000 for the loss of the comfort and society of her son. The jury found that the hospital violated federal law, both by failing to stabilize Usbaldo and by failing to appropriately transfer Usbaldo. The jury also found that Sierra Kings violated state law by failing to provide him with the emergency services and care to determine that an emergency medical condition existed, and by failing to provide him with the care and treatment necessary to alleviate his condition. These latter findings entitle Ms. Alvarado to recover legal fees.

Prior to the trial, Ms. Alvarado had settled her claim with the emergency room physician for $150,000.

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