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Pearson v. St. Paul

Decided: April 21, 1987.

MICHELENE PEARSON, GENERAL ADMINISTRATRIX AND ADMINISTRATRIX AD PROSEQUENDUM OF THE ESTATE OF JUDITH PEARSON, DECEASED; AND MICHELENE PEARSON, INDIVIDUALLY, PLAINTIFFS-APPELLANTS,
v.
H. ST. PAUL; RUTH CHIN-HICKS; UNITED HOSPITALS ORTHOPEDIC CENTER, DEFENDANTS-RESPONDENTS, AND (FICTITIOUSLY NAMED) JOHN DOE, M.D., ET ALS.; RICHARD ROW, M.D., ET ALS., DEFENDANTS



On appeal from the Superior Court, Law Division, Essex County.

Pressler, Baime and Ashbey. The opinion of the court was delivered by Pressler, P.J.A.D.

Pressler

Plaintiff Michelene Pearson, individually and as general administratrix and administratrix ad prosequendum of the estate of Judith Pearson, appeals from an order of involuntary dismissal entered at the close of her liability proofs. We reverse.

This is a medical malpractice case. Plaintiff's decedent, an otherwise healthy 16-year-old girl, was admitted to United Hospitals Orthopedic Center in June 1982 for arthroscopic surgery of the left knee, a procedure which, according to this record, is relatively simple and not life threatening. The procedure was performed under general anesthesia administered by defendant Irene Alexis St. Paul, a trained, certified nurse anesthetist. No anesthesiologist was present. At the conclusion of the procedure, the child was moved by stretcher from the operating room to the nearby recovery room, accompanied by St. Paul and two residents. All three left almost immediately thereafter, and the child was left in the care of the recovery room nurse, defendant Ruth Chin-Hicks. There was one other patient then in the six-bed recovery room to whom Chin-Hicks was then attending. The child went into cardiac arrest within 10 or 15 minutes after her arrival in the recovery room. She sustained severe brain damage before she could be resuscitated, remained in a coma for five days, and then died.

According to the testimony of St. Paul, the child was beginning to overcome the effects of anesthesia while still in the operating room. She was moving her arms and had responded to St. Paul's command to place her arms at her sides. According to the testimony of Chin-Hicks, the child was still asleep on her arrival in the recovery room but her breathing was normally deep and her color and vital signs were within normal range. Some 10 or 15 minutes later she, Chin-Hicks, was alerted to a

problem by the child's shallow respiration, and it was her opinion that the breathing had been shallow "a few minutes" before she noticed it. The child did not respond to Chin-Hicks' efforts to rouse her, and Chin-Hicks, believing the child to be having an "anesthesia problem," called for help from that department. St. Paul arrived, assessed the situation, and started to give the child oxygen. She also directed Chin-Hicks to administer narcon, a drug which reverses the effects of the narcotic component of the anesthesia which St. Paul had administered. When that had no effect, she directed Chin-Hicks to administer prostigmine and atropine, which reverse the effect of curare, the muscle-paralyzing component of the anesthesia and which had also been administered before the child was removed from the operating room. At that point, the child had still not revived, and an anesthesiologist was summoned. The efforts made by the medical staff from that point on were not, however, availing.

The trial judge granted the involuntary dismissal motion because he concluded that plaintiff's cause of action was inadequately supported by expert testimony. He characterized the testimony of plaintiff's medical expert as offering only a net opinion, and he excluded from evidence the report of an anesthesiologist consulted by the medical examiner in attempting to determine the cause of death. We are persuaded that he erred in both respects.

Plaintiff's medical expert, offered to establish the negligence of both St. Paul and Chin-Hicks, was Dr. David Callum Carmichael Stark, an anesthesiologist on the staff of Mount Sinai Hospital in New York City between 1965 and 1983 and chairman of its department of anesthesiology during the last four years of his tenure there. In 1983 he accepted an appointment as chief of anesthesiology at a teaching hospital in Syracuse as well as an appointment as clinical professor at the Upstate Medical Center. His qualifications and credentials were impeccable.

Dr. Stark first explained the nature and effect of the anesthetic drugs used during the child's surgery, as well as the effect and purpose of their respective reversing drugs. In response to the question as to whether he had "an opinion with reasonable medical probability as to what caused this tragic event," he answered as follows:

It was my opinion that she met her death because of the negligent administration of the type of anesthesia that she received; by the failure on the part of the recovery room staff adequately to monitor her condition; to recognize the serious depression of the ...


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