Barbara Hoffman's Medical Malpractice: Spinal Surgery Complications, Exams of Law of Torts

Download Barbara Hoffman's Medical Malpractice: Spinal Surgery Complications and more Exams Law of Torts in PDF only on Docsity! TORTS II PROFESSOR DEWOLF SUMMER 2002 August 2, 2002 FINAL EXAM Instructions DO NOT GO BEYOND THIS PAGE UNTIL THE EXAM ACTUALLY BEGINS. THIS IS A CLOSED BOOK EXAM! While you are waiting for the exam to begin, be sure that you have written your EXAM NUMBER on EACH bluebook, that you have read these instructions, and that you are otherwise ready to begin. IMPORTANT: This exam will last THREE HOURS. You should plan on spending AT LEAST 20 minutes reading the questions carefully and outlining your answers on a separate sheet of paper. Before writing your answers, REREAD each question to be sure you haven't missed anything. DOUBLE-SPACE your answers in the bluebook. Use SEPARATE BLUEBOOKS for EACH QUESTION. Label each bluebook according to each question and, if necessary, book number, e.g., "Question 1, Book 1"; "Question 1, Book 2"; "Question 2"; etc. When you are finished, turn to the back cover of the first bluebook, and place the second, third, fourth, etc. bluebook in order inside the end of the first bluebook, so the whole makes a single package. Then put it in the box at the front. You are welcome to use abbreviations, but indicate what they are, e.g., `Andropov ("A") would be sued by Brezhnev ("B"), alleging that A would be liable to B ... .' PLEASE IGNORE issues relating to legal causation; assume that any but-for cause of an injury is also a proximate cause of that injury. Plan on spending at least 15 minutes at the end PROOFREADING your answers. You may not write ANOTHER WORD after time is called. A STATUTORY APPENDIX is provided that gives the law of this jurisdiction, the State of Evergreen, on some issues. If no law is specified on the point you are interested in, please comment on the possible alternatives. Each question has been assigned a point total, and the exam as a whole has a point total of 135. Spend the amount of time on each question reflecting its relative worth. You may KEEP your copy of the exam questions if you wish. REMEMBER THE HONOR CODE! Don't identify yourself. DOUBLE SPACE! DOUBLE SPACE! DOUBLE SPACE! GOOD LUCK!!! TORTS II, SUMMER 2002, FINAL EXAM Page 2 of 11 QUESTION 1 (75 points) Barbara K. Hoffman had a history of back problems that began with a hospitalization in 1976. She was later diagnosed by her doctor as having a herniated disc, requiring bed rest. Hoffman was hospitalized again in 1986 or 1987 for back problems. In 1988, she had back surgery, a laminectomy, at the L2-3 vertebrae. She suffered complications from the surgery, including paralysis and swelling of her spinal cord. She recovered after receiving steroid and physical therapy. Hoffman was in pain once more in 1997, which was not relieved by steroid and physical therapy. In December 1998, Hoffman had experimental surgery performed by Dr. F. Todd Wetzel, a 360-degree spinal fusion that fused together three discs and two vertebrae. Pain began in her upper back in August 1999, following an accident involving a Springdale Transportation Authority (STA) bus, wherein a myelogram revealed that a bone had overgrown a nerve in her back. Prior to the accident, Hoffman had no previous problems with her upper spine. Hoffman also suffered from clinical depression, causing her to attempt suicide in 1994. She was hospitalized and, thereafter, received weekly medical attention and medication for her depression. On September 27, 1999, Hoffman underwent back surgery, which included a decompression of the L4-5 and L3-4 discs in her spine, reexploration of a prior spinal decompression, a laminectomy at the L3-4 vertebrae, a bilateral facetectomy at the L4-5 vertebrae and a bilateral foraminotomy at the L3-4 and L4-5 vertebrae. Dr. Wetzel, who performed the surgery at Weiss Hospital, first explained to Hoffman that the procedure was to be fairly simple, would last for one and one-half hours and would relieve pressure on the L3, L4 and L5 areas of the spine. Prior to the surgery, Hoffman was positioned on an Andrews Spinal Surgery Table (Andrews Table), Model SST-3000®, a table designed, manufactured and sold by Orthopedic Systems, Inc. ("OSI"), which is used to position patients for spinal surgery with their hips flexed and in a kneeling position at a 90-degree angle. Hoffman states that after being prepared for back surgery, she next remembered waking up in the intensive care unit, where nurses told her that she had hepatitis, causing her nausea. Doctors informed her that she had liver failure, kidney failure, gastrointestinal bleeding, pneumonia, a heart arrhythmia and septicemia. Dr. Michael Berger, an internist, and Dr. Nelson Kanter, a pulmonary specialist, told Hoffman that "everything that could go wrong went wrong." Hoffman's renal physician told her that she was "very, very sick," and that she was "never going to be the same again, ever." According to Hoffman, following her surgery, "nobody expected me not to die." Dr. Wetzel repeatedly stated in front of her that he was glad she did not die. During her recovery, Hoffman underwent temporary kidney dialysis, from which she suffered hallucinations, and had seven blood transfusions within two weeks. When she asked for an explanation for her near-death experience, she was given "a different story from everybody," and was told, "sh** happens." Dr. Wetzel told Hoffman that her complications were due to the anesthesia she was given prior to surgery. Nurses, residents or whomever came into her hospital room told Hoffman that a monitor alarm went off during surgery, her blood pressure dropped and doctors had trouble "getting a vein or artery in order to give [Hoffman] the stuff to push it back up." She was told the monitor was broken. She was discharged from the hospital on October 19, 1999. After release from the hospital, Hoffman could not leave her home for two or three months. Thereafter, she underwent continued physical therapy and rehabilitation. Prior to the surgery, she had retained a law firm, Harvey L. Walner and Associates, to handle the accident claim against the STA, resulting in a back pain claim, precipitating the September 27, 1999 surgery. On October 28, TORTS II, SUMMER 2002, FINAL EXAM Page 5 of 11 claimant's contributory fault, but does not bar recovery except as provided in section 6 of this chapter. § 34-51-2-6 Barring of recovery; degree of contributory fault Sec. 6. (a) In an action based on fault that is brought against: (1) one (1) defendant; or (2) two (2) or more defendants who may be treated as a single party; the claimant is barred from recovery if the claimant's contributory fault is greater than the fault of all persons whose fault proximately contributed to the claimant's damages. (b) In an action based on fault that is brought against two (2) or more defendants, the claimant is barred from recovery if the claimant's contributory fault is greater than the fault of all persons whose fault proximately contributed to the claimant's damages. § 34-51-2-8 Jury instructions; multiple defendants Sec. 8. (a) This section applies to an action based on fault that: (1) is brought against two (2) or more defendants; and (2) is tried to a jury. (b) The court, unless all the parties agree otherwise, shall instruct the jury to determine its verdict in the following manner: (1) The jury shall determine the percentage of fault of the claimant, of the defendants, and of any person who is a nonparty. The jury may not be informed of any immunity defense that might be available to a nonparty. In assessing percentage of fault, the jury shall consider the fault of all persons who caused or contributed to cause the alleged injury, death, or damage to property, tangible or intangible, regardless of whether the person was or could have been named as a party. The percentage of fault of parties to the action may total less than one hundred percent (100%) if the jury finds that fault contributing to cause the claimant's loss has also come from a nonparty or nonparties. (2) If the percentage of fault of the claimant is greater than fifty percent (50%) of the total fault involved in the incident which caused the claimant's death, injury, or property damage, the jury shall return a verdict for the defendants and no further deliberation of the jury is required. (3) If the percentage of fault of the claimant is not greater than fifty percent (50%) of the total fault, the jury shall then determine the total amount of damages the claimant would be entitled to recover if contributory fault were disregarded. (4) The jury next shall multiply the percentage of fault of each defendant by the amount of damages determined under subdivision (3) and shall enter a verdict against each defendant (and such other defendants as are liable with the defendant by reason of their relationship to a defendant) in the amount of the product of the multiplication of each defendant's percentage of fault times the amount of damages as determined under subdivision (3). TITLE 34. CIVIL PROCEDURE ARTICLE 13. CAUSES OF ACTION: CLAIMS AGAINST THE GOVERNMENT TORTS II, SUMMER 2002, FINAL EXAM Page 6 of 11 CHAPTER 3. TORT CLAIMS AGAINST GOVERNMENTAL ENTITIES AND PUBLIC EMPLOYEES § 34-13-3-3 Immunity of governmental entity or employee Sec. 3. A governmental entity or an employee acting within the scope of the employee's employment is not liable if a loss results from the following: (1) The natural condition of unimproved property. (2) The condition of a reservoir, dam, canal, conduit, drain, or similar structure when used by a person for a purpose that is not foreseeable. (3) The temporary condition of a public thoroughfare that results from weather. (4) The condition of an unpaved road, trail, or footpath, the purpose of which is to provide access to a recreation or scenic area. (5) The design, construction, control, operation, or normal condition of an extreme sport area, if all entrances to the extreme sport area are marked with: (A) a set of rules governing the use of the extreme sport area; (B) a warning concerning the hazards and dangers associated with the use of the extreme sport area; and (C) a statement that the extreme sport area may be used only by persons operating extreme sport equipment. This subdivision shall not be construed to relieve a governmental entity from liability for the continuing duty to maintain extreme sports areas in a reasonably safe condition. (6) The initiation of a judicial or an administrative proceeding. (7) The performance of a discretionary function. (8) The adoption and enforcement of or failure to adopt or enforce a law (including rules and regulations), unless the act of enforcement constitutes false arrest or false imprisonment. (9) An act or omission performed in good faith and without malice under the apparent authority of a statute which is invalid if the employee would not have been liable had the statute been valid. (10) The act or omission of anyone other than the governmental entity or the governmental entity's employee. (11) The issuance, denial, suspension, or revocation of, or failure or refusal to issue, deny, suspend, or revoke, any permit, license, certificate, approval, order, or similar authorization, where the authority is discretionary under the law. (12) Failure to make an inspection, or making an inadequate or negligent inspection, of any property, other than the property of a governmental entity, to determine whether the property complied with or violates any law or contains a hazard to health or safety. (13) Entry upon any property where the entry is expressly or impliedly authorized by law. (14) Misrepresentation if unintentional. (15) Theft by another person of money in the employee's official custody, unless the loss was sustained because of the employee's own negligent or wrongful act or omission. (16) Injury to the property of a person under the jurisdiction and control of the department of correction if the person has not exhausted the administrative remedies and procedures provided by section 7 of this chapter. (17) Injury to the person or property of a person under supervision of a governmental entity and who is: (A) on probation; or TORTS II, SUMMER 2002, FINAL EXAM Page 7 of 11 (B) assigned to an alcohol and drug services program, a minimum security release program, or a community corrections program. (18) Design of a highway if the claimed loss occurs at least twenty (20) years after the public highway was designed or substantially redesigned; except that this subdivision shall not be construed to relieve a responsible governmental entity from the continuing duty to provide and maintain public highways in a reasonably safe condition. (19) Development, adoption, implementation, operation, maintenance, or use of an enhanced emergency communication system. (20) Injury to a student or a student's property by an employee of a school corporation if the employee is acting reasonably under a discipline policy. (21) An error resulting from or caused by a failure to recognize the year 1999, 2000, or a subsequent year, including an incorrect date or incorrect mechanical or electronic interpretation of a date, that is produced, calculated, or generated by: (A) a computer; (B) an information system; or (C) equipment using microchips; that is owned or operated by a governmental entity. However, this subdivision does not apply to acts or omissions amounting to gross negligence, willful or wanton misconduct, or intentional misconduct. For purposes of this subdivision, evidence of gross negligence may be established by a party by showing failure of a governmental entity to undertake an effort to review, analyze, remediate, and test its electronic information systems or by showing failure of a governmental entity to abate, upon notice, an electronic information system error that caused damage or loss. However, this subdivision expires June 30, 2003. (22) An act or omission performed in good faith under the apparent authority of a court order that is invalid, including an arrest or imprisonment related to the enforcement of the court order, if the governmental entity or employee would not have been liable had the court order been valid. § 34-13-3-4 Limitation on aggregate liability; punitive damages prohibited Sec. 4. The combined aggregate liability of all governmental entities and of all public employees, acting within the scope of their employment and not excluded from liability under section 3 of this chapter, does not exceed three hundred thousand dollars ($300,000) for injury to or death of one (1) person in any one (1) occurrence and does not exceed five million dollars ($5,000,000) for injury to or death of all persons in that occurrence. A governmental entity is not liable for punitive damages.