VERDICT
Defense
CASE
Ramon Ortiz, by and through his Conservator, Rebecca Rios-Capellan v. WMC-A, Inc. dba Western Medical Center Anaheim; Integrated Healthcare Holdings, Inc.; and Lisa Castro
No. 30-2012-00608184-CU-PO-CJC
COURT
Superior Court of Orange County, Orange
JUDGE
Thierry P. Colaw
DATE
6/19/2015
PLAINTIFF ATTORNEY(S)
Stephen M. Garcia, Garcia, Artigliere & Medby, Long Beach, CA
DEFENSE ATTORNEY(S)
Craig S. Dummit, Dummit, Buchholz & Trapp, LLC, Los Angeles, CA
(WMC-A, Inc., Integrated Healthcare Holdings, Inc.)
Harmon B. Levine, Dummit, Buchholz & Trapp, LLC, Los Angeles, CA
(WMC-A, Inc., Integrated Healthcare Holdings, Inc.)
None reported (Lisa Castro)
FACTS & ALLEGATIONS
At approximately 6:20 a.m. on May 25, 2012, plaintiff Ramon Ortiz, 56, a mentally disabled patient of Western Medical Center-Anaheim, was in a television room with four other psychiatric patients when he was allegedly assaulted by one of the patients.
Ortiz, who had a long history of schizoaffective disorder, was admitted to Western Medical Center-Anaheim after being non-compliant with his medications and assaulting other patients at a psychiatric board and care facility. He was subsequently admitted to Unit 5, which is one of three locked psychiatric units at the medical center. While Ortiz was non-compliant with his medications, he hit a housekeeper on April 16, 2012, and was in an altercation with a peer on April 17, 2012. He also had an altercation with his roommate, during which he suffered a fractured nose, on April 19, 2012. As a result, a psychiatrist put Ortiz on 1-to-1 observation, but it was discontinued on April 25, 2012, after Ortiz became compliant with his medications and he was found to be no longer hitting or striking anyone. However, three days later, Ortiz was noted to have kicked a patient who was bothering him. As a result, Ortiz was transferred from Unit 5 to Unit 3, a unit for less acute patients, for “administrative reasons” on May 6, 2012. Nine days later, a nurse noted that Ortiz once again punched another patient and a psychiatrist’s noted Ortiz struck two other patients on May 23, 2012. At 8 p.m. the following day, a nurse noted that Ortiz was anxious and trying to argue or fight with a peer.
After Ortiz was transferred to Unit 3, another patient, Lisa Gastro, was admitted to the psychiatric unit on a three-day hold, beginning on May 19, 2012, after it was determined that she a danger to herself. The next day, her psychiatrist certified her for an additional 14-day hold after finding that Castro was gravely disabled.
Thus, at about 6:20 a.m. on May 25, 2012, Ortiz was in a T.V. room with Castro and three other psychiatric patients when an altercation broke out. Ortiz claimed that he was assaulted by Castro. Ortiz subsequently reported the incident to his nurse several hours later, at 9 a.m. He claimed that during the previous shift, he was pushed against a wall by another patient, hit his head, and slumped to the floor. Ortiz then reported symptoms of numbness and urinary incontinence to his nurse at 11:40 a.m. As a result, a physician was called and X-rays and brain CT scan was ordered. Ortiz then complained of worsening neurological symptoms to his treating physician, who visited him in the afternoon, and the physician had Ortiz transferred to the care of a neurosurgeon on Western Medical Center-Anaheim at 7:30 p.m.
Ortiz ultimately underwent emergency surgery to evacuate a hematoma in his fractured cervical spine and has subsequent fixation surgery, but he was allegedly left unable to walk without assistance for over two years thereafter.
Ortiz, through his conservator, Rebecca Rios-Capellan, sued Castro; the operator of Western Medical Center-Anaheim, WMC-A Inc.; and the medical center’s parent company, Integrated Healthcare Holdings Inc. Ortiz alleged that Castro’s actions constituted assault and battery. He also alleged that WMC-A and Integrated Healthcare were negligent in their failure to appropriately monitor the patients in the psychiatric ward and that their negligence constituted dependent adult abuse.
Castro was ultimately voluntarily dismissed from the case during trial.
Plaintiff’s counsel contended that WMC-A and Integrated Healthcare failed to protect Ortiz from his own aggressive behavior, failed to keep Ortiz on 1-to-1 observation, and failed to keep Ortiz away from Castro, who was a danger to Ortiz and whom the medical center should have been aware of. This, counsel argued that the medical center should have been much more vigilant in protecting Ortiz from other potentially violent and assaultive patients, considering his own history of aggressive and assaultive behavior.
In addition, plaintiff’s counsel argued that the medical center was chronically understaffed, including on the subject date of May 25, 2012, when the alleged assault on Ortiz occurred. Counsel contended that there was a failure to have any hospital personnel in the T.V. room to monitor the psychiatric patients at the time of the subject incident and that WMC-A and Integrated Healthcare failed to comply with mandatory reporting requirements for elder abuse on the various occasions when Ortiz hit or kicked other patients. Plaintiff’s counsel also contended that Ortiz’s medical records were incomplete, erroneous, and fraudulent and that as a result, WMC-A and/or Integrated Healthcare repeatedly failed to advise Ortiz’s doctors of his continued aggressive behavior during his 40-day stay at the medical center so that the doctors could have ordered 1-to-1 or closer observation. Counsel further contended that WMC-A and Integrated Healthcare failed to develop adequate care plans or change them when Ortiz assaulted other patients and that there was a failure to have Ortiz places on the high acuity unit as a result of his repeated assaultive and aggressive behavior over the last two days before the subject incident. In addition, plaintiff’s counsel contended that WMC-A and Integrated Healthcare failed to notify Ortiz’s psychiatrist about the two assaults by Ortiz two days before the incident or about the attempted fighting with another patient the night before the incident.
Counsel for WMC-A and Integrated Healthcare admitted that no report was made about the incident on April 19, 2012, when Ortiz’s roommate fractured Ortiz’s nose, but argued that there was no requirement to report the other alleged occasions, where an assault on a psychiatric patient was unwitnessed by staff and where staff could not confirm whether an assault even occurred. Counsel also argued that only Ortiz’s psychiatrist could order a change of unit and noted that the psychiatrist testified that he was aware of Ortiz’s behavior and had determined that Ortiz was in the appropriate unit.
Thus, WMC-A and Integrated Healthcare denied liability, and claimed that they, at all times, complied with the standard of care in nursing and the standard of care for hospitals. Counsel for WMC-A and Integrated Healthcare contended that the circumstances of how Ortiz became injured were unclear, as Ortiz gave several contradictory statements about what happened. Counsel also contended that there was never a failure to render care, as all of the doctors’ orders were followed for medications and for observation of Ortiz every 15 minutes. Counsel further contended that at no time were WMC-A or Integrated Healthcare on notice of any potential violent threat posed by Castro to Ortiz.
INJURIES/DAMAGES
epidural/extradural hematoma; facture, cervical; hematoma; laminectomy; numbness
Ortiz sustained fractures of the cervical and thoracic vertebrae and an epidural hematoma. He initially reported symptoms of numbness and urinary incontinence, and subsequently underwent X-Rays and a brain CT scan. However, when his neurological complaints worsened, Ortiz was transferred to the care of a neurosurgeon who performed an emergency laminectomy to evacuate a hematoma in Ortiz’s fractured cervical spine in the early morning of May 26, 2012. Ortiz then underwent a subsequent surgery on May 31, 2012.
Ortiz claimed that although the surgeries were successful, he was unable to walk without assistance for over two years.
Thus, plaintiff’s counsel asked the jury to award Ortiz up to $5 million, including approximately $88,000 in paid medical expenses (Medi-Cal).
RESULT
The jury found that there was no negligence on the part of WMC-A or Integrated Healthcare. It also found that there was neglect, but that there was no recklessness. Thus, the jury determined that there was no dependent adult abuse and rendered a defense verdict.
DEMAND
$2,000,000
OFFER
$750,000 (during trial)
INSURER(S)
CAN for Integrated Healthcare Holdings Inc. and WMC-A Inc. (excess)
TRIAL DETAILS
Trial Length: 21 days
Trial Deliberations: 3 days
Jury Composition: 7 male, 5 female
PLAINTIFF EXPERT(S)
Denise K. Rounds, R.N., psychiatric nursing, Huntington Beach, CA
Frank K. Yoo, M.D., neurosurgery, La Jolla, CA
DEFENSE EXPERT(S)
Carl Bryant, R.N., C.L.N.C., standard of care, El Cajon, CA (staffing expert)
David J. Paster, M.D., psychiatry, Encino, CA
POST TRIAL
Plaintiff’s counsel moved for a new trial, but the motion was denied on Sep. 4, 2015.
Counsel for WMC-A and Integrated Healthcare moved for recovery costs and expert witness fees, which was granted by the court. Thus, according to defense counsel, costs and fees in the amount of $219,447 are to be paid by the plaintiff.