Catholic Healthcare West, doing business as Mark Twain St. Joseph’s Hospital, and medical professionals agreed to pay a $3.5 million malpractice settlement approved at a court hearing Tuesday, and hospital officials are refusing to discuss the case.

Just after exiting the courtroom Tuesday, the plaintiff in the case, Dianna L. McGee, said, “I’m lucky to be alive.”

A statement from McGee’s attorney on file in court records said this was a “tragic medical negligence case” involving multiple missed opportunities by defendants to timely diagnose and surgically treat McGee’s medical condition, causing her to lose all but six inches of her small bowel, leaving her totally dependent on a stomach tube for nutrition, which will severely restrict all of her activities for the rest of her life.

“Patient care is our highest priority, and we respect the privacy of our patients and legally cannot discuss the specifics of their care,” Patti Monczewski, interim president at Mark Twain St. Joseph’s Hospital, wrote in a statement. “We are pleased to have reached a resolution in this matter.”

When asked for further comment, McGee said she, her four children and her attorneys had signed gag orders, and were not allowed to discuss the settlement.

McGee’s town of residence was not available.

Below is a summary of a report written by Dr. Marvin E. Ament, board certified pediatric gastroenterologist, who examined the plaintiff.

McGee, now 51, underwent a gastric bypass procedure five years ago, performed by Dr. Patrick J. Coates in Modesto, which was successful, and she lost nearly 90 pounds, Ament wrote.

In 2009, she developed abdominal pain and was diagnosed in 2010 by a doctor at Mark Twain St. Joseph’s Hospital with constipation, however her pain progressively worsened, he continued. Later in 2010, she underwent a scan of her abdomen, which showed problems and an operation revealed she had extensive small bowel necrosis second ary to volvulus – an obstruction caused by the twisting of the stomach or intestine – through an internal hernia that was likely the consequence of problems with the gastric bypass surgery, Ament wrote.

McGee underwent a near total enterectomy (removal of a segment of the intestine) with a stomach tube for feeding.

Her pain continued, and she was taken to the University of California Medical Center where Dr. Douglas Farmer performed further abdominal surgery to save her life, records state. Farmer reversed her gastric bypass surgery, removed necrotic tissue and restored intestinal continuity by removing one foot of small intestine, Ament wrote.

She spent time in the hospital receiving treatment for sepsis, multiple abscesses and inflammation of the tissue that lines her abdomen along with small bowel leakage, Ament continued.

After being released from the hospital, she was told because of the shortness of her intestine, she would be requiring total home parenteral nutrition management, which means her body had to be supplied with its nutritional needs by bypassing the digestive system and dripping nutrient solution directly into a vein, Ament added.

McGee’s condition is such that she requires a caretaker seven days a week, 365 days a year. Currently, her daughter Bonnie is providing the services she needs, but she cannot do this indefinitely, Ament wrote.

Further complicating McGee’s condition is damage her body received from being morbidly obese prior to her gastric bypass surgery and suffering from arthritis, Ament wrote.

As of his report, McGee was taking 21 medications each day.

Ament expects McGee to live for another 25-to-30 years.

McGee retained Dr. Bruce G. Fagel, a Beverly Hills physician and attorney to represent her in a malpractice suit against CHW, Mark Twain St. Joseph’s Hospital and others. Instead of going to trial, parties agreed to resolve the suit in mediation, which occurred in March of this year.

Fagel said his office is involved in numerous cases with Catholic Healthcare West, now known as Dignity Health.

“It’s the largest nonprofit hospital chain in the western United States,” he said. “I believe this is the first case we’ve had with Mark Twain St. Joseph’s Hospital.”

At mediation, this case settled for $3.5 million, with $1 million from Dr. Marc Walter and $2.5 million from Mark Twain St. Joseph’s Hospital. This settlement included a waiver of any future potential wrongful death claim for the potential heirs of McGee as a condition of the settlement. The sum of $250,000 has been allocated to the four children of McGee, who would be heirs upon her death.

After attorney fees in the amount of $74,166, the balance of $175,834 will be divided evenly among McGee’s four children, with $43,958.50 to each child. The balance of $3.25 million represents the recovery to McGee, which will be used to pay the MediCal lien of $295,884.24, costs and cost reserve of $75,000 – with any net balance remaining after final costs returned to McGee’s trust – attorney fees of $502,916 (17.5 percent), $2 million for the defendant to purchase two annuity policies that will pay $9,640 per month, for the life of McGee, increasing at 3 percent per year with a five-year minimum guarantee.

The balance of $372,084 will be used to pay off the mortgage on McGee’s house and other past bills, with the remaining balance to fund a special needs trust for which McGee’s daughter has been qualified as bondable for the amount in the trust, plus the first year annuity payments.

According to court documents, CHW, doing business as MTSJH, is self-insured for $5 million and $145 million in aggregate insurance. Dr. Glenn L. Levine is insured for $1 million/$3 million. No insurance was listed under defendant Ryan S. Thompson’s name.

Though Dr. Levine and Dr. Thompson's names were listed in the court documents, neither were found to be negligent, and neither paid out any money in the settlement, according to a source from the hospital.

“The settlement was approved yesterday,” Fagel said Wednesday. “I can’t comment on the settlement. It’s confidential.”

Fagel did say the documents his office filed with the court are correct. Those documents state the settlement was for $3.5 million. Many defendants in malpractice cases require confidentiality as a part of the settlement, as was the case in this matter.

“It simply means neither me nor my client can directly comment on the names of the clients or how much the settlement was,” Fagel said.

In 1975, the Legislature set a $250,000 limit for how much a plaintiff can receive in pain, suffering and emotional distress.

“Everything else above that, which can get into the multiple millions, is for medical care cost or lost earnings,” Fagel said.

 Contact Joel Metzger at joel@calaverasenterprise.com

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