United States District Court, S.D. Mississippi, Northern Division
ANTHONY COTTEN, INDIVIDUALLY, AND ON BEHALF OF ALL WRONGFUL DEATH BENEFICIARIES OF TONI COTTEN, DECEASED; AND THE ESTATE OF TONI COTTEN, DECEASED BY AND THROUGH LYNNITA BARTEE, ADMINISTRATRIX PLAINTIFFS
THE UNITED STATES OF AMERICA; H.C. WATKINS MEMORIAL HOSPITAL; RUSH MEDICAL FOUNDATION; RUSH HEALTH SYSTEMS, INC.; IVAN ZAMORA, M.D.; JAMES LOCK, M.D.; EMCARE PHYSICIAN SERVICES, INC., EMERGENCY MEDICAL SERVICES CORPORATION, EMCARE PHYSICIAN PROVIDERS, INC., EMCARE, INC., AND JOHN DOES 1-5 DEFENDANTS
MEMORANDUM OPINION AND ORDER
LEE UNITED STATES DISTRICT JUDGE.
Cotten died from sepsis at 5:00 on the morning of August 20,
2013, less than 20 hours after presenting at the emergency
department of H.C. Watkins Memorial Hospital. Following her
death, plaintiffs Anthony Cotten, individually and on behalf
of all wrongful death beneficiaries of Toni Cotten, deceased,
and the Estate of Toni Cotten, deceased, by and through
Lynnita Bartee, Administratrix, filed the present action
against H.C. Watkins Memorial Hospital, among others,
alleging medical malpractice in the care and treatment she
received at H.C. Watkins Memorial Hospital. Plaintiffs have
now moved for partial summary judgment as to the standard of
care and breach of the standard of care on their claim
against defendant H.C. Watkins Memorial Hospital. Defendant
Rush Medical Foundation d/b/a H.C. Watkins Memorial Hospital
(Watkins Hospital or Hospital) has responded in opposition to
the motion. The court, having considered the memoranda of
authorities, together with attachments, submitted by the
parties, concludes that plaintiffs' motion should be
following facts are undisputed. On the morning of August 19,
2013, Toni Cotten, age 18, arrived at the emergency
department of Watkins Hospital, accompanied by her father.
Ms. Cotten complained that she was weak and had pain in her
extremities. She reported she had been having symptoms for
about forty-eight hours. She also provided a medical history,
which included that she had sickle cell
disease. She was seen in the emergency department
by Dr. Ivan Zamora, who noted that “[t]his is a typical
[sickle cell pain] crisis for patient and except for severity
there are no unusual symptoms.” Although Dr. Zamora
suspected Ms. Cotten might also have an infection since she
had fever and her white blood count was elevated, he assumed
what she had was a “[sickle cell] like syndrome,
” for which he ordered IV pain medication and fluids.
He also ordered type and screen and cross-match three units
of packed red blood cells in preparation for a blood
Ms. Cotten was still in the emergency department, Dr. Zamora
ordered urine and blood cultures to investigate the potential
of infection. In the meantime, he ordered IV administration
of Cipro, a broad spectrum antibiotic, STAT, to be
administered after blood cultures were drawn. At 2:15 p.m., Dr.
Zamora ordered Ms. Cotten admitted to acute inpatient unit
and around 2:30 p.m., she was moved from the emergency
department to the hospital floor. It is undisputed that while
Ms. Cotten was in the emergency department, the antibiotics
Dr. Zamora ordered were not administered. The emergency
department nurse assigned to Ms. Cotten, Sara Beckman, noted
that Cipro was hung awaiting to be started infusion pending
blood cultures to be drawn by the lab; however, blood was
never drawn for the blood culture while Ms. Cotten was in the
emergency department and the Cipro was not administered.
p.m., after Ms. Cotten was moved to the floor, Dr. Zamora
ordered transfusion of two units of packed red blood cells;
transfusion of the first unit began at 4:30 p.m. At 5:20, Dr.
Zamora gave an order for IV Cipro 400 mg, “start
now.” And at 6:05 p.m., he entered an order for IV
Cipro “now” and twice a day, and for Cipro
injections every twelve hours. Transfusion of the first unit
of packed red blood cells ended at 6:55 p.m. and the floor
nurse started the second unit at 8:25 p.m. The Cipro Dr.
Zamora ordered had not been administered. The floor nurse
noted in the medical record at 9:00 p.m. “medication
held, pt. receiving blood at this time.” After the
second transfusion ended at 10:10 p.m., Dr. James Lock, who
had taken over Ms. Cotten's care after Dr. Zamora left
work for the day, ordered a third transfusion, which was
started at 10:40 p.m.. At that point, blood still had not
been drawn for the cultures ordered by Dr. Zamora and the
Cipro he had ordered had not been administered. At 12:02 a.m.
on August 20, the nurse made another note in the medical
record that Cipro was not given. The third transfusion was
complete at 12:30 a.m. Finally, at 1:58 a.m., blood was
collected for the cultures Dr. Zamora had ordered.
the next hour, Ms. Cotten's condition deteriorated
further. By 2:50 a.m., the nurse noted, she was becoming
“unresponsive” and her extremities were
“cold”; at 3:00 a.m., a code was called, and at
3:29 a.m., a second code was called. She was intubated; and
while they were able to regain a pulse, Ms. Cotten did not
regain consciousness. At 4:48 a.m., Dr. Lock ordered Ms.
Cotten transferred to Rush Medical Center in Meridian via
ambulance. However, minutes later, at 4:54, a third code was
called and she did not survive. She was pronounced dead at
move the court to enter partial summary judgment in their
favor establishing two specific matters: (1) that the failure
of the Watkins Hospital nurses to administer the antibiotic
Cipro to Toni Cotten was a breach of the applicable standard
of care and duty owed to Toni Cotten, and (2) that failure of
the Watkins Hospital nurses to ensure that blood for the
blood culture was timely drawn was a breach of the applicable
standard of care and duty owed to Toni Cotten by Watkins
Hospital and its employees.
judgment is proper when the evidence shows that “there
is no genuine dispute as to any material fact and the movant
is entitled to judgment as a matter of law.”
Fed.R.Civ.P. 56(a); Anderson v. Liberty Lobby, Inc.,
477 U.S. 242, 250-52, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986).
A dispute regarding a material fact is “genuine”
if the evidence is such that a reasonable jury could return a
verdict in favor of the nonmoving party. Anderson,
477 U.S. at 248, 106 S.Ct. 2505.
party moving for summary judgment bears the initial
responsibility of informing the district court of the basis
for its motion and identifying those portions of the record
it believes demonstrate the absence of a genuine issue of
material fact. Id. at 323. The non-moving party must
then go beyond the pleadings and designate “specific
facts showing that there is a genuine issue for trial.”
Id. at 324.
prevail in a medical malpractice case under Mississippi law,
the plaintiff must prove that there was “a duty by the
defendant to conform to a specific standard of conduct for
the protection of others against an unreasonable risk of
injury; (2) a failure to conform to the required standard;
and (3) an injury to the plaintiff proximately caused by the
breach of such duty by the defendant.” Hubbard v.
Wansley, 954 So.2d 951, 956-57 (Miss. 2007) (citing
Drummond v. Buckley, 627 So.2d 264, 268 (Miss.
1993)). Generally, “‘[w]hen proving these
elements in a medical malpractice suit, expert testimony must
be used'” to “‘identify and articulate
the requisite standard that was not complied with'”
and to “‘establish that the failure was the
proximate cause, or proximate contributing cause, of the
alleged injuries.'” Id. (quoting
Barner v. Gorman, 605 So.2d 805, 809 (Miss. 1992)).
This general rule is subject to “an ...