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Simpson v. Regents of the University of California-UCI Medical Center

Dr. Fagel achieved a verdict of $22 million on behalf of a 35 year-old woman who suffered brain injuries from pulmonary edema after nursing employees negligently administered excess fluid following surgery. The plaintiff underwent surgery to remove a benign tumor from her uterus without complications. After surgery, she was moved to the post-anesthesia care unit (PACU) and given IV fluids and Inderal after an attending anesthesiologist diagnosed her with hypovolemia. Two hours later, after a staff shift, the plaintiff was given additional Inderol and IV fluids by a second anesthesiologist. After the second anesthesiologist left, a third administered 500cc of a volume expander and the plaintiff was then transferred out of the PACU. A few hours later, a night nurse administered her with even more fluids after a timed order showed up on her computer, which had been mistakenly entered by a PACU nurse earlier. The nurse also continued to give her the volume expander that remained in her IV, although the anesthesiologist only intended for the expander to be administered while she was in the PACU.  The next morning, a day nurse set up a full liquid breakfast in bed for the plaintiff, as directed by a hospital intern. 30 minutes later, a nurse’s aide found the plaintiff unresponsive and called in medical staff to begin resuscitation. Once she responded and stabilized, an MRI was taken of her brain, which revealed hypoxic-ischemic injury to her basal ganglia.

Due to lack of oxygen to her brain, the plaintiff suffered severe brain damage and now experiences bradykinesia (extreme slowness in movements) of all four limbs and dysarthria (disturbance of articulation due to emotional distress, paralysis, incoordination or spasticity of muscles), among other problems. Although she has slightly been able to improve her level of function with rehabilitation, she will still require assistance in all activities of daily living for the rest of her life. The defendant maintained that the plaintiff’s injuries were due to a sudden, unpredictable aspiration that caused respiratory arrest and secondary pulmonary edema, not a fluid overload.

Dr. Fagel was able to prove that the nursing employees were negligent in their administration of excess fluids, which caused the plaintiff to develop pulmonary edema. Most importantly, he was able to display that the patient lost consciousness while eating breakfast because she aspirated fluid from her stomach or from the liquids she was eating. The miscommunications that accompanied the numerous changes in the plaintiff’s care resulted in a series of errors and the subsequent fluid overload. With proper communication between the various nurses and anesthesiologists who cared for the plaintiff, her injuries clearly could have been prevented.

Of the plaintiff’s $22 million recovery, approximately 20.5 million will be used to cover past and future medical costs, $1 million for loss of household services, and 500,000 for future loss of earning capacity.

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