(Courtesy Jo Lynn Southard / Maine Lawyers Review)
In some ways it was a typical medical malpractice case - although all such cases are "tricky," said plaintiff's attorney Alison Wholey Mynick - but Mynick felt there were two notable points in this case.
"In Maine these cases take so long, because of the pre-screening system," Mynick said. The plaintiff's family had to carry the claim forward after plaintiff's death; the injury at issue here was not a cause of her death.
Mynick practices with Briggs & Counsel in Rockport.
Sybil Lavway had cardiac surgery in 2003. The claim arose when Lavway was injured by the IV administration of dopamine. Dopamine is used to improve a patient's cardiac and renal functioning and is therefore commonly given after cardiac surgery. However, dopamine is also caustic.
Lavway developed a serious injury in her arm at the site of the IV transmission of dopamine. Dopamine is normally given through a central line, which is more secure. If dopamine is given in a peripheral IV line, for example, in the arm, the patient must be kept very still. Unfortunately, Lavway was not a model patient and, indeed, pulled out IV lines from each arm.
The other issue that Mynick, a registered nurse as well as an attorney, pointed to was a lack of charting on the administration of dopamine. Lavway had a central line, as well as an IV in each arm. "She received several meds by IV," Mynick said, "but there was no documentation of which IV tube was used. If they had only identified in the chart which IV tube was used, we wouldn't have had a trial."
Edward Gould of Gross, Minsky & Mogul represented defendant EMMC. He said the charting issue was contested by both sides, but said that defendant's expert "said that charting the location of the IV was not at all required under the applicable standard of care."
"As a practical matter," Gould said, "there's only so much a nurse can chart without having less time for patients." He also noted that at the time Lavway was hospitalized, notes were still handwritten and are now electronic. He did not know if that meant more detailed information was being charted.
Plaintiff's expert disagreed, however, and Mynick said, "I can't imagine giving a patient an IV and note writing down the site. If you give an intramuscular injunction, you have to note the location."
Although EMMC maintained that dopamine was not administered in the peripheral IV, the injury to Lavway's arm was treated as a chemical burn, which is consistent with damage from Dopamine. It is a significant injury; she had to have surgery at a later date, and continued to have problems with her left arm.
Justice Jeffrey Hjelm found that dopamine extravasation was the "better explanation for Lavway's injury." He awarded $600,000 plus costs to Lavway's estate.
