Hospital wins suit over heart-transplant death

A St. Louis jury has decided that a hospital was not liable in the death of an organ transplant patient who perished of ailments related to rejection of her donor heart.

“She was admitted to the hospital and the rejection of the heart couldn’t be reversed,” said Russell Makepeace of Sandberg Phoenix & von Gontard, which defended Barnes-Jewish Hospital. “It led to problems with her other organs and she followed a downward trajectory until she ultimately died.”

The patient, Sharnique Gully, had received the transplant a few years before but, according to the plaintiff’s petition, went to the hospital in August 2011 for rejection of the organ.

Much of the case revolved around the administration of dobutamine, a drug designed to keep Gully’s failing heart pumping during a procedure called plasmapheresis, which Makepeace said was designed to clear the blood of antibodies that were causing the rejection.

The next-of-kin plaintiff alleged in the suit that Gully’s intravenous line “infiltrated” meaning that the catheter had become dislodged from the blood vessel preventing the drug from remaining at proper levels in her bloodstream and leaving her without an adequate dose of the medication.

Plaintiff’s attorney Sean Lyons, of Hendler Lyons Flores, said it was clear that infiltration had occurred and several records he introduced buttressed that contention. He argued that pharmaceutical and other records showed that, over 48 hours, the amount of dobutamine used dropped below proper levels.

“During that period of time, she went from improving to doing worse,” Lyons said.

However, Makepeace said medical personnel testified that she was receiving the drug in the proper amount and that other records backed his case in that regard.

He also introduced testimony contending that Gully’s situation would have deteriorated far faster than it actually did if she hadn’t been getting the dobutamine.

“We showed records that said the meds were being given and we had testimony from the nurses that rejected the argument that the medications weren’t being given,” Makepeace said. “The experts testified that the theory on that point did not match the clinical picture.”

“This patient had a very large chart where information could be charted in multiple places and the jury saw all of the records and the jury, I think, focused on the clinical picture rather than single pages out of the chart,” he added.

Lyons felt the testimony of staff was less conclusive as to whether the proper dosage had been given. He believed the records were clear-cut and said the jury’s decision surprised him.

“It seems inescapable that they didn’t get her the drug that she was supposed to be getting,” he said.

The petition alleged both wrongful death and lost chance of recovery. Lyons said it may be that the jury felt Gully had little or no chance of survival based on the treating cardiologist’s testimony.

However, he said his own expert put her odds at 50 percent and that doctors initially gave her hopeful indications of her chances.

“We even had a text where Sharnique was texting her friends saying ‘I’ll be home next Tuesday,’” he said.

The plaintiff argued that a decline in Gully’s blood pressure could have indicated a lack of dobutamine in her system. However, Makepeace countered that the dip was normal given the circumstances.

“The most common side effect of plasmapheresis is a drop in blood pressure,” he said.

Lyons said that Gully had been through the procedure a number of times previously but had never experienced problems of this magnitude.

Makepeace said that the jury decided for the defense 10-2 on both counts.

“I think that they saw the doctors had done everything within the limits of medicine to prolong her life,” he said. “They realized that the doctors had done what could be done and her death was just unavoidable.”

Lyons said that while he felt his case for negligence was strong, it may not have swayed jurors if they felt her chances of survival were negligible.

“Perhaps the jury believed that it didn’t matter,” he said.