June 5, 2000
Honorable Board of Supervisors
383 Kenneth Hahn Hall of Administration
500 West Temple Street
Los Angeles, California 900l2
Re: Estate of Torin Comeaux, Maebelle Comeaux and Torin Comeaux, a minor, by and through his Guardian Ad Litem Lisa Dancy v. County of Los Angeles
Los Angeles Superior Court Case No. TC 010 735
Dear Supervisors:
The Claims Board recommends that:
1. The Board authorize settlement of the above-entitled action in the amount of $250,000.00.
2. The Auditor-Controller be directed to draw a warrant to implement this settlement from the Health Department.
Enclosed is the settlement request and a summary of the facts of the case.
The Litigation Report, including the Corrective Action Report, is being transmitted to you under separate cover by the Health Department.
Return the executed, adopted copy to Frances Lunetta, Suite 648 Kenneth Hahn Hall of Administration, Extension 4-1754.
Very truly yours,
Barbara N. Uyeda, Chairperson
Los Angeles County Claims Board
BNU/fsl
Enclosure
M E M O R A N D U M
May 17, 2000
TO: LOS ANGELES COUNTY CLAIMS BOARD
FROM: RANDOLPH M. EVEN, Esq.
Even, Crandall, Wade, Lowe and Gates
GARY N. MILLER
Principal Deputy County Counsel
RE: Estate of Torin Comeaux, Maebelle Comeaux and Torin Comeaux, a minor, by and through his Guardian Ad Litem Lisa Dancy v. County of Los Angeles
Los Angeles Superior Court Case No. TC010735
DATE OF
INCIDENT: April 12 -13, 1997
AUTHORITY
REQUESTED: $250,000
COUNTY
DEPARTMENT: DEPARTMENT OF HEALTH SERVICES
CLAIMS BOARD ACTION:
Approve Disapprove Recommend to Board of
Supervisors for Approval
, Chief Administrative Office
BARBARA N. UYEDA
, County Counsel
LLOYD W. PELLMAN
, Auditor-Controller
MICHAEL L. GALINDO
on , 2000
SUMMARY
This is a recommendation to settle for $250,000 the wrongful death lawsuit brought by Torin Comeaux (minor son) for the death of Torin Comeaux while hospitalized at LAC+USC Medical Center on April 13, 1997, subsequent to his transfer from King/Drew Medical Center on April 12, 1997.
LEGAL PRINCIPLES
The County is liable for the failure of its hospital and medical staff to provide services consistent with the appropriate standard of care for the circumstances encountered.
SUMMARY OF FACTS
On April 12, 1997, at 4:36 p.m., Torin Comeaux, a 31-year-old man, was admitted to the Emergency Room of King/Drew Medical Center for treatment of a gunshot wound to his left leg. Medical personnel assessed the blood pressure in the left foot as compared to the blood pressure in the arm (ankle-brachial index [ABI]), and determined that it was abnormally low, a sign of a critical vascular injury in the left leg. By 5:45 p.m., medical personnel suspected that the bullet may have caused an injury to the large vessel that supplies oxygenated blood to the lower leg (popliteal artery) on the left side.
Medical personnel were aware at this time that a surgeon with a speciality pertaining to blood vessels (vascular surgeon) was not available to treat an arterial injury affecting blood flow, and, therefore, that Torin Comeaux would need to be transferred to another facility for surgical repair of the arterial injury. However, prior to ordering a transfer, a decision was made to perform an x-ray of the blood vessels after injection of contrast material (angiogram) of the left leg to determine the exact area of the popliteal artery injured. A known risk of a delay in performing immediate surgery to repair an injured blood vessel is the build-up of metabolic waste products, which may be released and transferred to the rest of the body after blood flow (perfusion) is restored, resulting in severe organ damage or death (reperfusion injury).
The angiogram was completed at 8:45 p.m., and the results confirmed that the popliteal artery had been cut (transected) by the bullet. At 11:16 p.m., Torin Comeaux was transferred by helicopter to LAC+USC Medical Center for immediate surgery.
Torin Comeaux was admitted to the Emergency Room of LAC+USC Medical Center at 11:45 p.m. However, before medical personnel were able to transfer him to surgery, he suffered a severe epileptic seizure (grand mal seizure). It was noted that his blood pressure was abnormally low (hypotension), and he was unresponsive to any stimulation. He was given transfusions of blood and fluids to raise his blood pressure.
On April 13, 1997, at 1:40 a.m., Torin Comeaux underwent surgery to repair the injury to the popliteal artery in his left leg. During surgery, he was given transfusions of blood and fluids to raise the percentage of the volume of blood occupied by red blood cells (hematocrit). An abnormally increased volume of circulating blood (hypervolemia) may place additional stress on the heart. Although his hematocrit had reached an acceptable level by 3:30 a.m., he continued to receive additional infusions of blood. Medical personnel repaired the popliteal artery, and perfusion to the left leg was restored.
Surgery was concluded at 8:20 a.m. At 9:21 a.m., Torin Comeaux’ heart rate and blood pressure decreased, and a distress call requiring immediate resuscitative efforts (code blue) was made. Restoration of heart and lung function using artificial respiration and manual closed chest compression (cardiopulmonary resuscitation [CPR]) was initiated, but he could not be resuscitated. Torin Comeaux was pronounced dead at 9:45 a.m.
An autopsy performed by the Los Angeles County Coroner attributed the cause of death to a gunshot wound to the leg, and to a disease affecting the heart muscle (cardiomyopathy). Torin Comeaux’s cardiomyopathy placed him at an increased risk of death due to a reperfusion injury and hypervolemia.
DAMAGES
If this matter proceeds to trial, the claimant will likely seek the following:
Torin Comeaux,
Loss of Future Support $ 75,000
Loss of Care, Comfort
and Companionship (MICRA limit) $250,000
TOTAL $325,000
The proposed settlement includes:
Torin Comeaux,
Loss of Care, Comfort
and Companionship $172,085
Attorneys Fees (MICRA Estimate) $ 72,915
Costs of Litigation $ 5,000
TOTAL $250,000
A portion of the recommended settlement may be directed by claimants to be used to purchase an annuity. The amount and structure of the annuity has not been selected at this time.
STATUS OF CASE
The current trial date has been vacated pending approval of this settlement.
Expenses incurred by the County of Los Angeles in the defense of this case through
May 5, 2000, are attorneys fees of $36,893.30 and $11,973.01 in costs.
The total cost to the County of Los Angeles as a result of this settlement is as follows:
Indemnity (Settlement Amount) $250,000.00
County Attorneys Fees and Costs $ 48,866.31
TOTAL $298,866.31
EVALUATION
Medical experts will be critical of the failure of medical personnel at 5:45 p.m., on
April 12, 1997, to order Torin Comeaux transferred to LAC+USC Medical Center when they suspected that he had suffered an injury to the popliteal artery of the left leg, and the decision to perform an angiogram prior to transfer. The failure to order a transfer at 5:45 p.m., and the decision to perform an angiogram prior to ordering the transfer, resulted in an 8-hour delay before Torin Comeaux underwent surgery to repair the injury to his popliteal artery, and an increased risk of a reperfusion injury.
Medical experts will also be critical of the failure of medical personnel to discontinue infusions of blood and fluids once Torin Comeaux’s hematocrit had reached an acceptable level at 3:30 a.m., on April 13, 1997. This failure resulted in an abnormally increased volume of blood, which, because of the underlying cardiomyopathy, Torin Comeaux’s heart was unable to adequately handle, and contributed to the results observed here.
We join with our private counsel, Even, Crandall, Wade, Lowe and Gates, and our claims administrator, Professional Risk Management, in recommending settlement in the amount of $250,000.
The Department of Health Services concurs in this settlement.