A Florida man died after receiving multiple doses of hydromorphone to control pancreatitis pain.
The deceased had sleep apnea, and court filings allege that his attending physician did not ask him about this medical history before prescribing hydromorphone.
The jury awarded the deceased’s family $20 million.
A Florida jury awarded $20 million to the wife and child of a man who died after a 2020 emergency room visit.
Joshua Hamby was 57 when he sought treatment at Boca Raton Regional Hospital on May 27, 2020. He presented with epigastric pain and was diagnosed with acute biliary pancreatitis. Attending physician Joshua Glauser, MD, admitted Hamby and ordered IV hydromorphone for pain control. Hamby was not placed in a monitored bed.
According to court documents, Hamby received multiple hydromorphone doses. The initial dosage was 1 mg; a later order increased the dosage to 4 mg. On the afternoon of May 28, 2020, Hamby was found unresponsive, with no pulse or breath.
Medical staff were able to resuscitate Hamby, and he was placed on life support; however, the lack of oxygen left Hamby with a severe anoxic brain injury. He passed away a week later, on June 4, 2020, after life support was withdrawn.
Hamby had a history of sleep apnea, increasing his risk of complications from opioids. Court filings allege that Dr. Glauser never asked Hamby if he had sleep apnea and that prescribing hydromorphone without checking for a history of sleep apnea is negligent. The documents also allege that Dr. Glauser was negligent insofar as he did not place Hamby in a monitored bed, monitor his vital signs, or appropriately respond to his change in status. Hamby’s cardiopulmonary arrest, the malpractice complaint argues, was the result of hydromorphone toxicity and could have been prevented by Dr. Glauser.
The defense argued that Dr. Glauser followed an appropriate treatment protocol for Hamby’s pain. They stated that Dr. Glauser did order Hamby to be placed on a floor with regular nurse check-ins. They also claimed that he discussed respiratory issues with Hamby.
“We spent a great deal of time, both in our direct examinations and in our cross-examination of the defense experts, establishing that the standard of care for patients did not change during COVID.”
After a weeklong trial and 4 hours of jury deliberation, a ruling returned in favor of the plaintiff. The jury awarded the Hamby family $20 million. The jury award includes $9 million for Mazena Hamby for the loss of her husband’s companionship and protection and for her pain and suffering, $11 million to the Hamby’s child for the loss of parental companionship, and over $210,000 in medical and funeral expenses.
The pandemic, standards of care, and malpractice
The COVID-19 pandemic had significant effects on healthcare in the US and around the world. Although some of these effects still linger and could become permanent, others were most prevalent during the height of the pandemic. In the spring and summer of 2020, resource shortages, including medical provider time, were drastic in many locations. As a result, crisis standards of care were in place.
Crisis standards of care apply anytime that a lack of resources requires decisions that could lead to a poor outcome for a patient or provider. Often, these standards come into play during natural disasters or other localized events. During COVID-19, use was more widespread, and professional organizations, such as the American Medical Association and the American Association of Medical Colleges, published updated guidelines to help physicians manage the unprecedented challenges of COVID-19.
Guidelines emphasize ethics and planning and help physicians relatively navigate triage, resource allocation, and management of provider time. They discuss how clinical decisions need to focus on realistic benefits to the patient. However, even hospitals and other providers with strong plans for crisis standards of care in place were under extreme stress during the early days of the pandemic.
How did this affect medical malpractice suits?
Surprisingly, not much. Cases related to COVID-19 have started to hit courts across the country, but there are fewer than anticipated.
Among the lawsuits that have made their way to court, many have been against employers or government policies regarding masking, vaccine mandates, and social distancing. Medical malpractice pandemic suits have included an increase in suits related to telehealth care, likely connected to the rise in telemedicine during the pandemic, as well as malpractice suits connected to:
Delays in care or diagnosis related to COVID-19
Failure to diagnose conditions other than COVID-19
Failure to treat COVID-19
Failure to prevent the spread of COVID-19
It’s likely that more lawsuits related to the height of the pandemic will come, but trends have been established.