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Date: 11-04-2016

Case Style:

Rhonda E. Roach and E. Dale Roach v. Associates Anesthesiologists, Inc., P.C., Saint Francis Hospital, et al.

Case Number: CJ-2014-4641

Judge: Caroline Wall

Court: District Court, Tulsa County, Oklahoma

Plaintiff's Attorney: Clark Brewster


Jennifer DeAngelis

Defendant's Attorney:





Bill Fiasco


and




Jennifer Annis for Associated Anesthesiologists, Inc., P.C., et al.





Mike Barkley for Saint Francisco Hospital, Inc.

Description: Tulsa, OK - Rhonda E. Roach and E. Dale Roach sued Associates Anesthesiologists, Inc., P.C., Raenalle J. Degidio, CRNA, Dennis Morris, M.D., Christopher D. Emerson, M.D., Kent Alan Woolard, M.D., Saint Francis Hospital, Inc. and Saint Francis Health System, Inc. on medical negligence theories claiming to have been injured and/or harmed as a direct result of substandard health care provided to Uriah R. Roach, a minor child, while a patient at Saint Francis and under the care of the the names physicians. Rhonda E. Roach and E. Dale Roach are the parents of Uriah Roach claiming:

COMES NOW the Plaintiffs, Rhonda E. Roach and E. Dale Roach, parents and next friends of Uriah R. Roach (a/k/a Uriah Howard), a minor child, by and through their attorneys, Clark 0. Brewster and Jennifer L. De Angelis of Brewster & De Angelis, P.L.L.C., and for their claims for relief against Defendants Associated Anesthesiologists, Inc., P.C., Saint Francis Hospital, Inc., Saint Francis Health System, Inc., Raenalle J. Degidio, C.R.N.A., Dennis· W.
Morris, M.D., and Christopher D. Emerson, M.D., state and allege as follows:
C)
JURISDICTION AND VENUE

1 . This is an action for medical negligence resulting in permanent, debilitating anoxic brain injury to Uriah R. Roach (hereinafter "Uriah").
2. Plai ntiffs, Rhonda E. Roach and E. Dale Roach, are Uriah's parents and are residents of Creek County, Oklahoma.
3. At all times material hereto, Associated Anesthesiologists, Inc., P.C. (hereinafter

"AA!"), is a physician group practice comprised of anesthesiologists and certified registered nurse anesthetists who provide anesthesia and medical care to patients at Saint Francis Hospital.
4. Saint Francis Hospital, Inc. (hereinafter "SFH") is an Oklahoma corporation and 1s a hospital and medical facility located in Tulsa, Oklahoma that represented itself to be competently staffed to provide safe and capable anesthesia and medical services to pediatric patients.
5. Saint Francis Health System, Inc., (hereinafter "SFHS") is an Oklahoma corporation located in Tulsa, Oklahoma that owns, controls and/or manages SFH, Warren Clinic, physician practices and other aspects of the medical services delivered to patients at SFH.
6. SFH/SFHS operates, manages, owns and controls the Ambulatory Surgery Center in the Natalie Medical Building (hereinafter "ASC").
7. At all times material hereto, Raenalle Degidio, C.R.N.A. (hereinafter "CRNA Degidio") was a certified registered nurse anesthetist practicing with AA! in Tulsa County, Oklahoma and held herself out to the public and to the Plaintiffs as a specialist qualified and capable to practice anesthesiology.
8. At all times material hereto, Dennis Morris, M.D. was a medical doctor employed by AA! and practicing in Tulsa County, Oklahoma who held himself out to the public and to the Plaintiffs as a specialist qualified and capable to deliver safe anesthesia and medical care to patients.
9. At all times material hereto, Christopher Emerson, M.D. was a medical doctor employed by AA! and practicing in Tulsa County, Oklahoma who held himself out to the public

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and to the Plaintiffs as a specialist qualified to deliver safe anesthesia and medical care to

patients.

10. All acts complained of herein occurred in the City of Tulsa, County of Tulsa, and State of Oklahoma.
11. As required by Okla. Stat. tit.12, §19, Plaintiffs have consulted with a qualified expert who has rendered an opinion that Plaintiffs' claims are meritorious and that Defendants have committed professional negligence, and committed breaches in the standard of care in their treatment of Uriah. See Affidavit of Jennifer L. De Angelis attached hereto as Exhibit "A."
OPERATIVE FACTS

12. Plaintiffs hereby incorporate paragraphs 1-11 as though fully set forth herein.

13. Uriah was born with cleft palate and cleft lip for which he had undergone corrective surgeries without incident.
14. On Thursday, October 2, 2014, Uriah was playing at school and his finger was accidentally slammed in a door. Uriah was treated at Drumright Regional Medical Center Hospital Emergency Department by a physician's assistant, Helga Price (hereinafter "PA Price"), and diagnosed with a fracture and laceration.
15. PA Price contacted Dr. Chekofsky at Warren Clinic Orthopedics who provided her advice for treatment of Uriah's injury and told Uriah's parents to follow up with Dr. Chekofsky on Monday, October 6, 2014.
16. Prior to this injury, Uriah was scheduled to undergo elective surgical procedures at the University of Oklahoma Children's Hospital, namely, pharyngeal flap repair and tonsillectomy. The surgery was performed on Friday, October 3, 2014 without incident. Uriah had a rapid recovery and was discharged to home around 3:30 p.m. on October 4, 2014.


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17. Over the weekend, Uriah had few complaints, maintained his diet of liquids and soft foods and was playful and active with his brothers and sisters.
18. On Monday, October 6, 2014, Uriah and his parents went to the offices of Dr.

Chekofsky at Warren Clinic Orthopedics for the scheduled follow up. Dr. Chekofsky examined Uriah, took photographs of his finger, and informed the family that surgery was urgently required to prevent infection and avoid vascular compromise.
19. Dr. Chekofsky told Uriah and his parents that he would repair the fracture and perform a revision of the partially amputated finger. Dr. Chekofsky attempted to schedule the surgery for that afternoon, but there was no time in the surgery schedule. Uriah's hand surgery was scheduled for Tuesday, October 7, 2014 at ASC located in the Natalie Medical Building.
20. Pre-operative anesthesia evaluation was performed by AA! at SFH on the afternoon of October 6, 2014. Mrs. Roach informed both Dr. Chekofsky and the anesthesia team about Uriah's history and in particular about the surgery he had three days prior. Mrs. Roach was reassured by all providers that Uriah would be fine and that there was no reason to delay the orthopedic surgery.
21. Uriah and his parents arrived at the ASC early in the morning on October 7, 2014. Mrs. Roach again reminded the anesthesia staff of Uriah's recent surgery and again was reassured that it was safe to proceed to surgery and Uriah would be fine. As Uriah was taken to surgery he told his mom not to worry, he would be fine.
22. Shortly after Uriah was taken back to surgery, two nurses approached Mr. and Mrs. Roach and began to pray. After a few minutes, Mrs. Roach asked what was going on with her son. She was then informed that Uriah's heart had stopped twice and that the situation was critical. Thereafter, physicians informed Mr. and Mrs. Roach that Uriah was gravely ill and

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would be transported to the Pediatric Intensive Care Unit at Saint Francis Children's Hospital

(hereafter referred to as the "PICU").

23. Uriah's parents went to the PICU and learned that the anesthesia team had trouble establishing an airway for Uriah, and that he underwent a prolonged Code Blue and resuscitation. Uriah was pale, intubated and required a ventilator and massive amounts of medications to sustain his life.

24. As the days passed, Uriah's condition did not improve: he had seizures; was not showing purposeful movement; grimaced in pain, cried and recoiled to touch or efforts to render treatment. On October 13, 2014, an MRI scan confirmed global hypoxic ischemic encephalopathy "consistent with a global anoxic or hypoxic event" which reportedly spared only his brain stem from injury.

25. Uriah's parents continued to ask nurses and doctors what happened to cause the devastating brain injury during the elective surgery to fix a broken finger. They were repeatedly told either that the medical team did not know what happened or that they couldn't get an airway. They were frequently told Uriah's prognosis was poor and that he may not survive.

26. The medical records from the ASC, even though incomplete, reveal the cause of Uriah's anoxic injury. It is apparent that the anesthesia providers in the ASC lacked experience in dealing with pediatric patients and were unprepared for the potential of a difficult airway. Pediatric equipment was not present in the room and pediatric-trained personnel were not timely consulted which led to Uriah suffering through two prolonged periods of sustained anoxia. Oxygen saturations dropped into the 30s and 40s and Uriah suffered cardiac and respiratory arrest at least twice during the Code Blue.




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27. On October 24, 2014, Uriah was removed from the ventilator and subsequently he

underwent surgery at SFH for placement of a tracheotomy tube and a feeding tube. Uriah did minimally respond to his family, particularly to his mother, and often cried when she left his hospital room.
28. On October 29, 2014, Uriah was discharged from SFH to The Children's Center Rehabilitation Hospital in Bethany, Oklahoma. Initial examination revealed that Uriah contracted an infection at SFH around his tracheotomy and feeding tube that required immediate treatment in addition to the complex sequelae from the anoxic brain injury. Uriah has shown little improvement in his neurologic function, physical capability or responsiveness and will require 24-hour care in a long-term care facility for the foreseeable future.
FIRST CLAIM FOR RELIEF
Negligence (All Defendants)

29. Plaintiffs hereby incorporate paragraphs 1-28 as though fully set forth herein.

30. The injury sustained by Uriah occurred as a direct and proximate result of the negligence, careless disregard and recklessness of all of the Defendants. The conduct when viewed in its totality and compared with reasonably accepted standards must be characterized as unacceptably deficient. These acts and omissions complained of herein include, but are not limited to, the following:

a. Defendants embarked upon a method and course of treatment which they knew or should have known would have life-threatening consequences for Uriah.

b. Defendants performed this surgery in the ASC which lacked the proper equipment and staff to treat a potentially difficult airway in a pediatric patient.

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c. Defendants failed to timely and properly diagnose, monitor and treat Uriah which
resulted in permanent, global anoxic brain injury in this patient.

d. Defendants misdiagnosed and/or misunderstood Uriah's condition prior to and upon induction and failed to undertake basic and necessary measures to prevent prolonged anoxia.

e. CRNA Degidio, under the direction and supervision of Dr. Morris, utilized an anesthesia plan and technique that was below accepted standards of care given the clinical circumstances present in Uriah.

f. SFH and SFHS failed to have necessary specialists on staff at the ASC available to render proper anesthesia care and timely resuscitative care to its pediatric patients.

g. Defendants failed to protect Uriah's airway and thereby disregarded the patient's safety for which they were solely responsible.

h. Defendants failed to inform Uriah's parents that the anesthesia team lacked experience and necessary equipment to provide safe and competent care to Uriah depriving them of the opportunity to have the surgery performed at a facility capable and competent to care for their son.

1. SFH's electronic medical record system is designed to create and/or permits providers to create a record that is confusing, incomplete and misleading which jeopardizes the health, safety and well being of their patients, including Uriah.

31. As a direct and proximate result of the negligence, careless disregard and recklessness of the Defendants, Uriah has suffered devastating and permanent physical and mental injury and Plaintiffs have suffered damages in the form of medical expenses, expenses incurred and expected to be incurred to provide necessary care and maintenance for Uriah,

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mental and physical pain and anguish and economic loss, all in excess of Seventy-five Thousand

and No/I 00 Dollars ($75,000.00) and Plaintiffs further seek an award of punitive or exemplary damages against Defendants in excess of Seventy-five Thousand and No/100 Dollars ($75,000.00).
SECOND CLAIM FOR RELIEF
Negligence - Res Ipsa Loquitur

32. Plaintiffs hereby incorporate paragraphs 1-3 1 as though fully set forth herein.

33. The medical devices used for treatment in this matter were under the exclusive control and management of Defendants.

34. Defendants breached their duty to Plaintiffs to properly treat Uriah and exercise competent skills during Uriah's induction and anesthesia management.

35. Uriah's injuries were of a kind which ordinarily does not occur in the absence of negligence.

36. As a direct and proximate result of the negligence, careless disregard and recklessness of the Defendants, Uriah has suffered devastating and permanent physical and mental injury and Plaintiffs have suffered damages in the form of medical expenses, expenses incurred and expected to be incurred to provide necessary care and maintenance for Uriah, mental and physical pain and anguish and economic loss, all in excess of Seventy-five Thousand and No/ I 00 Dollars ($75,000.00) and Plaintiffs further seek an award of punitive or exemplary damages against Defendants in excess of Seventy-five Thousand and No/I 00 Dollars ($75,000.00).

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THIRD CLAIM FOR RELIEF

Corporate Negligence, Respondeat Superior, Ostensible Agency (Associated Anesthesiologists, Inc., P.C., Saint Francis Hospital, Inc., and Saint Francis Health System, Inc.)

37. Plaintiffs hereby incorporate paragraphs 1-36 as though fully set forth herein.

38. The permanent injuries to Uriah and the permanent mental and physical suffering endured occurred as a direct result of the negligence, carelessness and recklessness of Defendants AAI, SFH and SFHS. Plaintiffs were unsuspecting that Defendants permitted and encouraged inattentive, inexperienced, unqualified and untrained doctors and nurses to provide patient care services within its walls. The conduct when viewed in its totality and compared with reasonably accepted standards must be characterized as unacceptably deficient and grossly negligent. The acts and omissions complained of herein include, but are not limited to, the following:

a. Upon information and belief, the anesthesia staff at SFH/ASC assigned to this case were not trained in pediatric anesthesia despite Defendants' representations to the public and to the Plaintiffs that it is fully and competently staffed to perform this case in this clinical setting as well as provide anesthesia care during other procedures on pediatric patients who present to its facility.

b. Defendants failed to adequately monitor or equip its facilities with equipment, and/or implement policies, protocols and systems which would facilitate proper and timely diagnosis and treatment of Uriah's intra-operative condition.
c. Defendants breached their non-delegable duty to properly credential and monitor CRNA Degidio and Drs. Morris and Emerson to whom they have granted active, unrestricted privileges when Defendants knew or should have known that they lacked proper training and/or are incompetent to perform the kind of pediatric anesthesia care necessary to treat Uriah.

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d. Defendants breached their duty by failing to take reasonable steps to ensure their

patient's safety when they knew or should have known that their anesthesia team lacked experience to perform the kind of pediatric anesthesia care necessary to treat Uriah.

e. Defendants permitted and encouraged assignment of anesthesia cases to be made based upon matters of convenience and without adequate consideration for the patient's medical condition and history.

39. Upon information and belief, Defendant CRNA Degidio and Drs. Morris and Emerson are agents and/or employees of AAI. Defendant AAI has a contract with SFH to provide anesthesia care to SFH's patients. Therefore, Defendants CRNA Degidio, and Drs. Morris and Emerson are agents of SFH.

40. Plaintiffs looked to Defendants to provide safe and competent anesthesia care.

Neither Plaintiffs nor Uriah had a prior patient relationship with AAI, CRNA Degidio or Drs. Morris and Emerson. SFH and their agent, AAI selected the anesthesia care team for Uriah's surgery on October 7, 2014 without input by Plaintiffs and therefore CRNA Degidio or Drs. Morris and Emerson are the ostensible agents of SFH. SFH, SFHS and AAI are responsible for the negligent acts of their agents and/or employees, namely, Defendants CRNA Degidio, and Drs. Morris and Emerson.

41. As a direct and proximate result of the negligence, careless disregard and recklessness of the Defendants, Uriah has suffered devastating and permanent physical and mental injury and Plaintiffs have suffered damages in the form of medical expenses, expenses incurred and expected to be incurred to provide necessary care and maintenance for Uriah, mental and physical pain and anguish and economic loss, and other damages all in excess of Seventy-five Thousand and No/100 Dollars ($75,000.00) and Plaintiffs further seek an award of


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punitive or exemplary damages against Defendants in excess of Seventy-five Thousand and

No/100 Dollars ($75,000.00) and to apprise the public at large that society does not condone hospital and corporate acts which perpetuate injury to patients by inadequately staffing and equipping its facilities.

FOURTH CLAIM FOR RELIEF

Deceit

(All Defendants)

42. Plaintiff incorporates paragraphs I through 41 as though fully set forth herein.

43. Defendants knowingly made numerous false and/or misleading statements and/or factual omissions in the medical records of Uriah. Those false statements and factual omissions include, but are not limited to:

a. Gaps in recordation of critical medical care events;

b. Failure to identify persons present during induction and during the Code Blue on October 7, 2014; and

c. Failure to identify equipment used during the anesthesia and resuscitative process.

44. Defendants falsified Uriah's medical records thereby breaching their duty to the patient to maintain the integrity, accuracy, truth and reliability of his medical records.

45. Defendants' deliberate falsification of Uriah's medical records was done solely to protect their own interest forsaking the safety of this patient, which acts jeopardized the life and health of Uriah and therefore, constituted gross negligence.

46. As a direct result of Defendants' deceit, Uriah was deprived of necessary medical care and his caregivers were deceived regarding the true cause and timing of his iatrogenic injury. As a further result of this deceit, Uriah has suffered great pain of body and mind, severe physical injuries, and Plaintiffs have incurred expenses for medical care and therapy and are

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entitled to damages in the form of medical expenses, permanent physical injury impairment,
physical and mental pain and suffering all in excess of Seventy-five Thousand and No/100 Dollars ($75,000.00). Plaintiffs further seek an award of punitive or exemplary damages against Defendants in excess of Seventy-five Thousand and No/100 Dollars ($75,000.00) to deter Defendants from committing such recklessness and gross negligence in the future and to apprise the public at large that society does not condone such actions or omissions to act.

DEMAND FOR RELIEF

WHEREFORE, Plaintiffs Rhonda E. Roach and E. Dale Roach, parents and next friends of Uriah R. Roach, pray for judgment against Defendants in excess of Seventy-five Thousand and No/100 Dollars ($75,000.00) jointly and severally as follows:

A. For judgment on their First Claim for Relief and for an award of compensatory damages in an amount in excess of Seventy-five Thousand and No/I 00 Dollars ($75,000.00) and exemplary or punitive damages against Defendants Associated Anesthesiologists, Inc., P.C., Saint Francis Hospital, Inc., Saint Francis Health System, Inc., Raenalle J. Degidio, CRNA, Dennis W. Morris, M.D., and Christopher D. Emerson, M.D., in an amount in excess of Seventy­ five Thousand and No/100 Dollars ($75,000.00) to deter the Defendants from committing such recklessness and gross negligence in the future, and to apprise the public at large that society does not condone such actions or omissions to act.

B. For judgment on their Second Claim for Relief and for an award of compensatory damages in an amount in excess of Seventy-five Thousand and No/I 00 Dollars ($75,000.00) and exemplary or punitive damages against Defendants Associated Anesthesiologists, Inc., P.C., Saint Francis Hospital, Inc., Saint Francis Health System, Inc., Raenalle J. Degidio, CRNA, Dennis W. Morris, M.D., and Christopher D. Emerson, M.D., in an amount in excess of Seventy-

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five Thousand and No/100 Dollars ($75,000.00) to deter the Defendants from committing such

recklessness and gross negligence in the future, and to apprise the public at large that society does not condone such actions or omissions to act.

C. For judgment on their Third Claim for Relief and for an award of compensatory damages in an amount in excess of Seventy-five Thousand and N oll 00 Dollars ($75,000.00) and exemplary and punitive damages against Defendants Associated Anesthesiologists, Inc., P.C., Saint Francis Hospital, Inc., and Saint Francis Health System, Inc., in an amount in excess of Seventy-five Thousand and No/100 Dollars ($75,000.00) to deter the Defendants from committing such recklessness and gross negligence in the future, and to apprise the public at large that society does not condone such actions or omissions to act.

D. For judgment on their Fourth Claim for Relief and for an award of compensatory damages in an amount in excess of Seventy-five Thousand and No/100 Dollars ($75,000.00) and exemplary or punitive damages against Defendants Associated Anesthesiologists, Inc., P.C., Saint Francis Hospital, Inc., Saint Francis Health System, Inc., Raenalle 1. Degidio, CRNA, Dennis W. Morris, M.D., and Christopher D. Emerson, M.D., in an amount in excess of Seventy­ five Thousand and No/100 Dollars ($75,000.00) to deter the Defendants from committing such recklessness and gross negligence in the future, and to apprise the public at large that society does not condone such actions or omissions to act.

E. For the costs of this action, interest as provided by law and for such other and further relief as this Court deems just and proper.

Outcome: PACE, KIRSTEN: PLAINTIFF PRESENT AND REPRESENTED BY JENNIFER DEANGELIS. DEFENDANT'S REPRESENTED BY ANTHONY FIASCO, JEFF WILSON AND THOMAS HULL. CASE COMES ON FOR FRIENDLY SUIT HEARING. 2 WITNESSES SWORN. REPORTER: TAMARA RICHARDS. COURT ORDER APPROVING SETTLEMENT AGREEMENT WITH MINOR CHILD. ALL SUPPLEMENTAL ORDERS ARE SUBMITTED AND SIGNED BY THE COURT. ORDER OF DISMISSAL TO BE ENTERED WHEN PARTIES FILE A RECEIPT OF TRUST ACCOUNT WITHIN 30 DAYS.
ORDER TO SEAL DOCUMENTS ENTERED

Plaintiff's Experts:

Defendant's Experts:

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