Opinion
C.A. No. 01C-12-031 HdR.
August 26, 2004.
ORDER
This 26th day of August, 2004, upon considering the evidence presented on July 21, 2004 on the issue of apportionment of liability between Dr. Edward Alexander and Dr. Robert James, the arguments of counsel and the record in this case, the Court finds as follows:
1. Dr. Alexander had overall responsibility for the care of Kenneth Xiques and chose to make a change in the patient's mobility status knowing that he had a cervical fracture at C-4 that the specialist, Dr. James, diagnosed as "apparently" stable with a need for "better studies." Dr. James wrote in his consultation report that "[w]hether or not any more has to be done remains to be seen." Dr. Alexander issued an out-of-bed order without consulting Dr. James about the possible effect of this upon the cervical fracture or the spinal cord. As a result of Dr. Alexander's out-of-bed order, the discontinuance of paralytic agent Nimbex and the movement of the patient's head, a subluxation of the spine occurred.
2. Dr. James, as the consulting neurosurgeon, was the physician primarily responsible for the assessment and treatment of the cervical fracture. The patient was intubated and on a ventilator with all the attendant pulmonary risks of that treatment. Dr. James knew, or should have known, that the patient would not be maintained on chemical paralytics indefinitely and that at some point he would be mobilized. He did not advise Dr. Alexander of any danger associated with the mobilization which was reasonably foreseeable.
3. Both physicians share responsibility on the facts presented. Liability is apportioned 65% to Dr. Edward Alexander and 35% to Dr. Robert James.