Patient sues hospital, claims employees failed to properly screen him before MRI

A California court ruled that the evidence in a recent case did not support the deceased plaintiff’s claim that the hospital employees’ failure to properly screen a patient was neglect under the Elder Abuse and Dependent Adult Civil Protection Act.

The plaintiff in the case of Kruthanooch v. Glendale Adventist Medical Center had a history of coronary artery disease, hypertension, hyperlipidemia, and diabetes. In 2016, he visited the Glendale Adventist Medical Center since he awoke “weaker than usual.” He underwent an electrocardiogram (ECG) and a magnetic resonance imaging scan (MRI).

The MRI technologist was not trained on the dangers of ECG pads in the MRI machine. However, she checked the plaintiff for metal and got his medical history beforehand. When the plaintiff returned to the emergency department, the nurse saw a burn on his abdomen.

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In 2018, the plaintiff filed a civil complaint against the hospital. He alleged elder abuse due to the hospital’s failure to screen him for electrically conductive materials before the MRI. The plaintiff’s estate was substituted in the proceedings after his death.

The estate introduced expert testimony from a diagnostic radiology specialist. The specialist claimed that the hospital’s screening process before the MRI was inconsistent with the standard of care in radiology. Allegedly, the hospital’s employees did not receive proper training and deviated from the industry’s standard practice.

On the other hand, the hospital introduced the expert testimony of a reconstructive plastic surgery specialist. This specialist said that performing the MRI with ECG pads was within the standard of care and was consistent with the way that MRIs were conducted in outpatient surgery centers and hospitals. The specialist alleged that the ECG pads’ metal did not burn the plaintiff, that the actual cause was unknowable, and that the plaintiff was ill.

The jury found that the hospital’s employees failed to use the proper degree of care; that this failure was a substantial factor in causing harm; that the hospital’s officer, director, or managing agent authorized the employees’ conduct; and that the estate proved recklessness, oppression, or malice. The jury awarded no damages.

Regardless of this verdict, the hospital filed a motion. The trial court granted the motion and issued a judgment in the hospital’s favor. The trial court made the following findings:

• Recklessness required the plaintiff to prove that the employer either had advanced knowledge of the employee’s unfitness and employed them with a conscious disregard of others’ rights or safety; authorized or ratified the wrongful conduct; or was personally guilty of oppression, fraud, or malice;
• The belief of the MRI technologist and the MRI safety officer that it was safe to allow ECG pads in the MRI machine did not show subjective knowledge of a high degree of risk;
• The diagnostic radiology specialist’s testimony proved only the objective standard but not the employees’ subjective beliefs;
• The diagnostic radiology specialist’s description of the hospital’s conduct as “reckless” was not referring to the legal use of the term.

The estate appealed. The California Court of Appeal for the Second District affirmed the trial court’s judgment.

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First, the appellate court found that the estate failed to prove with substantial evidence that there was a robust caretaking or custodial relationship with ongoing responsibilities between the plaintiff and the hospital. Instead, the plaintiff’s and the hospital’s relationship was that of a patient and a healthcare provider, the appellate court said.

The appellate court noted that a substantial caretaking or custodial relationship was a requirement for recovering damages for neglect under the Elder Abuse and Dependent Adult Civil Protection Act in line with the case of Winn v. Pioneer Medical Group, Inc. (2016).

Second, the appellate court held that the estate failed to prove with substantial evidence that the hospital’s failure to properly screen the plaintiff was neglect under the Act. The evidence supported the conclusion that the hospital harmed the plaintiff because of the negligent provision of care but not due to a failure to provide medical care, the appellate court said.