Hopkins v. Stevens Hospital

Result: JURY VERDICT – $456,600
Medical Malpractice / Massive Overdose Medication to Premature Baby

Nolan Hopkins was born to Kathryn Hopkins at Stevens Hospital on August 25, 1999, about six weeks premature and weighing about 3½ pounds. Nolan developed apnea about five hours after birth. Apnea is when the baby stops breathing for short periods. Nolan’s physician ordered that Nolan receive an infusion of Aminophylline (aka Theophylline), which stimulates respiration so Nolan would breath normally. Unfortunately, Stevens Hospital staff gave Nolan ten (10) times the amount of Aminophylline ordered by his doctor. Aminophylline is a highly toxic and potentially lethal drug and the blood serum level must be closely monitored to keep the drug within the therapeutic range of 6 to 13 (micrograms per milliliter). Within hours of the commencement of the Aminophylline, Nolan became fussy and agitated, and began grunting and flaring his nostrils. His blood serum level of Aminophylline was measured and found to be 77 and on recheck was 91.8. Nolan had been given a toxic overdose of Aminophylline. His breathing became labored and he developed pulmonary edema and respiratory distress. The hospital called the Poison Control Center to find out what to do. No one at Stevens Hospital had ever encountered a baby with such a massive overdose of Aminophylline or such high blood serum levels. Nolan was intubated and placed on mechanical ventilation to breath and was emergently transferred to Children’s Hospital in Seattle.

The concentration of Aminophylline in his blood had risen to 136 (a lethal level) upon arriving at Children’s Hospital. He received multiple blood volume exchange transfusions to cleanse the Aminophylline from his blood. It took five days for the Aminophylline levels in his blood to return to the therapeutic range. Nolan suffered two head bleeds (intraventricular hemorrhages) and hydrocephalus. Nolan spent about six weeks at Children’s Hospital and Northwest Hospital, and underwent five neurosurgical procedures (brain surgeries) to place drains to remove the blood and excess fluids from the ventricles of his brain. The drains alleviated the swelling and Nolan survived due to excellent care received at the hospitals. He now has a permanent ventriculoperitoneal shunt (a drain from his brain to his abdominal area) to drain fluid from his brain in order to prevent the future development of hydrocephalus.

Initially, Nolan’s doctors felt that he would be severely brain damaged. However, due to prompt and excellent medical care at Children’s Hospital, Nolan is now 3½ years old and doing very well. He is considered normal, though he has been diagnosed as having “mild diffuse encephalopathy” from the hydrocephalus. How that will manifest itself during Nolan’s lifetime is not known nor predictable with any medical certainty.

Stevens Hospital denied that it was negligent and asserted that it did not give Nolan a massive overdose of Aminophylline. However, after reviewing several declarations from plaintiffs’ medical experts and plaintiffs’ motion for summary judgment, Judge Gerald Knight determined that there was an overdose and Stevens Hospital was negligent as a matter of law for giving a massive overdose of Aminophylline, and granted plaintiffs a summary judgment on that issue on September 21, 2001. The defense acknowledged the overdose of Aminophylline for the first time on the day of trial and the judge permitted Stevens Hospital to portray itself as apologetic for the incident, but denying any damages to Nolan. Stevens Hospital blamed Nolan’s brain hemorrhage, hospitalization surgeries and intraventricular shunt on everything except the Aminophylline overdose: a patent ductus arteriosis, intrauterine growth retardation; utero-placental insufficiency; late fetal heart rate decelerations; prematurity; in-utero hemorrhage; neonatal hemorrhage not caused by the Aminophylline overdose; silent hemorrhage; hemorrhage second to prematurity; pre-eclampsia; smoking; congenital heart disease; too small (1670 grams); too young (33.5 weeks); and infarcts to placenta. The issues for the jury were twofold: which of Nolan’s injuries were caused by the overdose of Aminophylline and how much money to award to Nolan and to his mother, Kathryn Hopkins. Stevens Hospital claimed that the overdose did not cause significant problems and that Nolan’s problems were due solely to his prematurity and other “possibilities.”

No one from Stevens Hospital ever contacted Kathryn Hopkins to explain how Nolan was overdosed with Aminophylline on August 25, 1999, or to apologize. Nor did anyone at Stevens Hospital ever offer to pay any of the expenses related to the overdose. Nor did anyone from Stevens ever assure her that steps had been taken so that this type of tragedy would not occur in the future. No one came to court from Stevens Hospital to testify about an overdose that almost killed Nolan. Stevens Hospital did not notify any regulatory authorities about the overdose and there was no investigation of Stevens Hospital’s error by federal or state authorities. However, Kathryn Hopkins and her family got to tell Nolan’s story to the jury and the jury responded by awarding $456,600 in damages against Stevens Hospital.

This case went to trial on April 7, 2003 before Judge Charles S. French in Snohomish County and on April 16, 2003, the jury of twelve persons returned a verdict for $456,600 to Nolan and his mother, Kathryn Hopkins due to Stevens Hospital negligent overdose of Aminophylline. The verdict was apportioned by the jury as follows: $250,000 to Nolan Hopkins for non-economic (general) damages; $150,000 to Kathryn Hopkins for non-economic (general) damages; and $56,600 for economic damages (past and future medical expenses).