AIDAN MING-HO LEUNG v. VERDUGO HILLS HOSPITAL
















Filed 3/23/11




CERTIFIED FOR PARTIAL PUBLICATION*





IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

SECOND APPELLATE DISTRICT

DIVISION FOUR

AIDAN MING-HO LEUNG, a Minor, etc., Plaintiff and Appellant, v. VERDUGO HILLS HOSPITAL, Defendant and Appellant.

B204908 (Los Angeles County Super. Ct. No. BC343985)

STORY CONTINUE FROM PART III….


Aidan was born at the Hospital on a Monday and released Tuesday, approximately 24 hours later. As compared to other infants, he was at an increased risk of developing hyperbilirubinemia and kernicterus: he showed four major clinical risk factors (being male, being of East Asian descent, being breast fed, and having bruises), and one minor risk factor (being less than 38 weeks gestation -- 37 weeks, 2 days -- based on the ultrasound of the fetus taken by Nancy Leung's obstetrician). According to Dr. Bhutani, the Hospital nursing staff should have recognized Aidan's risk, communicated it to the Leungs, and stressed that a follow-up appointment within two to three days of discharge was mandatory. It may be inferred that knowledge of Aidan's risk -- that he had an elevated danger of developing a condition from unmonitored jaundice that could lead to brain damage -- was information that would have materially changed the way his parents attended to Aidan once he was discharged from the Hospital. Had the Hospital not been negligent in failing to implement Alert 18, had the nursing staff not been negligent in failing to properly assess and inform the Leungs of Aidan's risk, and had the staff also not been negligent in failing to inform the Leungs that a follow-up appointment within two to three days after discharge was mandatory, the likelihood of Aidan's hyperbilirubinemia occurring and going untreated would have been substantially reduced. The Leungs would have understood the heightened need to monitor Aidan's breast feeding and stool, to examine him for jaundice, and to have his risk for hyperbilirubinemia assessed in an appointment no later than Thursday (three days after his Monday discharge).
This negligence was exacerbated by the Hospital's negligent failure to provide sufficient coaching to Nancy Leung on breast feeding. Nancy testified that while in the Hospital, she told two of the attending nurses, Susan McBroom and Margaret McClammy, she was not sure she was breast feeding correctly. At least three times, she told them that she was concerned Aidan was not getting enough milk. The nurses encouraged her to keep trying, but only once did she receive any coaching. For five to ten minutes, as Nancy put Aidan to her breast, Nurse McClammy instructed her, helped her position him, and observed that he seemed to latch on. According to Dr. Bhutani, however, the relevant standard of care required more: the coaching should have ensured that an actual transfer of milk from mother to infant was taking place, and should have ensured that Nancy knew how to detect that such a transfer was occurring as by the sound of Aidan swallowing and the feel of his body as he did so. Dr. Bhutani testified that specific instructional coaching was essential: â€