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Natoli v. Massillon Community Hospital

December 1, 2008


CHARACTER OF PROCEEDING: Appeal from the Stark County Court of Common Pleas Court Case No. 2005 CV 01939.

The opinion of the court was delivered by: Delaney, J.

JUDGES: Hon. William B. Hoffman, P.J. Hon. John W. Wise, J. Hon. Patricia A. Delaney, J.



{¶1} Plaintiff-appellant Virginia Natoli, as the administratrix of the estate of her late father, Paul Fortney, appeals from awards of summary judgment granted by the Stark County Court of Common Pleas to defendants-appellees Massillon Community Hospital ("Massillon Hospital") and Emergency Medicine Physicians of Stark County, Ltd. ("EMP").


{¶2} On June 14, 2003, at approximately 6:30 p.m., Mr. Fortney, age 76, presented to the Emergency Room of Massillon Community Hospital ("Massillon Hospital"). He was accompanied by his daughter, Virginia Natoli, and grandson, Paul Marchette. Mr. Fortney previously had his lower right leg amputated due to vascular disease and was in a wheelchair.

{¶3} According to Ms. Natoli, her father complained of extreme pain in his right side, including the right hip and stump area.*fn1 Mr. Fortney had previously suffered a stroke and had some expressive aphasia, but was able to communicate his condition to his daughter, who relayed the information to the emergency room receptionist. They were instructed to have a seat in the waiting area due to the volume of patients. Over the next forty-five minutes, while in the waiting room, Mr. Forney's condition significantly deteriorated. He began to groan, hyperventilate, and vomit. The emergency room nurses allegedly did not attend to Mr. Fortney despite his family's insistence.*fn2 He went into cardiac arrest and finally was taken back to the emergency treatment room at 7:22 p.m. and seen by Dr. Jeffrey Yolsten, an emergency room physician employed by EMP. The record reflects there was a contractual agreement between EMP and Massillon Hospital for management of the emergency room.

{¶4} Resuscitation efforts were unsuccessful and Mr. Fortney was pronounced dead at 8:27 p.m. An autopsy was performed and the cause of death was determined to be a massive "ruptured abdominal aortic aneurysm", a fatal condition if not surgically treated.

{¶5} On June 13, 2005, plaintiff filed a wrongful death and survivorship claim against Massillon Hospital, EMP and Dr. Yosten. Plaintiff's complaint alleged that the defendants negligently failed to timely diagnose and treat Mr. Fortney's medical condition, resulting in his untimely death. She further alleged the defendants were negligent in their operation, staffing, training and/or regulation of the hospital.

{¶6} The defendants timely answered and discovery progressed. The case was assigned for jury trial on May 21, 2007.

{¶7} Plaintiff identified two experts Dr. Samuel Kiehl and Dr. David Feldbaum. Dr. Kiehl, a board certified emergency medicine physican, opined in his report, dated November 7, 2005, that both Massillon Hospital and EMP failed to meet the standard of care because no appropriate triage was performed.*fn3 For example, there was no evidence of Mr. Fortney's vital signs being taken or satisfactory history taken or appropriate observation of Mr. Fortney's deteriorating condition.*fn4

{¶8} Dr. Kiehl also reviewed the contract between EMP and Massillon Hospital in formulating his opinion.*fn5 In his report, he further stated EMP provided the medical director of the emergency room to Massillon Hospital pursuant the contract. The medical director was contractually obligated to direct and operate the emergency department, which would include a mechanism whereby patients are appropriately triaged and those with potentially serious illnesses or injury are treated in an appropriate timely way.*fn6 According to Dr. Kiehl's report, Massillon Hospital did not have a written triage protocol in 2003. He opined that both Massillon Hospital and EMP fell beyond the standard of care by failing to ensure that a written triage policy was developed and that it was properly applied.*fn7

{¶9} Dr. Feldbaum is a board certified vascular surgeon. He testified in his deposition that Mr. Fortney's chance of survival from the ruptured abdominal aortic aneurysm was less than fifty percent.*fn8 He further stated that Mr. Fortney was walking and he had conversed while in the waiting room.*fn9 He further opined that the failure to adequately evaluate the patient in a reasonable timely manner delayed the eventual ability of Mr. Fortney to have a potential operation that had a small chance, at most 10 percent, of saving his life if a surgeon and surgical team were available.*fn10 He also stated that a patient's past medical ...

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