Gomez v. Sauerwein

Christiana Anaya suffered from uncontrolled diabetes, which left her susceptible to serious infections. She went to the Toppenish Community Hospital with a urinary tract infection. Blood test results revealed Ms. Anaya had a yeast infection. The lab called Ms. Anaya's primary care facility (the Yakima Valley Farm Workers Clinic) where Respondent Dr. Mark Sauerwein was covering for Ms. Anaya's usual provider. Sauerwein was concerned about the lab results. Due to the serious nature of a blood infection, the doctor decided that if Ms. Anaya was feeling ill, she should come in immediately for treatment. If she was feeling better, it was more likely that the test result was a false positive, a common occurrence in microbiology labs. Dr. Sauerwein used the complete clinical picture available to him to conclude that the lab result was a false positive resulting from contamination but had the nurse contact Mrs. Anaya to move her next appointment up to the following week. Dr. Sauerwein did not tell Mrs. Anaya about the test result. The lab positively identified candida glabrata as the yeast in Ms. Anaya's blood. An infection of glabrata in the blood is serious. Lab microbiologists entered this information into Ms. Anaya's medical record but did not notify Dr. Sauerwein, the Clinic, or anyone else about the positive test result. Before Ms. Anaya's next visit to the Clinic, her condition worsened. Ms. Anaya went to Yakima Memorial Hospital where she was prescribed amphotericin B, which is highly toxic to the kidneys. Given the compromised state of Ms. Anaya's kidneys from her diabetes, a health care provider would not normally prescribe amphotericin B until positively identifying glabrata. Unfortunately, the amphotericin B treatment came too late to stop the infection from spreading to the internal organs. Ms. Anaya died at age 32 of cardiac arrest, deprivation of oxygen to the brain, and fungal sepsis; all stemming from type II diabetes mellitus. Mr. Anaya Gomez, as personal representative of Ms. Anaya's estate, filed suit against Dr. Sauerwein and the Clinic for malpractice. Three weeks before the jury trial, the estate moved to add a claim for failure to obtain informed consent. At the close of Mr. Anaya's case, the defense moved for judgment as a matter of law on the informed consent claim. The trial judge granted the motion and dismissed the informed consent claim, arguing that case law precluded the claim in misdiagnosis cases. The jury then found Dr. Sauerwein did not breach any duty owed to Ms. Anaya. After its review, the Supreme Court concluded that when a health care provider rules out a particular diagnosis based on the patient's clinical condition-including test results, medical history, presentation upon physical examination, and any other circumstances surrounding the patient's condition that are available to the provider the provider may not be liable for informed consent claims arising from the ruled out diagnosis. The Court affirmed the appellate court, which affirmed the trial court's judgment. View "Gomez v. Sauerwein" on Justia Law