Florida Senate - 2012 (NP) CS for SB 10 By the Committee on Rules; and Senator Flores 595-04180-12 201210c1 1 A bill to be entitled 2 An act for the relief of Aaron Edwards, a minor, by 3 Lee Memorial Health System of Lee County; providing 4 for an appropriation to compensate Aaron Edwards for 5 damages sustained as a result of the medical 6 negligence by employees of Lee Memorial Health System 7 of Lee County; providing a limitation on the payment 8 of fees and costs; providing an effective date. 9 10 WHEREAS, Mitzi Roden and Mark Edwards’ only child, Aaron 11 Edwards, was born on September 5, 2007, at Lee Memorial 12 Hospital, and 13 WHEREAS, during Mitzi Roden’s pregnancy, Mitzi Roden and 14 Mark Edwards attended childbirth classes through Lee Memorial 15 Health System and learned of the potentially devastating effect 16 that the administration of Pitocin to augment labor may have on 17 a mother and her unborn child when not carefully and competently 18 monitored, and 19 WHEREAS, Mitzi Roden and Mark Edwards communicated directly 20 to Nurse Midwife Patricia Hunsucker of Lee Memorial Health 21 System of their desire to have a natural childbirth, and 22 WHEREAS, Mitzi Roden enjoyed an uneventful full-term 23 pregnancy with Aaron Edwards, free from any complications, and 24 WHEREAS, on September 5, 2007, at 5:29 a.m., Mitzi Roden, 25 at 41 and 5/7 weeks’ gestation awoke to find that her membranes 26 had ruptured, and 27 WHEREAS, when Mitzi Roden presented to the hospital on the 28 morning of September 5, she was placed on a fetal monitoring 29 machine that confirmed that Aaron Edwards was doing well and in 30 very good condition, and 31 WHEREAS, Mitzi Roden tolerated well a period of labor from 32 9 a.m. until 12:30 p.m., but failed to progress in her labor to 33 the point of being in active labor. At that time, Nurse Midwife 34 Patricia Hunsucker informed Mitzi Roden and Mark Edwards that 35 she would administer Pitocin to Mitzi in an attempt to speed up 36 the labor, but both Mitzi Roden and Mark Edwards strenuously 37 objected to the administration of Pitocin because of their 38 knowledge about the potentially devastating effects it can have 39 on a mother and child, including fetal distress and even death. 40 Mitzi Roden and Mark Edwards informed Nurse Midwife Patricia 41 Hunsucker that they would rather undergo a cesarean section than 42 be administered Pitocin, but in spite of their objections, Nurse 43 Midwife Patricia Hunsucker ordered that a Pitocin drip be 44 administered to Mitzi Roden at an initial dose of 3 milliunits, 45 to be increased by 3 milliunits every 30 minutes, and 46 WHEREAS, there was universal agreement by the experts 47 called to testify at the trial in this matter that the 48 administration of Pitocin over the express objections of Mitzi 49 Roden and Mark Edwards was a violation of the standard of care, 50 and 51 WHEREAS, for several hours during the afternoon of 52 September 5, 2007, the dosage of Pitocin was consistently 53 increased and Mitzi Roden began to experience contractions 54 closer than every 2 minutes at 4:50 p.m., and began to 55 experience excessive uterine contractility shortly before 6 56 p.m., which should have been recognized by any reasonably 57 competent obstetric care provider, and 58 WHEREAS, in spite of Mitzi Roden’s excessive uterine 59 contractility, the administration of Pitocin was inappropriately 60 increased to 13 milliunits at 6:20 p.m. by Labor and Delivery 61 Nurse Beth Jencks, which was a deviation from the acceptable 62 standard of care for obstetric health care providers because, in 63 fact, it should have been discontinued, and 64 WHEREAS, reasonable obstetric care required that Dr. 65 Duvall, the obstetrician who was ultimately responsible for 66 Mitzi Roden’s labor and delivery, be notified of Mitzi Roden’s 67 excessive uterine contractility and that she was not adequately 68 progressing in her labor, but the health care providers 69 overseeing Mitzi Roden’s labor unreasonably failed to do so, and 70 WHEREAS, in spite of Mitzi Roden’s excessive uterine 71 contractility, the administration of Pitocin was increased to 14 72 milliunits at 7:15 p.m., when reasonable obstetric practices 73 required that it be discontinued, and a knowledgeable obstetric 74 care provider should have known that the continued use of 75 Pitocin in the face of excessive uterine contractility posed an 76 unreasonable risk to both Mitzi Roden and Aaron Edwards, and 77 WHEREAS, Lee Memorial’s own obstetrical expert, Jeffrey 78 Phelan, M.D., testified that Mitzi Roden experienced a tetanic 79 contraction lasting longer than 90 seconds at 8:30 p.m., and Lee 80 Memorial’s own nurse midwife expert, Lynne Dollar, testified 81 that she herself would have discontinued Pitocin at 8:30 p.m., 82 and 83 WHEREAS, at 8:30 p.m., the administration of Pitocin was 84 unreasonably and inappropriately increased to 15 milliunits when 85 reasonable obstetric practices required that it be discontinued, 86 and 87 WHEREAS, at 9 p.m., Nurse Midwife Hunsucker visited Mitzi 88 Roden at bedside, but mistakenly believed that the level of 89 Pitocin remained at 9 milliunits, when, in fact, it had been 90 increased to 15 milliunits, and further, she failed to 91 appreciate and correct Mitzi Roden’s excessive uterine 92 contractility, and 93 WHEREAS, Lynne Dollar acknowledged that it is below the 94 standard of care for Nurse Midwife Patricia Hunsucker to not 95 know the correct level of Pitocin being administered to her 96 patient, Mitzi Roden, and 97 WHEREAS, at 9:30 p.m., the administration of Pitocin was 98 again unreasonably and inappropriately increased to 16 99 milliunits, when reasonable obstetric practice required that it 100 be discontinued in light of Mitzi Roden’s excessive uterine 101 contractility and intrauterine pressure, and 102 WHEREAS, as 9:40 p.m., Aaron Edwards could no longer 103 compensate for the increasingly intense periods of 104 hypercontractility and excessive intrauterine pressure brought 105 on by the overuse and poor management of Pitocin administration, 106 and suffered a reasonably foreseeable and predictable severe 107 episode of bradycardia, where his heart rate plummeted to life 108 endangering levels, which necessitated an emergency cesarean 109 section. Not until Aaron Edwards’ heart rate crashed at 9:40 110 p.m. did Nurse Midwife Patricia Hunsucker consult with her 111 supervising obstetrician, Diana Duvall, M.D., having not 112 discussed with Dr. Duvall her care and treatment of Mitzi 113 Roden’s labor since 12:30 p.m. Because Dr. Duvall had not been 114 kept informed about the status of Mitzi Roden’s labor, she was 115 not on the hospital grounds at the time Aaron Edwards’ heart 116 rate crashed, and another obstetrician who was unfamiliar with 117 Mitzi Roden’s labor performed the emergency cesarean section to 118 save Aaron Edwards’ life, and 119 WHEREAS, there existed at the time of Mitzi Roden’s labor 120 and delivery a compensation system whereby a nurse midwife such 121 as Patricia Hunsucker had a financial disincentive to consult 122 with her supervising obstetrician during the period of labor, 123 and 124 WHEREAS, Lee Memorial Health System had in place at the 125 time of Mitzi Roden’s labor and delivery rules regulating the 126 use of Pitocin for the augmentation of labor which required that 127 Pitocin be discontinued immediately upon the occurrence of 128 tetanic contractions, nonreassuring fetal heart-rate patterns, 129 or contractions closer then every 2 minutes, and 130 WHEREAS, in violation of rules regulating the use of 131 Pitocin for the augmentation of labor, Labor and Delivery Nurse 132 Beth Jencks and Nurse Midwife Patricia Hunsucker failed to 133 immediately discontinue the administration of Pitocin in the 134 face of hyperstimulated uterine contractions and excessive 135 intrauterine pressure and increased the amount of Pitocin being 136 administered to Mitzi Roden or remained completely unaware that 137 the levels of Pitocin were being repeatedly increased, and 138 WHEREAS, Aaron Edwards suffered permanent and catastrophic 139 injuries to his brain as a consequence of the acute hypoxic 140 ischemic episode at birth, and 141 WHEREAS, Aaron Edwards currently and for the remainder of 142 his life will suffer from spastic and dystonic cerebral palsy 143 and quadriparesis, rendering him totally and permanently 144 disabled, and 145 WHEREAS, Aaron Edwards currently and for the remainder of 146 his life will not be able to orally communicate other than to 147 his closest caregivers, and is entirely dependent on a computer 148 tablet communication board for speech, and 149 WHEREAS, Aaron Edwards suffers from profound physical 150 limitations affecting all four of his limbs such that he 151 requires supervision 24 hours a day and cannot feed, bathe, 152 dress, or protect himself, and 153 WHEREAS, Aaron Edwards will never be able to enter the 154 competitive job market and will require a lifetime of medical, 155 therapeutic, rehabilitation, and nursing care, and 156 WHEREAS, after a 6-week trial, a jury in Lee County 157 returned a verdict in favor of Aaron Edwards, Mitzi Roden, and 158 Mark Edwards, finding Lee Memorial Health System 100 percent 159 responsible for Aaron Edwards’ catastrophic and entirely 160 preventable injuries and awarded a total of $28,477,966.48 to 161 the Guardianship of Aaron Edwards, $1,340,000 to Mitzi Roden, 162 and $1 million to Mark Edwards, and 163 WHEREAS, the court also awarded Aaron Edwards, Mitzi Roden, 164 and Mark Edwards $174,969.65 in taxable costs, and 165 WHEREAS, Lee Memorial Health System tendered $200,000 166 toward payment of this claim, in accordance with the statutory 167 limits of liability set forth in s. 768.28, Florida Statutes, 168 NOW, THEREFORE, 169 170 Be It Enacted by the Legislature of the State of Florida: 171 172 Section 1. The facts stated in the preamble to this act are 173 found and declared to be true. 174 Section 2. Lee Memorial Health System, formerly known as 175 the Hospital Board of Directors of Lee County, is authorized and 176 directed to appropriate from funds not otherwise appropriated 177 and to draw a warrant as compensation for the injuries suffered 178 by Aaron Edwards in the sum of $15 million payable to the 179 Guardianship of Aaron Edwards to be placed in a special needs 180 trust created for the exclusive use and benefit of Aaron 181 Edwards, a minor. 182 Section 3. The amount paid by Lee Memorial Health System 183 pursuant to s. 768.28, Florida Statutes, and the amount awarded 184 under this act are intended to provide the sole compensation for 185 all present and future claims arising out of the factual 186 situation described in this act which resulted in the injuries 187 suffered by Aaron Edwards. The total amount paid for attorney 188 fees, lobbying fees, costs, and other similar expenses relating 189 to this claim may not exceed 25 percent of the amount awarded 190 under this act. 191 Section 4. This act shall take effect upon becoming a law.