Suit alleges hospital oblivious to boy's lithium overdose

David Yates Oct. 15, 2007, 8:12am

Memorial Hermann Baptist Behavioral Health Center

Slurring his words and vomiting, a 10-year-old bipolar patient at Memorial Hermann Baptist Behavioral Health Center suddenly collapsed and slipped into coma. The young boy was life-flighted to a Houston hospital and diagnosed with ventricular tachycardia due to lithium toxicity.

Four years after the incident, the guardian of the child is claiming Memorial Hermann medical personnel were "oblivious" to the fact that they were administrating "lethal doses of lithium" to her grandson.

Acting as next of friend, Rita Ogden filed a medical malpractice lawsuit against Baptist Hospitals of Southeast Texas and Doctors Ravikumar Kanneganti and Sharad Kulkarni on Oct. 10 in the Jefferson County District Court.

According to the plaintiff's original petition, the minor plaintiff was hospitalized for behavioral mental health problems (bipolar disorder and ADHD) in the Memorial Hermann Baptist Behavioral Health Center child psychiatry unit. During the admissions process, the hospital's admitting nurse allegedly reported in error to attending physician Kanneganti that the child was taking lithium carbonate 600 mg twice per day – twice the amount of the recommended dosage.

"Kanneganti ordered the continuation of that dose without checking the dose against the weight of the minor child, when the correct dose should have been 300 mg twice per day," the suit said. "Because of these nursing and medical errors, (the child) began his stay in the hospital receiving 1,200 mg of lithium carbonate per day…and this dose continued until his emergency transfer from the hospital on Aug. 7, 2003-at total of six days."

By the second day of the child's hospitalization, the results of a blood analysis performed by the hospital's laboratory reported and flagged the minor plaintiff's blood lithium level to be abnormal at 1.4 MMOL/L, indicative of lithium toxicity, the suit said.

"The hospital's lab failed to send a critical value report with the results or at any time thereafter," the suit said. "The nursing staff failed to respond to the abnormal blood lithium level in the lab report. Kulkarni, covering for Kanneganti, initialed the lab report to indicate he had reviewed it, but neither ordered a repeat lithium blood level test nor any other corrective action on the medication level.

"There is no indication that Kulkarni reported the abnormality or any concerns to Kanneganti. The hospital's nurses continued to give (the child) double lithium carbonate doses, with both physicians and the entire nursing staff remaining oblivious to the continuing overdoses."

On Aug. 7, 2003 a social worker brought the child to a hearing room at the hospital. The minor plaintiff could hardly walk or hold his head up and was slurring his words, drooling, and covered with sweat, the suit said.

Nurses attended to him but could not find the child's pulse," the suit said. "The minor plaintiff became diaphoretic, tachycardia, vomited and collapsed into a coma, resulting in his being rushed to the hospital's main campus emergency department.

"The child was found to have a lithium level of 3.1 and began to have episodes of ventricular tachycardia," the suit said. "He was life-flighted to Memorial Hermann Children's Hospital in Houston and admitted to intensive care, where an ultimate diagnosis of ventricular tachycardia due to lithium toxicity was made.

The plaintiffs alleged the defendants breached the ordinary standard of care owed to the minor plaintiff and were negligent in their treatment.

The suit lists the following acts of negligence allegedly committed by the defendants:

· Failing to take a proper history of current medications;

· Failing to verify dosage of medications previously given at the same hospital;

· Failing to check for proper pediatric dosage;

· Failing to assess proper dosage for patient by body weight in kilograms;

· Failing to read or appropriately respond to laboratory reports;

· Failing to report or call to the attention of attending physician or physicians toxic lithium levels;

· Administering lethal dosage of lithium carbonate for six successive days;

· Failing to be aware of the symptoms of lithium overdose;

· Failing to appropriately note responses to medication;

· Failing to recognize toxic levels of lithium in Tyler;

· Failing to have a critical value response to the abnormal lithium serum value

· Failing to have adequate policies and procedures for the Hospital's Fannin campus regarding treatment of minor behavioral patients;

· Failing to have adequate policies and procedures and/or supervision of nursing, pharmacy, and laboratory staffs and other Hospital employees;

· Failing to appropriately and timely diagnosis and provide or secure treatment for Tyler's overdosed condition;

· Failing to document lab values in Tyler's progress notes;

· Failing to appropriately intervene to limit and/or reverse Tyler's overdosed condition;

· Failing to properly revise Tyler's treatment plan;

· And Failing to have adequate mandatory policies for Hospital's medical staff.

The plaintiffs are suing for exemplary damages, plus past and future medical expenses, physical pain, mental anguish and loss of enjoyment of life.

The plaintiffs are demanding a trial by jury and are represented by attorney Kenneth Lewis of the Bush Lewis law firm.

Judge Donald Floyd, 172nd Judicial District, has been assigned to the case.

Case No. E180-497

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