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Allergic reaction not caused by blood pressure meds: defense

Type:

Verdict-Defendant

State:

California

Venue:

Orange County

Court:

Superior Court of Orange County, Santa Ana

Injury Type(s):

other-swelling; other-allergic reaction; epidermis-angioedema; pulmonary/respiratory-asthma

Case Type:

Medical Malpractice – Negligent Treatment, Prescription and Medication

Case Name:

Theresa Simpson v. Maria Ruby Leynes, M.D.,
No. 30-2014-00700356-CU-MM-CJC

Date:

April 8, 2016

Parties

Plaintiff(s):

Theresa Simpson (Female, 50 Years)

Plaintiff Attorney(s):

Grant Joseph Savoy;
Solouki and Savoy, LLP;
Los Angeles,
CA,
for
Theresa Simpson ■ Lindsay V. Salk;
Solouki and Savoy, LLP;
Los Angeles,
CA,
for
Theresa Simpson

Plaintiff Expert(s):

David Law; M.D.; Internal Medicine; Laguna Hills,
CA called by:
Grant Joseph Savoy, Lindsay V. Salk ■ James Pearle; M.D.; Pulmonary/Respiratory Diseases; Fullerton,
CA called by:
Grant Joseph Savoy, Lindsay V. Salk

Defendant(s):

Maria Ruby Leynes, M.D.

Defense Attorney(s):

Joseph J. Looney;
Carroll, Kelly, Trotter, Franzen, McKenna & Peabody;
Long Beach,
CA,
for
Maria Ruby Leynes, M.D.

Defendant Expert(s):

Andrew Wachtel;
Pulmonology;
Los Angeles,
CA called by:
Joseph J. Looney ■ Daniel Bressler;
Internal Medicine;
San Diego,
CA called by:
Joseph J. Looney

Insurer(s):

Hudson Insurance Group

Facts:

On May 1, 2013, plaintiff Theresa Simpson, a 50-year-old woman with a nine-year history of high blood pressure, suffered an allergic reaction, resulting in angioedema, which is rapid swelling of the subcutaneous tissues and submucosal membranes. As a result, Simpson suffered severe swelling of her lips, tongue, and throat. Simpson previously suffered an orthopedic injury at work in 2008 and subsequently treated the injury through a workers’ compensation group. A year later, she suffered four separate allergic "angioedema" reactions to either a substance or a medication. Her primary care doctors eventually concluded that the cause of the reactions was likely lisinopril, a medication used to control her high blood pressure. As a result, Simpson stopped taking lisinopril in June 2010, even though her blood pressure issues continued. In 2012, Simpson’s treating orthopedist, from the workers’ compensation group, concluded that Simpson’s chronic pain and associated injury problems were exacerbating Simpson’s hypertension. As a result, in September 2012, Simpson was referred to Dr. Maria Leynes, a board certified internist in the workers’ compensation group, for consultation on the hypertension. Leynes ultimately prescribed lisinopril to augment the blood pressure medications that Simpson was being prescribed by her primary care doctors. Eight months later, on May 1, 2013, Simpson suffered an angioedema reaction, resulting in severe swelling of her lips, tongue, and throat. She subsequently presented to a local emergency room and was hospitalized overnight. Her primary care doctors again thought that Simpson’s reaction was caused by lisinopril. Simpson sued Leynes, alleging that Leynes was negligent in failing to obtain a proper history before prescribing her lisinopril and that this negligence constituted medical malpractice. Simpson maintained that she had advised Leynes of her allergies to blood pressure medications, but could not recall the name of the medication during the appointment. She also claimed that she requested to have Leynes order a copy of her primary care medical records to investigate, prior to prescribing any additional medications. However, she claimed that Leynes failed to request the copies of her primary care medical records before prescribing lisinopril and that this failure was a violation of the standard of care. The plaintiff’s internal medicine expert opined that if Simpson expressed any uncertainty as to her medication allergy history, it was below the standard of care for Leynes to prescribe any additional blood pressure medication before investigating the patient’s medical history. Leynes contended that her treatment of Simpson was within the standard of care, that Simpson had not told her of any previous angioedema reactions to medication, and that Simpson did not request to have her records retrieved from her primary care doctors. The defense’s internal medicine expert testified that Simpson provided a clear and specific medical history, including her history of medication reactions, during her appointments with Leynes, and that there was no mention of any adverse reactions to blood pressure medication. Thus, the expert testified that the standard of care did not require Leynes to order previous records in that situation. The defense expert further opined that Simpson’s primary care records regarding a previous allergy to lisinopril were equivocal at best and that ordering the records would not have revealed any information about the consideration of lisinopril being the cause of the angioedema.

Injury:

Simpson suffered an angioedema attack on May 1, 2013, resulting in severe swelling of her lips, tongue, and face. She also suffered respiratory distress and had to be hospitalized overnight for treatment at the emergency room for her primary care hospital. Simpson claimed that the allergic reaction resulted in lingering swelling of her lips and tongue for several weeks. She also claimed that she developed adult onset asthma as a result of the May 2013 angioedema episode. The plaintiff’s expert pulmonologist testified that lisinopril was likely the cause of the angioedema, given Simpson’s history and the timing of the attack. The expert also opined that the asthma complaints were likely the result of the angioedema event and lisinopril, given the timing of the development of asthma immediately after the event. Simpson claimed that her respiratory condition/asthma significantly limits her ability to perform routine daily activities. She maintained that as a result, she will require multiple daily medications to manage her asthma for the rest of her life. The defense’s pulmonology expert opined that lisinopril did not cause the angioedema events, as in 2014, one year after the May 2013 attack, Simpson suffered yet another angioedema attack even though she was no longer taking lisinopril. Thus, the expert opined that it was unlikely that lisinopril was the cause of Simpson’s condition. The defense’s expert pulmonologist further opined that lisinopril does not cause asthma and that Simpson, in fact, does not have asthma. Instead, the expert opined that Simpson’s respiratory issues were secondary to obesity; severe deconditioning from her orthopedic limitations; a congenitally high diaphragm, compromising one lung; chronic pain; and anxiety.

Result:

The jury rendered a defense verdict.

Trial Information:

Judge:

Frederick Aguirre

Demand:

$550,000 (C.C.P. § 998)

Offer:

Waiver of costs (C.C.P. § 998)

Trial Length:

10
 days

Trial Deliberations:

1
 hours

Jury Vote:

12-0

Jury Composition:

5 male/ 7 female

Post Trial:

Defense counsel filed a cost bill, which is pending.

Editor’s Comment:

This report is based on information that was provided by plaintiff’s and defense counsel.