Cook County Jury Verdict for Doctor in Claim of Delayed Care for Congestive Heart Failure; Estate of Ruff v. Advocate Health & Hospitals Corp., et al.

Thirty-two-year-old Regina Ruff came to the emergency room at Advocate South Suburban Hospital in the morning on July 14, 2007 complaining of shortness of breath. Ruff had a history of congestive heart failure, hypertension, diabetes and non-compliance with the taking of some of her medicine.
At about 11:45 a.m., the emergency department doctor, defendant Sharon Smith, M.D., examined Ruff and ordered tests. That included lab, chest x-ray and EKG.

The chest x-ray that was done at 12:15 p.m. was interpreted by a radiologist at 12:30 p.m., suggesting bilateral pneumonia. Dr. Smith’s review of the chest x-ray films was indicative of both pneumonia and congestive heart failure. The lab results showed an elevated white blood count consistent with infection like pneumonia and elevated BNP (B-type Natriuretic Peptide), which is a substance secreted from ventricles or lower chambers of the heart that show pressure increases. These occur when a person has heart failure.

Dr. Smith ordered a blood culture followed by administration of antibiotics for the pneumonia and another drug for the congestive heart failure. Dr. Smith then called an attending physician, recommending admission, and consulted with a cardiologist. The cardiologist saw Ruff at 2:38 pm. The administrating nurse started the medicine for congestive heart failure intravenously at 3 pm. Shortly after that, Ruff’s breathing became labored, and she went into respiratory arrest. A code was called. She was resuscitated but never regained consciousness. She was declared brain dead, taken off life support and died on July 18, 2008. She is survived by her parents and three half-siblings.

Ruff’s family brought a lawsuit against Dr. Smith and a nurse stating that they were negligent by not giving prompt treatment and medicine to address her severe congestive heart failure and pneumonia and choosing not to give any medication more than 4 hours after she first arrived in the emergency room. There was also a claim against the radiologist stating that he had chosen not to correctly note the presence of congestive heart failure. The trial judge granted a motion in favor of the radiologist due to lack of proximate cause. The judge ruled that the claim against the radiologist could not be proved to have been a cause of Ruff’s death.

The case was presented to the jury as to Dr. Smith and as the hospital on an apparent agency theory. The basis of the apparent agency theory is that although Dr. Smith was not an employee of Advocate South Suburban Hospital, in the view of the patient, Regina Ruff, the doctor’s presentation appeared to make it look as though she was an employee and/or working for the hospital directly. That factual issue was presented to the jury for its decision.

The defendant Dr. Smith argued that she treated Ruff in a studied step-wise fashion for stabilizing her breathing with oxygen, ordering the necessary tests and interpreting the results as soon as they became available. The doctor also argued that she properly consulted with other physicians and specialists, including cardiology. Dr. Smith contended that her actions were all within the accepted standard of care for emergency medicine physicians. It was also argued that the sudden change in Ruff’s condition was likely due to an allergic reaction to an antibiotic.

Ruff’s family’s last settlement demand was $2 million – $4 million high/low agreement from Smith and a $1 million – $3 million high/low from Advocate Health & Hospitals.

The jury’s verdict was in favor of both the hospital and Dr. Smith and against the family of Regina Ruff. However, the jury answered the question, “Was Dr. Smith the apparent agent of Advocate?” The answer given was, “Yes.” Nevertheless, the jury found in favor of the doctor and the hospital.

Estate of Regina Ruff v. Advocate Health & Hospitals Corp., Dr. Sharon Smith, et al.
Kreisman Law Offices has been handling medical negligence cases for individuals and families for more than 36 years in and around Chicago, Cook County and its surrounding areas, including Bolingbrook, Naperville, Homewood, Riverside, Alsip, Arlington Heights and Evanston, Illinois.

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