Illinois Appellate Court Affirms $12.2 Million Jury Verdict for the Death of a Patient Who Died After a Failure to Receive an Emergency Blood Treatment

Matthew Gulino, the husband of the plaintiff, Joanne Gulino, visited his primary care physician in October 2009 complaining of nausea, fatigue, shortness of breath, chills and lightheadedness. The doctor diagnosed him with anxiety and prescribed Xanax after several tests showed the symptoms were not heart related.

Gulino returned to his doctor’s office two days later because the anti-anxiety medication wasn’t relieving his symptoms. Without doing any other tests, the doctor suggested that he see a psychiatrist.

The next day, Gulino visited the emergency room at Palos Community Hospital in Palos Heights, Ill., for the same symptoms. Based on Gulino’s reported symptoms and his previous anxiety diagnosis, the emergency room physician concluded that he was experiencing an acute anxiety reaction and prescribed strong anti-anxiety medication.

Three days after this last hospital visit and six days after his first doctor’s visit, Gulino woke up with slurred speech and mobility problems with his left arm. He was taken to Advocate Christ Medical Center in Oak Lawn where subsequent tests led doctors to diagnose him with a rare blood disease called thrombotic thrombocytopenic purpura (TTP).

In patients with TTP, a protein in their blood plasma causes platelets to clump together, which leads to clogged and damaged blood vessels. This condition prevents oxygen-carrying red blood cells from effectively passing through the blood vessels, leading to organ damage from the lack of oxygen.

TTP is fatal without prompt diagnosis and treatment. One of the only effective TTP treatments is a process called plasmapheresis in which a machine removes a patient’s blood, separates it from the plasma, combines it with donor plasma and returns it to the patient’s body.

On the very day that Gulino arrived at Advocate Christ Medical Center, doctors ordered that treatment. It was done at Acute Extracorporeal Services (AES) in Oak Park, Ill. Gulino arrived at Acute Extracorporeal at 4:30 p.m. the same day and the company dispatched a nurse, Maria Zurawski, to the hospital within 2 minutes of the order.

However, Zurawski stopped to perform a routine phlebotomy for another patient and returned to her home before she reported to the hospital. By the time Zurawski arrived at the hospital, at 11 p.m. that night, Gulino had already gone into cardiac arrest. Resuscitation efforts were unsuccessful and Gulino was pronounced dead at 11:40 p.m. from multiple organ failure.

Joanne Gulino, Gulino’s wife, filed a medical malpractice lawsuit against Gulino’s primary care physician, the emergency room physician at Advocate, Acute Extracorporeal Services and Zurawski. The lawsuit, filed in the Circuit Court of Cook County, alleged that AES and Zurawski were negligent by choosing not to promptly arrive at the hospital to deliver the blood treatment, recognized the need to immediately respond to the call for Gulino and to maintain and enforce a verification system to ensure nurses timely arrived to emergency-service calls.

There was a two-week trial in February 2013, and the jurors returned a verdict of $12,261,131 against Zurawski, AES and Advocate Christ Hospital. In addition, the jury entered a verdict of $26,131 for funeral and burial expenses, $2,235,000 for loss of support and $10 million for loss of society and grief and sorrow.

Christ Hospital settled Gulino’s claim after the verdict. There was no report as to what the settlement amount was.

The jury’s verdict found in favor of the two physicians and their respective employers. The only defendants found responsible for Gulino’s death by the jury were AES and Zurawski. These defendants appealed the verdict arguing that Gulino’s expert, a nurse of 35 years, who testified to a nurse’s standard of care upon emergency calls, was unqualified to offer such testimony since she lacked familiarity and experience with TTP patients.

This expert nurse testified that rather than stopping at another hospital and then her home before responding to the emergency call, the standard of care would have been to travel directly to Advocate Christ Hospital. In a 45-page opinion authored by Justice Aurelia Pucinski, the panel held that the nurse’s testimony was proper because it wasn’t offered to speak directly to the quality of Matthew Gulino’s blood treatment.

“Indeed, plaintiff’s negligent claim against defendants did not pertain to the quality of the plasmapheresis care defendants provided; rather, it was premised on defendants’ failure to provide any plasmapheresis treatment at all.”

In addition, the appeals panel found that the expert nurse’s testimony, even if found insufficient, the Illinois courts have established that medical expert testimony is unnecessary where a health-care provider’s conduct is so apparent that a layperson could understand the standard-of-care deviation.

The trial judge made a similar reference during the post-trial proceedings when he said Gulino’s case was “probably the clearest case” of such a deviation that he had seen in the 50 to 100 medical malpractice cases he handled. The appeals panel agreed with that sentiment.

“Arguably, Zurawski’s conduct and failure to report to Advocate to perform a procedure that she understood to constitute an emergency until six hours after being directed to do so, was so grossly negligent that expert witness testimony regarding the requisite standard of care was not even required in the instant case.”

Accordingly, the jury’s verdict of $12,261,131 was affirmed.

Gulino v. Zurawski, et al., 2015 IL App (1st) 131587.

Kreisman Law Offices has been handling medical negligence cases, wrongful death actions, birth injury cases and hospital negligence cases for individuals and families who have been injured or killed by the negligence of a medical provider for more than 38 years, in and around Chicago, Cook County and its surrounding areas including, Skokie, Round Lake, River Forest, Morton Grove, Lake Forest, Lockport, Joliet, Des Plaines, Cicero, Aurora, Arlington Heights, Elk Grove Village, Riverdale, Palos Hills, Palos Heights, Schiller Park, Justice, Burr Ridge, Calumet City, Chicago Ridge, Chicago Heights, South Holland, Worth, Homewood and Lyons, Ill.

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