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Larrimore v. Homeopathic Hospital Ass'n of Del.

Superior Court of Delaware, New Castle County

December 1, 1961

Betty F. LARRIMORE, widow and Administratrix of the Estate of Charles H. G. Larrimore, Plaintiff,
HOMEOPATHIC HOSPITAL ASSOCIATION OF DELAWARE, a corporation of the State of Delaware, Defendant.

Page 363

[54 Del. 236] Harold Leshem and Harvey B. Rubenstein (of Leshem & Rubenstein), Wilmington, for plaintiff.

Rodney M. Layton (of Richards, Layton & Finger), Wilmington, for defendant.

[54 Del. 237] STIFTEL, Judge.

Plaintiff, Betty F. Larrimore, administratrix of the estate of her late husband, Charles H. G. Larrimore, brought an action against Homeopathic Hospital Association of Delaware ('Hospital') based on the negligence of one of its nurses in the treatment of her late husband. This was not a death action. There was no claim made that the negligence was responsible in any way for the death of Mr. Larrimore. This action was brought by Mrs. Larrimore on behalf of her husband. It is an action which he would have been entitled to bring if he had been living. The jury returned a verdict of $30,000.

This matter is presently before the Court on defendant's renewal of its motion for a directed verdict or, in the alternative, for a new trial.

The facts upon which the action was maintained are as follows:

Charles Larrimore, deceased, was a test engineer for All American Aviation. In February, 1954, he was hospitalized because of a retinal hemorrhage, and while he was in the hospital a kidney condition known as chronic glomerulonephritis [1] [54 Del. 238] was diagnosed. This hospitalization lasted for approximately six or seven seeks, and during the hospitalization, Mr. Larrimore temporarily lost his sight, which soon returned to him upon his release from the hospital. After his release from the hospital he returned to work and was able to perform his duties; he also obtained a commercial pilot's license.

During 1957 Mr. Larrimore began receiving treatment from Dr. Stanley Verbit, an internist. On September 15, 1959, he was hospitalized by the doctor in an attempt to control his hypertension, which had deteriorated from a benign phase to a malignant type of hypertension, which was superimposed on the glomerulonephritis with renal failure. Dr. Verbit stated that if Mr. Larrimore's condition was permitted to remain as it was at the time of hospitalization, it could be expected from the natural history of this disease that he would live about 3 months. Therefore, the hospitalization was a last, desperate effort to try to reverse the difficulties Mr. Larrimore was encountering by trying to convert the malignant phase of hypertension into an ordinary phase of hypertension. It was understood that if one could convert this malignancy downward, Mr. Larrimore's prognosis would be improved.

Page 364

When Mr. Larrimore was admitted into the hospital, this problem was carefully explained to his wife.

The doctor determined that in order to reduce the blood pressure to a safe level, it was necessary to use a ganglionic blocking agent, and he selected a drug known as ansolysen in an attempt to manage the hypertension.

In starting the use of the ansolysen, it is not known what dosage is required or at what dosage undesirable effects may be produced. Consequently, a small arbitrary dosage of ansolysen is used in the beginning. In determining the dosage to be used on Mr. Larrimore, the doctor took into consideration that Mr. Larrimore was suffering from a chronic kidney disease and decided that the administration of this drug was to be initiated intramuscularly. Up until October 1, 1959, the [54 Del. 239] patient received no more than two milligrams of this drug parenterally through the muscle at each injection. By adjusting and using different dosages of this drug, varying degrees of blood pressure decrease may be selectively produced. The dosage that can be used to produce favorable degrees of blood pressure is limited by the side reactions that may be produced. The higher the dosage, the more potent the side reactions and the more troublesome the side reactions may become. One of the side effects of the use of ansolysen is related to a decrease in the ability of the kidneys to function.

On October 1, 1959, Dr. Verbit determined that the use of parenteral injections of ansolysen was no longer justified in the attempt to obtain control of the patient's blood pressure because his renal function, instead of improving, had deteriorated so that there was no longer any hope that the kidney disease could be controlled. Thus, since the attempt of the doctor to convert the hypertension from the malignant type to a less serious type was not accomplishing the desired purpose, it was decided to discontinue the intramuscular injections of the drug. Generally, it is considered dangerous to discontinue this type of treatment abruptly, once it is started, because there is a tendency that the hypertension will rebound and result in greater injury to the kidney. Because the doctor determined that the disease of the kidney could not be halted, he discontinued the parenteral administration of the drug and ordered the drug administered orally. Thus, on October 1, 1959, at 8 p. m., the parenteral method was discontinued and the oral method was begun. The doctor stated that after his order for oral administration of the drug, it was clear that it was now only a matter of time before the patient's ultimate demise would occur.

The entry on the hospital record for Mr. Larrimore on October 1, 1959, states:

[54 Del. 240] 'With diastolic now approaching 110 parenteral medication discontinued. Oral Ansolysen, 20 milligrams, three times a day started.'

The entry on the order sheet of October 1, 1959, which constitutes direct orders from the physician to the nursing staff, states:

Discontinue parenteral Ansolysen at eight p. m. Give oral Ansolysen, 20 milligrams, at eight p. m., 10-1-59, then 20 milligrams at eight p. m. and two p. m., on 10-2-59.'

The entry on the order sheet for October 2, 1959, states:

'Continue Ansolysen by mouth today and 10-3-59.'

The entry on the order sheet for October 4, 1959, states:

'Increase Ansolysen, 30 milligrams at eight p. m., 30 milligrams at two p. m., and 30 milligrams ...

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