In the State Court of Fulton County

State of Georgia

MYUNG JA OH Individually and as Representative of the Estate of BYUNG (BEN) OH, deceased,

                  Plaintiff,

— versus —

“ATLANTA MEDICAL CENTER”

WELLSTAR HEALTH SYSTEM, INC.

ADEFISAYO M. ODUWOLE, MD

MOREHOUSE HEALTHCARE, INC.

BARRY JEFFRIES, MD

DIAGNOSTIC IMAGING SPECIALISTS, P.A.

AMY D. WYRZYKOWSKI, MD

WELLSTAR MEDICAL GROUP, LLC

KHALID IQBAL, MD

ATLANTA SOUTH NEPHROLOGY PC

THOMAS W. SCHOBORG, MD

ATLANTA UROLOGICAL GROUP, P.C.

ZANDRAETTA L. TIMS-COOK, MD

JOHN P. OUDERKIRK, MD

AIDS HEALTHCARE FOUNDATION (INC)

JOHN/JANE DOE 1-10,

                  Defendants

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CIVIL ACTION

FILE NO. ___________

JURY TRIAL DEMANDED

Plaintiff’s Complaint for Damages

Nature of the Action

1.             This medical malpractice, wrongful-death action arises out of medical services negligently performed on Byung (Ben) D. Oh at Wellstar’s Atlanta Medical Center from April 30, 2018, through June 9, 2018.

2.             Plaintiff Myung Ja Oh is the wife of Ben Oh, deceased.

3.             At the time of his death, Ben Oh was 77 years old with a life expectancy of an additional 10.7 years.[1]

4.             As representative of Mr. Oh’s estate, Plaintiff Myung Oh asserts a claim for harm Mr. Oh suffered before he died.

5.             Plaintiff also asserts a wrongful-death claim pursuant to OCGA Title 51, Chapter 4.

6.             Pursuant to OCGA § 9-11-9.1, the Affidavit of Peter M. Mowschenson, MD, and the Affidavit of Meldon C. Levy, MD, are attached hereto as Exhibits 1 and 2, respectively. This Complaint incorporates the opinions and factual allegations contained in those affidavits.

7.             As used in this Complaint, the phrase “standard of care” means that degree of care and skill ordinarily employed by the medical profession generally under similar conditions and like circumstances as pertained to the Defendant’s actions under discussion.

Parties, Jurisdiction, and Venue

8.             Plaintiff Myung Ja Oh is a citizen of Georgia and the wife of Byung (Ben) D. Oh, deceased.

9.             Defendant “Atlanta Medical Center” refers to the primary employer of the nursing staff at the hospital that is located at 303 Parkway Drive NE, Atlanta, Georgia 30312 (the “Hospital”) and that does business under the name Atlanta Medical Center in May 2018.

10.          Plaintiff believes that employer was Defendant Wellstar Health System, Inc. However, if any other entity was the employer, each such entity is hereby on notice that but for a mistake concerning the identity of the proper party, the action would have been brought against it.

11.          Defendant Wellstar Health System, Inc. (“WHS”) is a Georgia corporation that places its Registered Office in Cobb County. WHS may be served through their Registered Agent, Leo E. Reichart, at 793 Sawyer Road, Marietta, Georgia 30062.

12.          At all relevant times, WHS was the employer of the nurses whose conduct is at issue in this lawsuit.

13.          Pursuant to OCGA §§ 14-2-510 and 14-3-510,[2] WHS is subject to venue in this county because the cause of action originated in Fulton County and the corporation has an office and transacts business in that county.

14.          Additionally, pursuant to OCGA § 9-10-31, WHS is subject to venue in this county because various co-defendants are subject to venue in this county.[3]

15.          WHS has been properly served with this Complaint.

16.          WHS has no defense to this lawsuit based on undue delay in bringing suit — whether based on the statute of limitations, the statute of repose, laches, or any similar theory.

17.          Defendant Adefisayo M. Oduwole, MD is a Georgia citizen. He lives in Fayette County and may be served at 155 Longcreek Drive, Fayetteville, Georgia 30214.

18.          Pursuant to OCGA § 9-10-31, Dr. Oduwole is subject to venue in this county because various co-defendants are subject to venue here.

19.          Dr. Oduwole has been properly served with this Complaint.

20.          Dr. Oduwole has no defense to this lawsuit based on undue delay in bringing suit — whether based on the statute of limitations, the statute of repose, laches, or any similar theory.

21.          At all relevant times, Dr. Oduwole acted as an employee or agent of Defendant Morehouse Healthcare, Inc.

22.          Defendant Morehouse Healthcare, Inc. (“MHI”) is a Georgia corporation. MHI places its Registered Office in Fulton County. MHI may be served through their Registered Agent, Michael A. Rambert, at 720 Westview Drive SW, Atlanta, GA, 30310.

23.          Plaintiff believes MHI was the employer or other principal of Dr. Oduwole, at all times relevant to this lawsuit. However, if any other entity was his principal, each such entity is hereby on notice that but for a mistake concerning the identity of the proper party, the action would have been brought against it.

24.          Pursuant to OCGA §§ 14-2-510 and 14-3-510, MHI is subject to venue in this county because it places its Registered Office here.

25.          MHI has been properly served with this Complaint.

26.          MHI has no defense to this lawsuit based on undue delay in bringing suit — whether based on the statute of limitations, the statute of repose, laches, or any similar theory.

27.          Defendant Barry Jeffries, MD, is a Georgia citizen. He lives in Fulton County and may be served at 5785 De Claire Ct, Atlanta, Georgia 30328.

28.          Dr. Jeffries is subject to venue in this county because he resides here. 

29.          Dr. Jeffries has been properly served with this Complaint.

30.          Dr. Jeffries has no defense to this lawsuit based on undue delay in bringing suit — whether based on the statute of limitations, the statute of repose, laches, or any similar theory.

31.          At all relevant times, Dr. Jeffries acted as an employee or agent of Defendant Diagnostic Imaging Specialists, P.A.

32.          Defendant Diagnostic Imaging Specialists, P.A. (“DIS”) — despite the misleading name — is a Georgia corporation.[4] DIS places its Registered Office in Fulton County. DIS may be served through their Registered Agent, National Registered Agents, Inc., at 289 S. Culver Street, Lawrenceville, GA, 30046.

33.          Plaintiff believes DIS was the employer or other principal of Dr. Jeffries, at all times relevant to this lawsuit. However, if any other entity was his principal, each such entity is hereby on notice that but for a mistake concerning the identity of the proper party, the action would have been brought against it.

34.          Pursuant to § OCGA 14-2-510, DIS is subject to venue in this county because it resides here.

35.          If DIS were a professional association, as its name implies, DIS would be subject to venue in this county because (a) pursuant to OCGA § 14-10-16, it has the power to sue and be sued in its own name, and it places its Registered Office in this county, and (b) because DIS is an unincorporated association[5] of which Dr. Jeffries is a member, and Dr. Jeffries resides in this county.

36.          DIS has been properly served with this Complaint.

37.          DIS has no defense to this lawsuit based on undue delay in bringing suit — whether based on the statute of limitations, the statute of repose, laches, or any similar theory.

38.          Defendant Amy D. Wyrzykowski, MD is a Georgia citizen. Dr. Wyrzykowski resides in Fulton County and may be served at 505 Allen Road NE, Atlanta, Georgia 30324.

39.          Dr. Wyrzykowski is subject to venue in this county because she lives here.

40.          Dr. Wyrzykowski has been properly served with this Complaint.

41.          Dr. Wyrzykowski has no defense to this lawsuit based on undue delay in bringing suit — whether based on the statute of limitations, the statute of repose, laches, or any similar theory.

42.          At all relevant times, Dr. Wyrzykowski acted as an employee or agent of Defendant Wellstar Medical Group, LLC.

43.          Defendant Wellstar Medical Group, LLC (“WMG”) is a Georgia limited liability company. WMG places its Registered Office in Cobb County. WMG may be served through their Registered Agent, Leo E. Reichart, at 793 Sawyer Road, Marietta, Georgia 30062.

44.          Plaintiff believes that at all relevant times, WMG was the employer or other principal of Dr. Wyrzykowski. However, if any other entity was her principal, each such entity is hereby on notice that but for a mistake concerning the identity of the proper party, the action would have been brought against it.

45.          Pursuant to OCGA §§ 14-2-510 and 14-11-1108, WMG is subject to venue in this county because the cause of action originated in Fulton County and the corporation has an office and transacts business in that county.

46.          Additionally, pursuant to OCGA § 9-10-31, WMG is subject to venue in this county because various co-defendants are subject to venue here.

47.          WMG has been properly served with this Complaint.

48.          WMG has no defense to this lawsuit based on undue delay in bringing suit — whether based on the statute of limitations, the statute of repose, laches, or any similar theory.

49.          Defendant Khalid Iqbal, MD, is a Georgia citizen. He resides in DeKalb County and may be served, at 2432 Circlewood Road NE, Atlanta, Georgia 30345.

50.          Pursuant to OCGA § 9-10-31, Dr. Iqbal is subject to venue in this county because various co-defendants are subject to venue here.

51.          Dr. Iqbal has been properly served with this Complaint.

52.          Dr. Iqbal has no defense to this lawsuit based on undue delay in bringing suit — whether based on the statute of limitations, the statute of repose, laches, or any similar theory.

53.          At all relevant times, Dr. Iqbal acted as an employee or agent of Defendant Atlanta South Nephrology PC.

54.          Defendant Atlanta South Nephrology PC (“ASN”) is a Georgia professional corporation. ASN places its Registered Office in Fulton County. ASN may be served through their Registered Agent, Muhammed Muhammedi, at 1275 East Cleveland Ave, East Point, GA, 30344.

55.          Plaintiff believes ASN was the employer or other principal of Dr. Iqbal, at all times relevant to this lawsuit. However, if any other entity was his principal, each such entity is hereby on notice that but for a mistake concerning the identity of the proper party, the action would have been brought against it.

56.          Pursuant to OCGA §§ 14-2-510 and 14-7-3, ASN is subject to venue in this county.

57.          ASN has been properly served with this Complaint.

58.          ASN has no defense to this lawsuit based on undue delay in bringing suit — whether based on the statute of limitations, the statute of repose, laches, or any similar theory.

59.          Defendant Thomas W. Schoborg, MD, is a Georgia citizen. He resides in Fulton County and may be served at 781 Ashland Avenue NE, Atlanta, Georgia 30307.

60.          Dr. Schoborg is subject to venue in this county because he lives here.

61.          Dr. Schoborg has been properly served with this Complaint.

62.          Dr. Schoborg has no defense to this lawsuit based on undue delay in bringing suit — whether based on the statute of limitations, the statute of repose, laches, or any similar theory.

63.          At all relevant times, Dr. Schoborg acted as an employee or agent of Defendant Atlanta Urological Group, P.C.

64.          Defendant Atlanta Urological Group, P.C. (“AUG”) is a Georgia professional corporation. AUG places its Registered Office in Fulton County. AUG may be served through their Registered Agent, Thomas W. Schoborg, at 285 Boulevard NE, Atlanta, Georgia 30312.

65.          Plaintiff believes AUG was the employer or other principal of Dr. Schoborg, at all times relevant to this lawsuit. However, if any other entity was his principal, each such entity is hereby on notice that but for a mistake concerning the identity of the proper party, the action would have been brought against it.

66.          Pursuant to §§ OCGA 14-2-510 and 14-7-3, AUG is subject to venue in this county.

67.          AUG has been properly served with this Complaint.

68.          AUG has no defense to this lawsuit based on undue delay in bringing suit — whether based on the statute of limitations, the statute of repose, laches, or any similar theory.

69.          Defendant Zandraetta L Tims-Cook, MD, is a Georgia citizen. She resides in DeKalb County and may be served at 4442 Brookes Walk, Tucker, Georgia 30084.

70.          Pursuant to OCGA § 9-10-31, Dr. Tims-Cook is subject to venue in this county because various co-defendants are subject to venue here

71.          Dr. Tims-Cook has been properly served with this Complaint.

72.          Dr. Tims-Cook has no defense to this lawsuit based on undue delay in bringing suit — whether based on the statute of limitations, the statute of repose, laches, or any similar theory.

73.          At all relevant times, Dr. Tims-Cook acted as an employee or agent of Defendant AIDS Healthcare Foundation (Inc.).

74.          Defendant John P. Ouderkirk, MD, is a Georgia citizen. He resides in Fulton County and may be served at 1785 Monroe Drive NE, Atlanta, Georgia 30324.

75.          Dr. Ouderkirk is subject to venue in this county because he lives here.

76.          Dr. Ouderkirk has been properly served with this Complaint.

77.          Dr. Ouderkirk has no defense to this lawsuit based on undue delay in bringing suit — whether based on the statute of limitations, the statute of repose, laches, or any similar theory.

78.          At all relevant times, Dr. Ouderkirk acted as an employee or agent of Defendant AIDS Healthcare Foundation (Inc.).

79.          Defendant AIDS Healthcare Foundation (Inc.) (“AHF”) is a foreign corporation authorized to do business in Georgia. AHF places its Registered Office in Gwinnett County. AHF may be served through their Registered Agent, Corporation Service Company, at 40 Technology Parkway South, #300, Norcross, GA, 30092.

80.          Plaintiff believes AHF was the employer or other principal of Dr. Tims-Cook and Dr. Ouderkirk, at all times relevant to this lawsuit. However, if any other entity was the principal of either doctor, then each such entity is hereby on notice that but for a mistake concerning the identity of the proper party, the action would have been brought against it.

81.          Pursuant to OCGA §§ 14-2-510 and 14-3-510, AHF is subject to venue in this county because the cause of action originated in Fulton County and the corporation has an office and transacts business in that county.

82.          Additionally, pursuant to OCGA § 9-10-31, AHF is subject to venue in this county because various co-defendants are subject to venue here.

83.          AHF has been properly served with this Complaint.

84.          AHF has no defense to this lawsuit based on undue delay in bringing suit — whether based on the statute of limitations, the statute of repose, laches, or any similar theory.

85.          Defendants John/Jane Doe 1-10 are those yet unidentified individuals and/or entities who may be liable, in whole or part, for the damages alleged herein. Once served with process, John/Jane Doe 1-10 are subject to the jurisdiction and venue of this Court.

86.          This Court has subject matter jurisdiction over all claims in this lawsuit.

87.          This Court has personal jurisdiction over all Defendants in this lawsuit.

Facts

88.          On April 30, 2018, Ben Oh, 77 yrs old, arrived at Wellstar’s Atlanta Medical Center ER by ambulance, after falling from a ladder while doing yard work. Mr. Oh suffered a burst fracture of the anterior vertebra at T12. 

89.          Mr. Oh was admitted as an inpatient, with spine surgery planned for days later, after a cardiac screening. The surgery would not happen until May 4.

90.          This Complaint centers on three primary issues on which Ben Oh suffered from medical negligence:

First, a failure by hospital staff to properly manage Mr. Oh’s chronic cardiac problems. This failure led to atrial fibrillation with rapid ventricular rate, severe respiratory distress, and respiratory interventions that put Mr. Oh at risk of infections. Mr. Oh eventually died from complications of infections.

This first primary act of negligence implicates cardiologist Dr. Adefisayo M. Oduwole and the nursing staff of Atlanta Medical Center.

Second, misplacement of a supra-pubic catheter that either caused or greatly aggravated a chyle leak — worsening Mr. Oh’s immune-compromised state and contributing to his death from sepsis.

This second primary act of negligence implicates interventional radiologist Dr. Barry Jeffries.

Third, mismanagement of the chyle leak after the misplaced catheter began draining multiple liters of chylous fluid. This also worsened Mr. Oh’s immune-compromised state and contributed to his death from sepsis.

This third primary act of negligence implicates attending physician, Dr. Amy D. Wyrzykowski, consulting nephrologist Dr. Khalid Iqbal, consulting urologist Dr. Thomas W. Schoborg, and consulting infectious-disease physicians, Dr. Zandraetta L. Tims-Cook and Dr. John P. Ouderkirk.

91.          These three primary acts of negligence do not exhaust the negligence that Mr. Oh suffered at Atlanta Medical Center. Some of the additional acts of negligence not detailed in this Complaint were committed by residents, whom we believe to have been employees of one or more of the corporate Defendants.

92.          Mr. Oh had a history of atrial fibrillation, and he regularly took amiodarone to control it.

93.          Mr. Oh’s wife and daughter brought in a list of Mr. Oh’s home medications. Twice, despite being specifically pressed to do so, the nurse failed to record Mr. Oh’s use of amiodarone.

94.          Before the surgery, cardiologist Dr. Oduwole examined Mr. Oh but did not ask about Mr. Oh’s home medications and did not order amiodarone for Mr. Oh.

95.          On May 4, 2018, Mr. Oh underwent surgery to repair and stabilize the spine. During the surgery, Mr. Oh’s heart went into atrial fibrillation, then returned to sinus rhythm.

96.          After the operation, Mr. Oh was transferred to the Neuro ICU.

97.          On May 5, 0630 hours, an X-Ray Chest report noted “Interval development of moderate atelectasis or infiltrate at the right lung base with a small right pleural effusion. Mild atelectasis is now seen at the left lung base.”

98.          Cardiac problems, including atrial fibrillation with rapid ventricular rate, can cause or worsen respiratory distress.

99.          The interventions for respiratory distress can increase the risk of infection.

100.       Mr. Oh was at particular risk of suffering harm from infection, because (in addition to his age) his lymphocyte levels were low from the time his first blood test was taken after he fell off the ladder and fractured his vertebra.

101.       Lymphocytes are a type of white blood cell that play an important role in fighting infections.

102.       Because Mr. Oh’s immune system had been compromised by low lymphochyte levels, it was particularly dangerous to him if he were to enter Afib with RVR and develop severe respiratory distress that would require interventions that frequently entail infections.

103.       However, despite Dr. Oduwole entering daily progress notes for Mr. Oh, amiodarone was not prescribed for Mr. Oh for days.

104.       On May 8, Mr. Oh began experiencing respiratory distress.

105.       A May 8 x-ray of his abdomen was ordered because of abdominal distension.

106.       A May 8, 2258 hours, progress note recorded: “BAT called to pt’s room for increased work of breathing. Pt seen and evaluated. Vital signs as follows: sats 94% on 4L NC, HR 120s, SBP 120s. Pt tachypneic with crackles heard throughout the precordium. Stat ABG consistent with respiratory alkalosis, paO2 50. CXR without evidence of ptx, consistent with bilateral congestion. EKG consistent with a.fib with RVR. Pt currently not on any rate controlling medications. Given a.fib with RVR and increasing tachypnea and risk of respiratory failure, pt transferred to the ICU with stat labs ordered. Amiodarone bolus and continuous gtt ordered. Pulmonary toilet, redirect pt - pt confused and agitated. Continue left chest tube to suction.”

107.       At that time — the night of May 8 — Mr. Oh still was “currently not on any rate controlling medications.”

108.       That night, Mr. Oh was transferred to the Cardiac ICU.

109.       On May 9, Mr. Oh was started on a bipap machine to help him breathe.

110.       A May 11, 0611 hours note recorded: “Pulm: ABG c/w respiratory alkalosis, on bipap this morning, pulmonary toilet, L CT to suction, yesterday CXR shows stable b/l pulmonary infiltrates. CTA chest neg for PE. Being treated for pneumonia.”

111.        On May 11, at 1135 hours, Mr. Oh was “in afib, rate in the 110s.”

112.       A May 12, 0806 hours note recorded: “abdomen is soft without significant tenderness, masses, organomegaly or guarding.”

113.       A May 13, 0916 hours note recorded: “Patient still requiring high supplemental 02, currently on vapotherm. Also still in A-fib despite scheduled metoprolol and PO amiodarone.”

114.       On May 14, Mr. Oh was discovered to have a MRSA infection, and treatment for it began.

115.       A May 15, 2000 hours note recorded: “respiratory rate very tachypnea and pt on 85% FiO2 on vapo therm’s, suctioned as needed.”

116.       A May 17, 2139 hours note recorded: “will resume PO regimen for afib to better control Hr. Respiratory status slightly improved until about 20 minutes after Pt. Desaturation with thick sputum. Suctioned aggressively and saturations improved with increase of 02 on vapotherm. … will insert dobhoff tube for nutrition and meds.”

117.       On May 18, Mr. Oh was intubated: “Called for the ICU team for consultation for urgent/emergent intubation for this patient. … At the time of intubation his 02 sat was 80% on a non-rebreather and his PO2 was 48. He appeared to be in extremis, with RR 30-40.”

118.       A 1238 hours note that day recorded: “He was intubated without difficulty and a large amount of thick secretions were suctioned out of his airway. His sats then came up to 100%. A bronchoscopy was then preformed with copious secretions noted. … Wean vent as tolerated. Continue NG meds and tube feeds.”

119.       On May 22, nephrology consulted and began following Mr. Oh. The initial consult record noted “suprapubic fullness” in the abdomen and noted, “Bladder scan done at bedside (nursing) revealed about 530cc urine in bladder despite foley catheter in place. Will need to rule out obstruction amidst suggestions of ATN sec to hypotension and ARDS plus/- drug related intestitial nephritis in this diabetic pt who needed contrast evaluation of his injury.”

120.       A May 23, 0959 hours ultrasound of the retroperitoneal area found “A free ascites fluid is present throughout the abdomen.”

121.       A May 23, 2031 hours note recorded: “Concern that foley is non-functional given 1L in bladder scan and minimal UOP. … I performed a bedside sonogram exam to evaluate for foley position. I as well as my chief resident on call were both able to visualize the foley in th bladder. To confirm this, we flushed the foley with 30cc NS and a total of 50cc of urine was returned albeit not the 1L we can see on the bladder scan. Given this, and at the request of Dr. Wyrzykowsi, I placed a stat consult to Urology for recommendations since we are not getting adequate urine return given functional foley and 1L bladder scan. I personally spoke with Urologist Dr. Schoberg who recommends we attempt to place a coude catheter. He believes our foley may be in the prostatic urethra given BPH. He would like us to place a coude and hub it to make sure its in the bladder. If this fails or we are unable to pass this, he recommends placing of a Suprapubic catheter.”

122.       A May 24, 0609 hours note recorded: “Bedside suprapubic catheter placement attempted yesterday, was not successful. Will have CT guided placement with urology today.”

123.       A May 24, 0700 hours, note recorded: “Dr. Schoborg at bedside. Foley cath placed. Noted pt with large amount of urine saturating 2 pads. Dressing to SP attempt site saturated. Urine draining. Foley cath with 200ml of urine noted as well. Slightly blood tinged. Linen and gown changed.”

124.       A May 24, 0800 hours note recorded: “Drainage pouch placed to low pubis area to drain urine into bag.”

125.       A May 24, 0900 hours note recorded: “Spoke with Dr. Schoborg. Notified him that surgery thought he was getting a SP cath placed in IR. Stated pt didn’t need SP and order cancelled.”

126.       On May 24, urologist Dr. Thomas W. Schoborg consulted and began following Mr. Oh. Dr. Schoborg’s initial note stated: “Chief Complaint: urethral stricture. Modifying Factors: inability to insert cath. Respiratory: No use of accessory muscles on room air. Abd/GI: Soft, Not tender, Not distended. Endo: No buffalo hump or hyperpigmentation.”

127.       On May 26, lab results showed that the MRSA infection had been cleared.

128.       A May 26, 0938 hours, note recorded: “Gl: Soft, NTND, no rebound or guarding. Urostomy bag collection urine from SPT attempt site. Renal: Foley in place with minimal output. Urostomy over SPT attempt site with >1L UOP”

129.       A May 28, 0607 hours, note recorded: “Gl: Soft, NTND, no rebound or guarding. Urostomy bag collection urine from SPT attempt site. Renal: Foley in place with minimal output. Urostomy over SPT attempt site with 650cc UOP during day shift.”

130.       A May 28, 1357 hours, urology note recorded: “i performed a bladder scan(personally) and felt the bladder was decompressed wthe foley.there is some persistent drainage from a prior attempt to insert an s-p tube. Will schedule a ct scan but not medically transportable at this juncture. Will schedule a renal u/s at the bedside to further assess any pssibility ok obstructive uropathy.”

131.       A May 29, 0608 hours, note recorded: “Gl: Soft, NTND, no rebound or guarding. Urostomy bag collection urine from SPT attempt site. Renal: Foley in place with minimal output. Urostomy over SPT attempt site with 400cc UOP during day shift,Foley with 140 cc OP in past 24 hrs. Renal: Got HD yesterday. Urology on board, attending performed bladder scan and reported adequate decompression of bladder. Poss CT per urology when patient more stable.”

132.       The next day, May 29, interventional radiologist Dr. Barry Jeffries placed a suprapubic catheter in Mr. Oh.

133.       Dr. Jeffries’ procedure note said: “Using local anesthesia, a 22-gauge needle was advanced into the bladder from a suprapubic approach. Needle position was confirmed by injection of 5 mL of Omnipaque 350. A 0.018 guidewires introduced followed by a 5 French exchange catheter and trocar. The tract was dilated to a 12 French diameter. A 12 French drainage catheter was introduced. The cope loop was reshaped. The catheter was attached to dependent drainage. Approximately 500 mL of whitish-brown urine was drained spontaneously. The catheter was secured to skin utilizing a single ligature of 3-0 nylon suture. There were no complications and the patient tolerated the procedure well.”

134.       Dr. Jeffries either did not perform or did not record contrast imaging to assist in placing the catheter. Dr. Jeffries recorded only two images — x-rays that could not confirm proper placement of the catheter:

135.        In fact, Dr. Jeffries misplaced the catheter.

136.       A later CT Pelvis with contrast (taken June 8) showed: “A suprapubic catheter has been placed superior to the urinary bladder and not within the urinary bladder. Extensive contrast material, presumably injected through the suprapubic tube is in the peritoneum outlining loops of bowel.”

137.       The misplaced suprapubic catheter immediately began producing large amounts of chylous fluid — seven liters in the first day — putting Mr. Oh at risk of further immune-suppression and thus increased vulnerability to infection.

138.       A May 30, 0701 hours, note recorded: “Suprapubic catheter placed yesterday by IR. Per nurse, 7L whitish UOP since placement. Foley discontinued. SPT with 7L recorded UOP since placement. Urine whitish and cloudy appearing.”

139.       A May 30, 1555 hours, note recorded: “Abdominal exam significantly improved since adequate drainage of bladder. … MRSA bacteremia. Resolved. F/U cultures negative at 72 hours. … Bladder outlet obstruction. S/p SPT with copious urine output. Will follow volume status and electrolytes closely.”

140.       A May 31, 0558 hours, note recorded: “Renal: Foley discontinued. SPT with >4L recorded UOP in last 24 hrs. Urine whitish and cloudy appearing. … Heme/lnfectious: Afebrile. Leukocytosis resolved and maintenance Cx negative. Completed treatment of Candida PNA with diflucan and MRSA bacteremia with zyvox. No Abx currently.”

141.       On May 31, Mr. Oh underwent a percutaneous tracheostomy.

142.       A June 1, 1058 hours, nephrology note recorded: “He has significant post obstructive diuresis which is slowly decreasing. … Most of his post obstructive diuresis is expected excretion of accumulated fluid volume.”

143.       A June 2, 1002 hours, note recorded: “ SPT with 9L recorded UOP in last 24 hrs. Urine is milky white. Dialyzed yesterday. … Urine sent for studies (lipids, calcium, phos) given milky white appearance.”

144.       A June 3, 1328 hours, nephrology progress note recorded: “He has significant post obstructive diuresis which persists indicating significant tubular injury and nephrogenic DI. Lymph leak in urine, possibly linked to lymphatic injury/obstruction. … Plan: In view of continuing polyuria, will try ddavp as sodium is now beginning to go up. Continue IVF / pressors to keep MAP more than 60. We have to be careful not to give too much fluid as it can perpetuate the polyuria. Will also give IV calcium gluconate to see if hypocalcemia may be contributing to the polyuria.”

145.       A June 4, 1600 hours, nephrology note recorded. “Polyuria with chyluria. Suprapubic catheter draining milky urine. Shock ? Sepsis ? Volume depletion caused by polyuria. Persistent chyluria may lead to severe protein loss, consider TPN if it persists.”

146.       A June 5, 0614 hours, note recorded: “SPT with approx 7L recorded UOP in past 24 hrs. Urine is less milky appearing today.”

147.       On June 6, the Infectious Disease service consulted and began following Mr. Oh. The initial infectious disease note recorded: “Chyluria and MRSA … Patient’s urine was reportedly normal prior to the placement of the suprapubic catheter. Repositioning the catheter is recommended, if this is feasible.”

148.       A June 6, 1728 hours, nephrology note recorded: “Chyluria worsening. Suprapubic catheter draining milky urine.”

149.       A June 7, 0609 hours note recorded: “Approx 10 liters of milky fluid drained through catheter in past 24 hours. Intake 11670. Output 14225 (Urine 13875; Stool 350).”

150.       On June 8 — 10 days after the misplaced catheter began draining large amounts of chyle from Mr. Oh’s body — the hospital staff made an incidental discovery that the catheter had been misplaced.

151.       A June 8, 0608 hours, note recorded: “today the patient went to radiology for a cystogram through the suprapubic tube that had been placed by interventional radiology. When contrast was injected through the catheter, it flowed freely into the peritoneal cavity and not the bladder. The tip of the tube was in the mesentery of the small bowel and no portion of the tube was within the bladder. Therefore, the tube was removed.”

152.       On June 9, at the instigation of Mr. Oh’s family, Mr. Oh was transferred to the Atlanta VA hospital.

153.       Attending physician Dr. Amy D. Wyrzykowski, consulting nephrologist Dr. Khalid Iqbal, and consulting urologist Dr. Thomas W. Schoborg — each of these physicians became aware of the large volume of abnormal fluid the day after the catheter was placed. The consulting infectious-disease physicians, Dr. Zandraetta L. Tims-Cook and Dr. John P. Ouderkirk, became aware of it on June 6 and June 7.

154.       None of those physicians responded in a reasonable or timely way to the large, ongoing chyle leak.

155.       Even after the misplaced suprapubic catheter was pulled, chyle continued leaking from the hole in Mr. Oh’s abdomen, where the catheter had been inserted.

156.       The VA records contain the following information:

·      June 19, 0754 hours: “Currently bag is set to gravity and draining peritoneal fluid, studies of the fluid reveal that fluid is seroequivalent with elevated TG. Chlylous ascites likely from postoperative cause (retoperitoneal lymph node dissection).”

·      June 20, 1446 hours: “Patient continues to put large amts of lymphatic fluid out of old drain site.” 

·      June 21, 1602 hours: “Regarding losses, currently we are investigating mechanisms to decrease chylous losses (approx 1.8 liters overnight).”

·      June 23, 1527 hours: “Chylous Ascitic fluid output: Concern for excess volume loss from abdomen decreasing oncotic pressure via protein loss, and worsening fluid losses. We are attempting to minimize nutritient and protein loss with initation of conservative therapies- Med chain TG, reduced lipids in TF. Will consider octreotide pending response to aforementioned items.” 

·      June 25, 2125 hours: “Shock: Likely fluid losses/ low oncotic pressure, doubt uncontrolled sepsis source. -continue midodrine, wean levophed, continue albumin. -Addressing chylous ascitic fluid losses. --Chylous Ascites- s/p injury to abdominal lymph draining vessel. Changed TF to include Med chain lipids, decrease fat content. Considering octreotide pending response to above. Awaiting fat sol vitamin levels. Serum IgM IgG low -likely lost in chyle. Discuss with hem/onc utility of replacing IgG in setting of infection. -discuss with emory IR possibility of performing lymphangiogram.” 

·      June 26, 1443 hours: “Major issue now is chylous fistula putting out large amounts.”

·      July 12, 1454 hours: “Abdominal ostomy/fistula output which appears to be chylous based on serologies remains a difficult problem to medically address and surgery has not been offered due to his unstable clinical status. Remains critically ill.” 

157.       On July 21, at 1848 hours, Mr. Oh died.

158.       The Death Certificate, issued on July 30, identified the cause of death as “Septic shock with multiorgan failure, due to prolonged chyle leak.”

Cause of Action: Injuries & Wrongful Death from Professional Negligence

159.       Plaintiff incorporates by reference, as if fully set forth herein, all preceding paragraphs of this Complaint.

160.       The individual Defendants and the nursing staff of Atlanta Medical Center committed negligent acts and omissions that harmed Ben Oh.

161.       The standard of care required the nursing staff to record Mr. Oh’s home medications and to request orders to continue administering his heart medication. The nursing staff failed to do so, and thereby violated the standard of care and harmed Mr. Oh by contributing to his cardiac disturbances, respiratory distress, and vulnerability to infection.

162.       The standard of care required Dr. Oduwole to review Mr. Oh’s home medications and to enter orders to continue administering his heart medication. Dr. Oduwole failed to do so, and thereby violated the standard of care and harmed Mr. Oh by contributing to his cardiac disturbances, respiratory distress, and vulnerability to infection.

163.       The standard of care required Dr. Barry Jeffries to place the suprapubic catheter with a reasonable degree of care and skill to ensure the catheter was in the bladder. Dr. Jeffries failed to do so, and thereby violated the standard of care and harmed Mr. Oh by contributing to his immune-suppression and vulnerability to infection, from which Mr. Oh died.

164.       Upon their respective discoveries of the large volume of abnormal fluid produced by the suprapubic catheter, the standard of care required each of the attending and consulting physicians — Dr. Amy D. Wyrzykowski, Dr. Khalid Iqbal, Dr. Thomas W. Schoborg, Dr. Zandraetta L. Tims-Cook, and Dr. John P. Ouderkirk — immediately to investigate the nature of the fluid and the cause of the leak, and then to investigate and pursue treatment options. Each of these physicians failed to respond in a reasonable, timely way. They each thus violated the standard of care and harmed Mr. Oh by contributing to his immune-suppression and vulnerability to infection, from which he died.

165.       These primary acts of negligence do not exhaust the negligence from which Mr. Oh suffered at Atlanta Medical Center. Some of the additional acts of negligence not detailed in this Complaint were committed by residents, whom we believe to have been employees of one or more of the corporate Defendants.

166.       These acts of negligence caused Mr. Oh to suffer conscious pain and suffering while he lived, and they caused his untimely death.

167.       The principals of the individual Defendants and of the Atlanta Medical Center nursing staff are vicariously liable for the negligence of their agents.

168.       Mr. Oh’s estate is entitled to recover from the Defendants for the physical, emotional, and economic injuries Ben Oh suffered before he died, as a proximate result of the standard-of-care violations identified here.

169.       Pursuant to OCGA Title 51, Chapter 4, Ben Oh’s wrongful death beneficiaries are entitled to recover from the Defendants for the lost value of Mr. Oh’s life and for special damages including funeral costs and other direct financial costs suffered as a proximate result of the standard-of-care violations identified here.

Damages

170.       Plaintiff incorporates by reference, as if fully set forth herein, all preceding paragraphs of this Complaint.

171.       As a direct and proximate result of the Defendants’ conduct, Plaintiff is entitled to recover from Defendants reasonable compensatory damages in an amount exceeding $10,000.00 to be determined by a fair and impartial jury for all damages Plaintiff suffered, including physical, emotional, and economic injuries.

172.       WHEREFORE, Plaintiff demands a trial by jury and judgment against the Defendants as follows:

a.    Compensatory damages in an amount exceeding $10,000.00 to be determined by a fair and impartial jury;

b.    All costs of this action; and

c.     Such other and further relief as the Court deems just and proper.

Respectfully submitted,

/s/ Lloyd N. Bell                            

Georgia Bar No. 048800

Daniel E. Holloway

Georgia Bar No. 658026

BELL LAW FIRM

1201 Peachtree St. N.E., Suite 2000

Atlanta, GA 30361

(404) 249-6767 (tel)

bell@BellLawFirm.com

dan@BellLawFirm.com

Attorneys for Plaintiff

[1] See National Vital Statistics Reports, Vol. 68, No. 7, June 24, 2019, Table 3. Life table for females: United States, 2017, available at https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_07-508.pdf.

[2] OCGA §§ 14-2-510 and 14-3-510 provide identical venue provisions for regular business corporations and for nonprofit corporations:

“Each domestic corporation and each foreign corporation authorized to transact business in this state shall be deemed to reside and to be subject to venue as follows: (1) In civil proceedings generally, in the county of this state where the corporation maintains its registered office…. (3) In actions for damages because of torts, wrong, or injury done, in the county where the cause of action originated, if the corporation has an office and transacts business in that county; (4) In actions for damages because of torts, wrong, or injury done, in the county where the cause of action originated.”

Note: These same venue provisions apply to Professional Corporations, because PCs are organized under the general “Business Corporation” provisions of the Georgia Code. See OCGA § 14-7-3. These venue provisions also apply to Limited Liability Companies, see OCGA § 14-11-1108, and to foreign limited liability partnerships, see OCGA § 14-8-46.

[3] “Subject to the provisions of Code Section 9-10-31.1 [regarding forum non conveniens], joint tort-feasors, obligors, or promisors, or joint contractors or copartners, residing in different counties, may be subject to an action as such in the same action in any county in which one or more of the defendants reside.”

[4] Despite the “P.A.” in the name, DIS was incorporated on July 1, 1977. DIS filed “Articles of Incorporation” and consistently identified itself in those articles as a “corporation,” not as an unincorporated professional association.

[5] OCGA § 14-10-2: “‘Professional association’ means an unincorporated association, as distinguished from a partnership….”