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Parents assail malpractice caps
after daughter's death at UCLA
Limits on payouts made it hard to find a lawyer
when Olivia Cull, 17, died after a routine
procedure. And the couple settled their lawsuit
before all the information they wanted was
revealed, her mother says.
January 22, 2011
By Molly Hennessy-Fiske
Los Angeles Times

Two years ago last week, Olivia Cull, 17, was
taken off life support. The standout student —
who planned to study classics at Smith College
— had slipped into a coma during a routine,
outpatient procedure at Mattel Children's
Hospital UCLA in Westwood.

The story of her death was presented to
Congress a few days ago, among cases cited
by patient advocates pushing to lift the caps on
damages for medical malpractice lawsuits.

As lawmakers search for ways to trim
healthcare costs, debate continues over the
country's medical malpractice laws. Physician
groups say caps limit frivolous lawsuits that can
drive good doctors out of business. But
patients and their families argue that limits on
payouts diminish accountability, making it hard
to find lawyers to take cases and force full
disclosure from doctors.

UCLA officials, who said they were "profoundly
saddened by the death of this young woman,"
said they worked with state regulators and
conducted a comprehensive investigation into
her death.

"It is our policy and practice in all cases,
including this one, to communicate honestly
with patients and their family members
regarding their care and treatment," officials
said in a statement.

But Olivia's parents said going to court was the
only way for them to learn the truth about their
daughter's death.

As a baby, Olivia had surgery to correct a
defect that left one side of her heart smaller
than the other. A second surgery was delayed
as she grew into a teenager who juggled violin
practice, robotics club and theater rehearsals.

On Jan. 9, 2009, Joyce "Joy" Cull walked her
daughter up the steps of the hospital for a
procedure to prepare for the final corrective
surgery. Doctors wanted to perform the
operation before Olivia left for college on the
East Coast in the fall.

Olivia was nervous, but her mother reassured
her. The catheterization procedure would take
only a few hours. Olivia had been through it
several times before. Doctors said she would
be home before dinner.

In black marker on her left heel Olivia had
written the ancient Greek letters for Achilles, a
reminder to stay strong.

Used to consent forms

In the years Olivia was treated at UCLA, her
parents became accustomed to consent forms.
Waiting with Olivia before the procedure, Joy
Cull, 52, had signed the standard surgical
consents without a second thought. She never
imagined they would have to cope with what
seemed like pro forma warnings.

By the time a cardiologist brought the bad news
to the recovery waiting room, Cull had a feeling
something was wrong. There had been an
"incident" in the lab, Cull remembers being told,
and Olivia had been deprived of oxygen for 40

"OK, 40 seconds — my kids can hold their
breath in the pool that long," Cull thought.

In the catheterization lab, Olivia was still on the
table. She looked as if she were asleep —
except for the breathing tube in her mouth. On
the floor near Olivia's head, Cull noticed a pool
of blood.

She touched Olivia's short brown hair, her arm
and heart-shaped face. Olivia's skin was cool.
Behind her, Cull said, she heard a nurse

A week after they came to the hospital, the
Culls held a wake in Olivia's hospital room.
Classmates visited from Brentwood's Archer
School for Girls, leaving notes at the foot of her

Eight days after Olivia arrived at the hospital,
her parents had her removed from the
ventilator. Olivia's 13-year-old sister crept into
the bed beside her. Her 11-year-old brother
stood with his parents, watching Olivia's chest
rise and fall.

Olivia's heart went on beating for three days.
On the third day, the Culls removed an internal
breathing tube, and Olivia died.

Distraught, the Culls sought answers from their
daughter's doctors. An autopsy conducted at
UCLA showed Olivia suffered brain damage as
a result of a heart attack she suffered at the
end of the catheterization, due in part to her
congenital heart defect.

The Culls did not believe the heart defect alone
caused Olivia's death. They suspected
something had gone wrong in the
catheterization lab.
Olivia's longtime
cardiologist told them her weak heart was
to blame
, the Culls said, but to them that
made no sense. Olivia was not an invalid;
she had been a healthy, active teenager, a
Girl Scout camp counselor.

Dissatisfied, they pushed harder, requesting
Olivia's medical records.
When they
demanded answers from hospital officials,
the Culls said, they were told to review
the records and, if they found a problem,
to contact a lawyer.

Robert Cull, 56, was an accomplished architect
who helped design Ronald Reagan UCLA
Medical Center. Joy, a homemaker, had a
master's degree in fine arts. As they sifted
through records, they wondered how others in
similar situations made sense of it all.

"It's confusing," Joy Cull said. "I could imagine
this happening over and over again because
families don't have the resources to find out
how their loved one passed away. We had to
claw our way through the system."

To get more information, the Culls decided to
sue the hospital. But like others, they
trouble finding a lawyer
willing to take the case.
Given the state cap on
damages, they said, many
lawyers did not consider their
case worth pursuing.

Although doctors groups complain of frivolous
malpractice lawsuits,
the number of
malpractice claims has
actually decreased in recent
years as families have had
difficulty pursuing claims
Joanne Doroshow,
director of the Center for
Justice & Democracy, a New
York-based advocacy group
told Congress at a hearing Thursday, the
second anniversary of Olivia's death.

In July 2009, weeks after first seeking counsel,
the Culls filed a wrongful death lawsuit after
lawyer Jin Lew at Los Angeles-based Michels &
Watkins agreed to take the case pro bono. The
suit alleged that the University of California
Board of Regents, which runs the hospital, and
everyone who cared for their daughter that day
were "negligent, careless and unskillful."

The lawyers found that Olivia's medical
records were incomplete, the Culls said,
and filed more requests until the hospital
supplied hundreds of additional pages.

In addition to the lawsuit, the Culls filed a
complaint with Los Angeles County health
officials that triggered an investigation by the
state Department of Public Health. In February,
state investigators reported that a
postdoctoral fellow who treated Olivia
removed her catheters without a doctor's
supervision. Investigators also found that
a second fellow who treated Olivia had not
been cleared to treat patients.

That information was new to the Culls.

In the corrective plan required by the state,
hospital officials defended both fellows, saying
they were trained to remove catheters.
hospital made one change in response to
the state investigation: It added another
to the consent form, warning
patients they might be treated by doctors in

Joy Cull wanted more. She attended each legal
deposition with Olivia's doctors and nurses,
filing additional complaints with state regulators
based on what she heard. She called and
wrote to state legislators, arguing against caps
on medical settlements.

Through depositions, the Culls learned the
identity of the two fellows the state faulted for
mistreating Olivia. Joy Cull recognized one: He
was the clean-cut young doctor who had
handed her the medical release forms that day.

In June, Shirley Watkins, a partner at the law
firm representing them, urged them to settle.
She said they were unlikely to learn more about
how their daughter died.

On Nov. 16, after months of reluctance,
the Culls agreed. Hospital officials would
pay them $250,000, the maximum allowed
under the cap.
They also promised to make
at least eight improvements in how they
supervise doctors, remove catheters,
document patients' heart rates and inform
parents that trainees will be treating their

"UCLA Medical Center deeply regrets the death
of Olivia Cull and takes responsibility for the
care and treatment provided to her," hospital
officials said in a statement the Culls insisted
they release as part of the settlement, as close
to an apology as they could get.
Eliodora Gomez de Perez.
Adolfo Perez. Esvin Perez
Gomez. Hilberth Artanan
Perez Gomez. Fender Adolfo
Perez Gomez v. County of
Los Angeles
Los Angeles Superior Court
Case No. BC 308 268
This wrongful death lawsuit
arises from the death of a
patient while hospitalized
at the Harbor/UCLA Medical
The Claims Board
recommended to the Board of
Supervisors the settlement
of this matter in the amount of
$199,000 as set forth in the
Claims Board
The vote of the Claims Board
was unanimous with all
members present

Oscar Nunez. individually. and
as Guardian Ad Litem for
Oscar Damian Nunez v.
County of Los Angeles
Los Angeles Superior Cour
Case No. PC 033 247
This wrongful death lawsuit
arises from the death of a
patient following her
discharge from Olive
View/UCLA Medical Center.
The Claims Board
recommended to the Board of
Supervisors the settlement
of this matter in the amount of
$350,000 as set forth in the
Claims Board
The vote of the Claims Board
was unanimous with all
members present.

Jeremy Tanq, et al. v.
County of Los Angeles
Los Angeles Superior Court
Case No. TC 018 583
This wrongful death lawsuit
arises from injuries sustained
by a
patient while hospitalized at
Harbor-UCLA Medical Center.
Action Taken
The Claims Board
recommended to the Board of
the settlement of this matter in
the amount of $167,000 and
that the Auditor-Controller be
instructed to draw a warrant to
implement this settlement
from the Department of Health
Services' budget.
See Supporting Document
Absent: None
Vote: Unanimously carried

Dead by mistake
County expected to settle
malpractice suit against

By Melissa Evans Staff Writer

Daily Breeze

Los Angeles County leaders
are expected Tuesday to
approve a $305,000
settlement in a medical
malpractice suit filed by the
family of a man who died at
County Harbor-UCLA Medical
Center near Torrance two
years ago.

Under the terms of the
settlement, the county will
admit no liability or
wrongdoing in the death of
Jose Hurtado, a father in his
late 40s who suffered
fractures and internal injuries
after a paragliding accident in
Rancho Palos Verdes.

Hurtado’s family, including
wife Renee Hurtado of Los
Angeles, filed the civil suit
after alleging that physicians
at Harbor-UCLA failed to
properly intubate the patient
before performing a
diagnostic procedure
intended to save his life.

County to Pay $120,000 in
Death of Patient
May 17, 2000

The Board of Supervisors on
Tuesday approved paying
$120,000 to the family of a 52-
year-old woman who died
after drinking from a cup of
toxic fluid left by her bedside
at Martin Luther King Jr./Drew
Medical Center.

As supervisors approved
settlement of the lawsuit by
the family of Blanca
Maldonado. they expressed
disbelief at reports that
another patient eight years
earlier died after drinking
another toxic solution
erroneously left by her
bedside and that the problem
had not been corrected in
time to save Maldonado's life.

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Supervisor Don Knabe
ordered the county's
inspector general for risk
management to investigate
the case to ensure that a
"corrective action plan" is
implemented now, "so this
does not happen a third time."

And Supervisor Gloria Molina
said that in many other cases,
health officials have pledged
to correct systemic problems
that cause harm to patients
but failed to do so.

"You go through this entire
process . . . and you have
staff that don't think it's
significant to implement,"
Molina said, noting that many
employees who fail to fix
identifiable problems remain
on the county payroll.

Supervisors over the years
have repeatedly spoken of
the need to prevent errors in
the county's six public
hospitals, both to cut down on
injuries and deaths to patients
and to lower the amount of
public money the board must
pay to settle medical
malpractice lawsuits each
year. At Knabe's urging, the
board even created an
inspector general last year to
ensure that chronic problems
uncovered in litigation are

But medical malpractice cases
remain plentiful at the county.
On Tuesday, supervisors
approved $600,000 more in
malpractice settlements in
addition to the Maldonado

Maldonado went to King/Drew
in January 1998 suffering
from anemia and complaining
of nausea and vomiting.
Medical staff members
prepared to remove some of
her bone marrow to determine
whether she had cancer and
prepared a liquid, known as
Zenker's solution, for use
during the procedure.

According to county
documents, medical staff
members left the highly toxic
solution in an unlabeled cup
on a tray by Maldonado's
bedside, but then decided to
postpone the procedure.
They did not remove the tray,
and four hours later
Maldonado complained that
she had drunk the fluid and
suffered severe stomach
pain. She died an hour later.

Although hospital officials
initially suggested that she
had died because of kidney
disease, an autopsy found
the cause of death to be
poisoning by mercuric
chloride and potassium
dichromate, chemicals in
Zenker's solution.

County lawyers urged the
$120,000 settlement, writing
in a memo to supervisors that
a jury could deliver a verdict
of more than $250,000
against the county should the
case go to trial. They wrote
that medical experts would
criticize leaving the Zenker's
solution unlabeled near
Maldonado. "These failures
exposed Blanca Maldonado to
the risk of ingesting a portion
of the Zenker's solution,
resulting in her death," the
memo states.

That analysis is strikingly
similar to one issued by
county lawyers five years ago
in a $250,000 settlement of a
wrongful death lawsuit filed
after a woman died at Harbor-
UCLA Medical Center in 1992
because she drank from a
bottle of mercuric chloride
that had been left by her

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In that case, county
documents state that the
bottle was left by Amalia
Arevalo's bedside because
Arevalo was supposed to fill it
with a stool sample to
determine the cause of her
illness. Though a nurse
stated she told Arevalo what
to do in Spanish, she left
Arevalo alone in the room.

"It was below the standard of
care to leave the test kit on
the table next to the patient's
bed without supervision and
clear instruction on its use
and hazards," county lawyers

A visibly frustrated Knabe
said that Harbor-UCLA issued
new plans to prevent the error
from occurring in the future
but that the health
department never ensured
those procedures were
implemented at other public

The other settlements
approved by supervisors
Tuesday were:

* A $487,500 settlement of a
lawsuit brought by a woman
whose leg was amputated
after a botched surgery at
Olive View-UCLA Medical
Center in Sylmar.

* A $125,000 settlement in the
case of a 14-year-old boy
who suffered nerve damage
in his legs and feet after
being left in a dangerous
position while not monitored.
In that case, according to
county documents, an
unsigned note was inserted
into the medical record falsely
stating that the boy, Sam Kim,
was monitored.

UCLA Cull case

UCLA Dermatology

UCLA Patient Advocates

UCLA Patrick Harron to be
arraigned in burning death in
chemistry lab

Courthouse News Service
Tuesday, September 22, 2015
Doctor Faces Liability for
Child-Abuse Suspicions

   (CN) - A child-abuse-suspecting
doctor who tried to keep a baby
hospitalized so that his parents
couldn't take him home must face civil
claims, the Ninth Circuit ruled Monday.
   Ruling 2-1, the federal appeals
court said Dr. Claudia Wang does not
have immunity from claims that she
seized the infant G.J. without
reasonable cause to believe his
parents were abusing him.
   At this juncture of the case, the
court must view the allegations in a
light most favorable to the parents.
The judges recited the case
background in this light, while also
noting that, as a lawyer for Los
Angeles County Social Services, the
mother, Jill Jones, was aware that
doctors would look for signs of abuse
when she brought G.J. to the
emergency room in February 2010.
   Jill told the Santa Monica UCLA
Medical Center that she had been
holding her sleeping infant son in her
arms, walking down stairs in their
Santa Monica loft, when she tripped,
and G.J. fell out of her arms, tumbled
down several stairs and landed on his
head on the hardwood floor.
   Doctors determined that G.J.'s
injuries, including a fracture on the
back of his skull, were consistent with
that explanation of the accident,
according to the ruling.
   Although the child also had rib
fractures, they were not visible on the
x-ray done on his chest that day.
   Wang reviewed the case in her
capacity as the medical director of
UCLA's Suspected Child Abuse and
Negligence (SCAN) team.
   Believing that the baby's injuries
were unusual and potentially
inconsistent with the parents'
explanation, Wang had Jill bring G.J.
back to the hospital about a week later
for what she called routine tests.
   Jill and her husband Michael say
Wang's reading of the tests and her
consultations with specialists brought
her to the incorrect conclusion that
G.J.'s rib fractures had occurred after
the accident and that he potentially
had a new skull fracture.
   Wang had the case reported to the
Department of Children and Family
Services (DCFS) and the UCLA police
   She also recommended admitting
G.J. into the hospital to determine
whether the baby had a metabolic
bone disorder that was causing the
fractures. Wang later admitted that her
primary purpose in making the
recommendation was to prevent Jones
from taking G.J. home.
   The Joneses say Wang knew that
she could not formally take G.J. into
custody but nevertheless coordinated
behind the scenes to keep G.J. in the
   Worried that they could lose custody
of G.J. by appearing resistant, the
Joneses spent the weekend in the
hospital with the baby, under the
supervision of a sitter whom Wang had
placed in the child's room.
   Three days later, a social worker
issued a hold on G.J. based on
Wang's suspicions. The Joneses lost
physical custody of G.J. for months
before a juvenile court found that the
baby had not been abused and would
not be at risk of abuse in the future.
   With the couple suing for violations
of their federal and state constitutional
rights, a federal judge denied Wang
summary judgment on the basis of
qualified immunity.
   The divided circuit panel affirmed
this decision Monday.
   "We offer no opinion on the ultimate
question of whether the Joneses'
constitutional rights were violated,"
Judge Mary Murguia wrote for the
majority. "We decide only that a jury is
needed to determine what a
reasonable parent in the Joneses'
position would have believed and
whether Dr. Wang's conduct amounted
to a seizure."
   Based on the Joneses' version of
facts, a jury could likely find that
reasonable parents in their position
would believe that they were not
allowed to take their child home,
especially considering the sitter that
was appointed to their room.
   "Short of a formal hold, there is no
stronger message to parents that they
are not free to make a decision for
their child than that the state does not
trust them to be alone with their infant
son," Murguia said.
   Exigent circumstances were not a
factor in the case, the majority found.
   "There was no evidence that the
Joneses neglected G.J., and there was
no evidence pointing to either Jill or
Michael as the potential abuser,"
Murguia said.
   In a dissenting opinion, Judge
Stephen McNamee said that Wang's
actions did not violate the Joneses'
constitutional rights.
   "I cannot join the majority in denying
qualified immunity to Dr. Wang, a
respected physician, professor, and
23-year veteran of the UCLA
Suspected Child Abuse and Neglect
team whose actions were anything but
malicious or incompetent," McNamee
   The majority "cobbles together
multiple facts spanning over three
days" to reach its conclusion that
Wang seized G.J., even though a
seizure is defined as a single act and
not a continuous fact, McNamee said.
   "In my opinion, G.J.'s progressing,
textbook injuries suffered while in the
exclusive custody of his parents gave
Dr. Wang adequate evidence of child
abuse and imminent harm to meet
even higher levels of suspicion than
that required by our case law," the
dissent states. "We should not now
expose Dr. Wang to liability simply
because she recommended further
   Attorneys for the parties have not
returned requests for comment.