Murray v. Unmc Physicians

806 N.W.2d 118 (2011)

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Nature of the Case

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Facts

P alleges that Ds caused the death of Mary, his wife, by negligently failing to administer Flolan therapy to treat her pulmonary arterial hypertension. Flolan is very expensive and short-acting, so patients on Flolan treatment need a constant supply of the drug because if its administration stops, pulmonary blood pressure rebounds and can be life-threatening. Patients who begin Flolan need to remain on it, essentially, for the rest of their lives-it must be administered 24 hours a day and costs approximately $100,000 a year. Thompson, M.D., was preparing to treat Mary's pulmonary arterial hypertension with Flolan. Thompson had already written the Flolan order before the catheterization, pending the results of the catheterization and insurance approval. The catheterization showed pulmonary arterial hypertension, significant heart failure, and reduced blood flow. While waiting for insurance approval, Mary has two incidents on July 4^th and July 10^th. Medical efforts failed to resuscitate her. P sued Ds. The battle of the experts produced conflicting opinions as to cause of death. P’s expert stated that the standard of care would have been to start Flolan and wait for insurance approval. Ds’ expert stated that the standard was to wait for approval because it was important to make sure that treatment was sustainable and backed this up with examples of discontinued use. P moved for a directed verdict in that insurance coverage cannot dictate what doctors do. It was denied. The jury gave the verdict to Ds. P motioned for a new trial, and it was granted. The court reasoned that the standard was treatment regardless of insurance availability; even Ds’ expert said treatment would have been given if an outside source of funds were available. Ds appealed.