The settlement of a lawsuit stemming from a patient's death in the aftermath of Hurricane Katrina has left more questions than answers for now, particularly given that similar cases are on the horizon.
Though emergency management was a focal point in the case—in particular, the fact a fuel pump was flooded over during Katrina, which stopped a generator from running—the bigger concern is one of assets, said Anna Grizzle, an attorney at Bass, Berry, & Sims PLC in Nashville.
"Katrina represents an example, for hospitals, of the constant struggle to allocate resources," said Grizzle, who represents healthcare companies in operational and compliance matters.
The settlement between the family of deceased patient Althea LaCoste and Pendleton Methodist Hospital, LLC, in New Orleans came last week in the midst of a jury trial, according to The Times-Picayune newspaper.
To what extent do you plan?
Because of the settlement, a matter yet to be resolved is how much a hospital must invest in preparing for nearly inconceivable disaster scenarios.
The Joint Commission's emergency management standards require hospital planners to identify and rank potential disasters that could affect the facility, and then take actions to mitigate those risks that have the greatest likelihood of either occurring or affecting hospital operations.
"[New Orleans] being below sea level, a hurricane is a possibility and flooding is a possibility," Grizzle said. "I don't think anyone knew the levies would break or that the entire city of New Orleans would be flooded. I don't think that would have ranked very high in possibility for any disaster analysis."
Previously filed court records indicated the family believed LaCoste died following Katrina because the hospital allegedly failed to design its emergency power infrastructure to withstand flood waters and allegedly failed to have an adequate plan in place to transfer patients.
Pendleton Methodist suffered terrible damage from flood waters and never reopened. LaCoste required a mechanical ventilator when she was admitted to Pendleton Methodist on August 28, 2005. During Katrina's rising waters, the hospital lost regular and emergency generator power, which caused various pieces of medical equipment to shut down, according to court records.
The hospital had two generators: one near the ground floor and one on the roof of the building. LaCoste's family argued that if the hospital had invested in a $10,000 submersible fuel pump, the roof generator might have kept operating, according to a The Times-Picayune.
Hospital lawyers said the facility was not negligent and that the emergency power system met or exceeded electrical codes, The Times-Picayune reported.
General negligence awards aren't capped
In an earlier ruling before the trial started, the Louisiana Supreme Court rejected an attempt by Pendleton Methodist to limit the potential award to $500,000, which is Louisiana's cap for medical negligence, Grizzle said.
The state has no cap for general negligence, which the LaCoste case was tried under.
"The court is saying, at least here, that more should have been done" by the hospital, Grizzle said of the earlier Supreme Court ruling.
Whether other jurisdictions in the country look to this ruling for guidance or let it remain as part of the unique circumstances of Katrina will be an important point for hospital CEOs and planners to follow, she added.
It's possible that courts and juries could look at the LaCoste lawsuit and others that are coming and apply them broadly to more common disaster scenarios.
Scott Wallask is senior managing editor for the Hospital Safety Center. He can be reached at swallask@hcpro.com.