January 27, 2020
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CS/HB 1303

A bill to be entitled
2An act for the relief of Lois H. Lacava by the Munroe
3Regional Health System, Inc.; providing for an
4appropriation to compensate her for injuries sustained as
5a result of the negligence of the Munroe Regional Medical
6Center; providing a limitation on the payment of fees and
7costs; providing an effective date.
9     WHEREAS, on November 8, 2005, Lois H. Lacava was admitted
10to the Munroe Regional Medical Center in Ocala, Florida, with an
11admitted diagnosis of a malunion of the right hip which was
12related to a prior fracture of the neck of the femur bone in her
13leg, and
14     WHEREAS, on November 11, 2005, Ms. Lacava had a total right
15hip arthroplasty along with hardware removal, and the following
16day Dr. Mehra examined Ms. Lacava and noticed that her right leg
17below the knee to her toes was cold to the touch and that her
18toes were discolored, and
19     WHEREAS, Dr. Mehra brought these observations to the
20attention of the nursing staff, ordered an arterial Doppler test
21to be performed immediately, and advised the nurse to continue
22to daily monitor Ms. Lacava's production of red blood cells and
23the effectiveness of a blood-thinning drug that Ms. Lacava was
24prescribed, and
25     WHEREAS, an arterial Doppler test is a blood pressure test
26that measures the lack of blood flow which may be caused by a
27blockage in the arteries in the legs, and
28     WHEREAS, Dr. Mehra was not on call on the evening of
29November 12, but the next morning he was paged by the nurse
30taking care of Ms. Lacava and told that her venous Doppler test,
31a test used to check the circulation in the large veins in the
32legs, was negative for deep venous thrombosis, and
33     WHEREAS, upon further questioning, Dr. Mehra realized that
34the arterial Doppler test had not been performed even though he
35had ordered a nurse to conduct the test, and
36     WHEREAS, the Doppler technician, upon hearing the clinical
37features and history of the patient, had been reluctant to
38perform an arterial Doppler test because the technician thought
39there was a venous problem in Ms. Lacava's leg, and
40     WHEREAS, a computer loading error required a venous Doppler
41test to be performed before an arterial Doppler test and, for
42unexplained reasons, the arterial Doppler test was never
43performed, and
44     WHEREAS, even though the venous Doppler test did not reveal
45any deep venous thrombosis, the lack of the arterial Doppler
46test prevented a femoral artery occlusion from being timely
47diagnosed, and
48     WHEREAS, Dr. Mehra ordered an evaluation for vascular
49surgery by Dr. Swaminathan and another arterial Doppler test to
50be performed immediately, and
51     WHEREAS, Dr. Swaminathan evaluated Ms. Lacava and ordered
52an angiogram, which revealed a blockage of the right femoral
53artery and dislocation of the right hip prosthesis, and Ms.
54Lacava was taken to the emergency operating room where Dr. Brill
55performed a right total hip arthroplasty revision and Dr.
56Swaminathan performed an excision of a blood clot of the right
57femoral vein, with repair to the right femoral artery, and
58     WHEREAS, Dr. Swaminathan also removed a blockage in the
59right tibial artery and cut the soft tissue component of the
60connective tissue in order to relieve tension or pressure within
61the right leg; however, Ms. Lacava ultimately experienced
62irreversible necrosis of her right lower leg, which required
63that her leg be amputated above the knee, and
64     WHEREAS, after her surgeries Ms. Lacava developed
65tachycardia secondary to toxemia from the gangrene of her right
66foot and lower leg, suffered a fracture of her superior pubic
67ramus and femoral prosthesis, acquired a staphylococcus
68infection, and developed diarrhea, and
69     WHEREAS, it was determined that Ms. Lacava was not a
70suitable candidate for a prosthesis due to her medical
71conditions that included an above-the-knee amputation of her
72right leg and a dislocated prosthetic hip, and
73     WHEREAS, a consent final judgment was entered in favor of
74Ms. Lacava against the Munroe Regional Health System, Inc., by
75the Circuit Court of the Fifth Judicial Circuit in and for
76Marion County for $450,000, wherein $200,000 was paid to Ms.
77Lacava within 30 days after entry of the consent final judgment,
78and the remaining balance of $250,000, pursuant to the agreement
79by the parties, would be reported to the Florida Legislature for
80its consideration as a claim bill, NOW, THEREFORE,
82Be It Enacted by the Legislature of the State of Florida:
84     Section 1.  The facts stated in the preamble to this act
85are found and declared to be true.
86     Section 2.  Munroe Regional Health System, Inc., is
87authorized and directed to appropriate from funds not otherwise
88appropriated and to pay the sum of $125,000 to Lois H. Lacava
89within 30 days after the effective date of this act and to make
90a second payment of $125,000 to Lois H. Lacava within 365 days
91after the initial payment, as compensation for injuries and
92damages sustained as a result of the negligence of Munroe
93Regional Medical Center.
94     Section 3.  The amount paid by Munroe Regional Health
95System, Inc., pursuant to s. 768.28, Florida Statutes, and the
96amount awarded under this act are intended to provide the sole
97compensation for all present and future claims arising out of
98the factual situation described in this act which resulted in
99injury to Lois H. Lacava. The total amount paid for attorney's
100fees, lobbying fees, costs, and other similar expenses relating
101to this claim may not exceed 25 percent of the total amount
102awarded under this act.
103     Section 4.  This act shall take effect upon becoming a law.

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