The Joplin Globe, Joplin, MO

July 17, 2013

Jury finds in favor of former St. John's Medical Center in wrongful death claim

By Jeff Lehr
news@joplinglobe.com

JOPLIN, Mo. — A Jasper County jury returned a verdict Wednesday in favor of the former St. John’s Regional Medical Center in the trial of a lawsuit brought by the family of a Joplin woman who died during an MRI scan at the hospital.

The son and two daughters of Ruth Moeskau, a retired secretary for the Joplin School District, brought the wrongful-death action against St. John’s, alleging inadequate monitoring of their 84-year-old mother during the procedure.

Moeskau died of an anoxic brain injury sustained during a scan in an outpatient clinic of St. John’s on Dec. 3, 2008. The scan was ordered following a diagnosis of breast cancer in an effort to determine how best to proceed in treating the disease, which had yet to metastasize and was considered curable.

The scan took about 40 minutes, during which Moeskau was lying face down inside the magnetic resonance imaging tube. She was given a squeeze bulb that could sound an alarm if she suffered any problems during the procedure. The technician performing the scan could observe her through a window and on a television monitor, and could communicate with her through a microphone system.

Roger Johnson, attorney for the plaintiffs, told jurors during opening statements in the three-day trial in Judge David Mouton’s courtroom in Jasper County Circuit Court that these safeguards proved to be inadequate.

During the procedure, Moeskau suffered cardiac and respiratory arrest. The technician performing the MRI did not realize this until she went in to check her after the scan was completed and found her gray, cold to the touch, unresponsive and not breathing, Johnson said. Her heart had stopped, he said.

A 911 call was placed and she was taken to the hospital’s emergency room where they were able to get her heart started back up. She was admitted to a cardiac intensive care unit. But her brain had suffered severe injury from a lack of oxygen, she was left in a coma and a decision was made to take her off life support a few days later. She died Dec. 16, 2008.

Trial testimony focused on the lack of any electronic monitoring of Moeskau’s heart beat during the MRI due to a hospital policy not requiring it for patients with no known respiratory or cardiac issues.

Also in debate was whether the technician’s communications with Moeskau were adequate. She had spoken with the patient over the two-way communication system at the start of the scan, and half-way through informed her when a contrast dye was about to be injected, but she did not speak with her after that.

Moeskau either suffered an adverse reaction to the gadolinium dye used in the procedure or a primary cardiac arrhythmia, Johnson told the jury during closing arguments. He suggested that one doctor’s initial thought that she may have suffered a reaction to the dye was the most likely explanation.

But no matter which of the two possibilities was the actual cause of death, Johnson argued, the core problem was that the hospital had “an upside-down, flawed policy” that did not provide for a sudden emergency.

“We know that what happened to her inside that MRI tube was a preventable, tragic accident,” he said.

But Tim Aylward, attorney for St. John’s, argued that the procedure was conducted “as safely as possible” by the technician and that the standard of care for MRI scans did not require the patient to be hooked up to a blood pressure cuff, heart monitor or pulse oximeter.

“The standard is informal talking with the patient,” he told the jury during closing arguments.

The defense maintained, however, that those communications must be kept at a minimum while the machine is running in order to keep the patient still and obtain the most resolute images possible.

Aylward argued that the squeeze bulb actually “amounts to constant monitoring” during MRI scans and that what happened to Moeskau was “exceedingly rare.” He reminded jurors of testimony they’d heard from a cardiologist who had been of an opinion that the most likely cause of her death was “a primary electrical disturbance” of the heart that she may have been unlikely to survive under any circumstances.



Plaintiffs

Plaintiffs in the lawsuit concerning the death of Ruth Moeskau were her son, James Moeskau, and daughters, Bette Schoeberl and Carol Hunt. They were seeking $150,000 each in non-economic damages and a little more than $65,000 for medical and funeral expenses.