Hopkins Hospital sued in death of girl, 2

Malpractice claim based on improper IV solution

January 14, 2004|By Erika Niedowski | Erika Niedowski,SUN STAFF

The parents of a young girl who died last month from a medication error filed a malpractice claim yesterday against Johns Hopkins Hospital and its Home Care Group, which improperly mixed an intravenous solution that apparently caused her heart to stop.

Hopkins has acknowledged "full responsibility" for the death of Brianna Cohen, who would have turned 3 next month. But her parents, Mark and Mindell Cohen, said yesterday that they were taking legal action because Hopkins had not cooperated fully and had placed "limited value" on her life.

Hopkins officials had no immediate comment on the action filed with the state's Health Claims Arbitration Office, which was set up to arbitrate cases before they go to court. Many parties waive that arbitration and wind up in court.

"While we sympathize with the Cohen family in this tragedy, we simply cannot comment on pending litigation," said Staci Vernick, a spokeswoman for the Hopkins Children's Center.

The Cohens said they wanted to settle the case out of court for the maximum $1.59 million allowed under the Maryland malpractice limits - $952,500 for their pain and suffering and $635,000 for Brianna's.

But Mark Cohen said that Hopkins was disputing the value of the girl's conscious suffering and questioning whether her death would meet the legal definition of a wrongful-death case.

Hopkins oncologists have said that Brianna, who was found to have an aggressive form of brain cancer in April, had only a 20 percent to 30 percent chance of surviving five years.

"In my opinion and in Mindie's opinion, they are minimizing the value of her life, and we feel very insulted," said Cohen. "I don't want some hospital to tell me that she had no value and that she didn't suffer."

No autopsy was performed at the request of the family after Brianna's death Dec. 4. But Hopkins officials said last month that the elevated level of potassium in her total parenteral nutrition bag, or TPN, likely caused her heart to stop.

The TPN bag, used by patients who can't consume a normal diet, contained nearly five times the prescribed amount of potassium, needed for proper muscle, kidney and nerve function, among other things.

The Cohens' lawyer, Gary A. Wais, said yesterday that Hopkins' tests of Brianna's TPN bag showed that it contained higher-than-prescribed amounts of other electrolytes including sodium and calcium.

Hopkins officials have said they do not know how the mistake in the mixing of the TPN bag occurred.

In their complaint, the Cohens fault not only the Home Care Group pharmacy that mixed the solution, but also the Children's Center outpatient pediatric oncology clinic for failing to treat Brianna's rising potassium level after it was recognized by staff.

A discharge form the Cohens received from the clinic the day before Brianna's death directed them to use a new IV solution with less potassium that night. But, according to the family, the Home Care Group called later to say that the new solution could not be delivered and that the clinic had said it would be all right to use the remaining mixture once more.

The state's Office of Health Care Quality is conducting its own investigation into Brianna's death. That should be finished in within two weeks, a spokesman said.

At a news conference yesterday, Mark Cohen said that no amount of money from Hopkins could ever compensate his family for Brianna's loss.

"I can assure you, I'd pay anything to have my little girl back," he said.

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