11-004112CB In Re: Senate Bill 70 (Estate Of Michael Munson, Kristi Mellen, Personal Representative) vs. * Status: Closed Settled and/or Dismissed prior to entry of RO/FO on Monday, April 2, 2012.

THE FLORIDA SENATE

SPECIAL MASTER ON CLAIM BILLS

Location

40 2 Senate Office Building

Mailing Address

404 South Monroe Street

Tallahassee, Florida 32399 - 1100

(850) 487 - 5237

DATE COMM ACTION

12 /2 /11 SM Fav orable

December 2 , 2011

The Honorable Mike Haridopolos

President, The Florida Senate

Suite 409, The Capitol

Tallahassee, Florida 32399 - 1100

Re : SB 70 (2012 ) Î Senator Ronda Storms

Relief of Kristi Mellen, as personal representative of the estate of

Michael Munson

SPECIAL MASTERÓS FINAL REPORT

THIS IS AN UNCON TES TED CLAIM FOR $2,800 ,0000,

BASED ON A CONSENT F INAL JUDGMENT BETWEE N

THE ESTATE OF MICHAE L MUNSON AND THE NOR TH

BROWARD HOSPITAL DIS TRICT, WHICH RESOLVE D A

CIVIL ACTION THAT AR OSE FROM THE NELIGEN T

PROVISION OF EMERGEN CY MEDICAL SERVICES AT

CORAL SPRINGS MEDICA L CENTER THAT RESUL TED

IN THE DEATH OF MR. MUNSON, WHO WAS

EXPERIENCING TREATAB LE CARDIAC DYSRHYTHM IA.

FINDINGS OF FACT: On Sunday, September 21, 2008, Michael Munson, a

married father of two minor children, was relaxing at home

with his family. Shortly before 11:00 a.m, Mr. Muns on

complained to Kristi Mellen Ï his wife and the claimant in this

proceeding Ï that he was experiencing chest pain, difficulty

breathing, as well as nausea and vomiting. Mr. Munson

further stated, "th is is bad . . . we need to go to the hospital,"

at which point Ms. Mellen drove him to the emergency room

at Coral Springs Medical Center ("Coral Springs"), a facility

owned by the North Broward Hospital District.

Video surveillance footage demonstrate s that at 11:11 a.m.,

Mr. Munson arrived at the emergency room Ï which was not

SPECIAL MASTERÓS FINAL REPORT Î SB 70 (2012)

December 2, 2011

Page 2

busy at that time Ï and was evaluated by a triage nurse one

minute later. Mr. Munson informed the nurse, Ms. Lynn

Parpard, that he was experiencing tingling in his arms,

burning in his chest, and difficulty breathing. Pursuant to

hospital policy, as well as the acceptable standard of

medical care, each of the foregoing symptoms required Ms.

Parpard to classify Mr. Munson as a high priority "code

heart" patient and to ensure that he received immediate

treatment (e.g., continuous EKG monitoring). Inexplicably,

however, Ms. Parpard erroneously determined Ï after merely

checking Mr. Munson's pulse rate and oxygen saturation

level and speaking to him for roughly one minute Ï that he

was suff ering from a panic attack. As a result, Mr. Munson

was not treated as a high priority patient, and Ms. Parpard

directed him to the registration desk, which was located

adjacent to the triage area.

At 11:13 a.m., Mr. Munson and Ms. Mellen began the

regis tration process with Mr. Craig Blair, a clerical worker

employed by the hospital. During the registration, Ms.

Mellen referenced Mr. Munson's symptoms, the nature of

which so concerned Mr. Blair that he tapped Ms. Parpard on

the shoulder and repeated what Ms. Mellen had told him.

Unfortunately, Ms. Parpard ignored Mr. Blair's concerns and

stated that Mr. Munson had already been assessed. Mr.

Blair continued with the registration, which concluded at

11:23 a.m.

At 11:26 a.m., while seated in the waiting area with his wife,

Mr. Munson suffered a massive heart attack and lost

consciousness. Ms. Mellen screamed for help, at which

point several nurses Ï other than Ms. Parpard, who never

got out of her chair Ï responded and discovered Mr. Munson

in full cardiac and respiratory arrest. Moments later, a "code

blue" was called, and at 11:29 a.m. Ï some 18 minutes after

he arrived at the hospital Ï Mr. Munson was placed on a

stretcher and removed to the treatment area.

During the treatment that ensued, Mr. Munson's EKG

showed that he was suffering from ventricular fibrillation.

Over the next 30 minutes, the emergency physician, Dr.

Ingrid Carter, made aggressive efforts to resuscitate Mr.

Munson, which included intubati on, repeated attempts at

defibrillation, and the administration of Amiodarone,

Epinephrine, Atropine, and Sodium Bicarbonate. Tragically,

SPECIAL MASTERÓS FINAL REPORT Î SB 70 (2012)

December 2, 2011

Page 3

Mr. Munson could not be revived and was pronounced dead

at approximately 12:10 p.m., leaving behind his two children,

ages 14 and 17, and his wife of 20 years. Four days later,

on September 25, 2008, the Coral Springs Medical Center

terminated Ms. Parpard's employment.

An autopsy was subsequently performed, which revealed

that the cardiac dysrhythmia that resulted in Mr. Munson's

death was caused by three vessel coronary artery disease Ï

a treatable condition. The autopsy report and Mr. Munson's

hospital records were later reviewed by two physicians: Dr.

Alen Gelb and Dr. Richard Gray, who specialize,

respectively, in the fields of emergency medicine and

cardiology. Collectively, the experts concluded that Mr.

Munson's condition was manageable, that Ms. Parpard's

failure to properly assess Mr. Munson and designate him as

a high priority patient fell below the accepta ble standard of

care, and that Mr. Munson more likely than not would have

survived had he received prompt treatment from the Coral

Springs emergency staff.

The undersigned has reviewed a report prepared by Dr.

David Williams, an economist retained by Mr. Munson's

estate. Dr. Williams calculated that the economic damages

(reduced to present value) from the death of Mr. Munson Ï a

licensed attorney and certified public accountant at the time

of the tragedy Ï totaled $1,656,581.00. Dr. Williams' report,

wh ich the undersigned credits, has not been challenged.

Had the negligence action against the North Broward

Hospital District proceeded to trial, it is likely that a jury

would have returned an award substantially in excess of the

amount sought through th e instant claim bill. Accordingly,

the undersigned concludes that the settlement is both

reasonable and responsible.

LITIGATION HISTORY: On June 30, 2009, in the circuit court for Broward County,

Ms. Mellen, as the personal representative of the e state of

Mr. Munson, filed a Complaint for Wrongful Death against

the North Broward Hospital District, Phoenix Emergency

Medicine of Broward, and Dr. Ingrid Carter. The matter

subsequently proceeded to mediation, at the conclusion of

which the parties ele cted to settle the matter for

$3,010,000.00. In particular, the North Broward Hospital

District agreed to "use its best efforts and recommend to its

SPECIAL MASTERÓS FINAL REPORT Î SB 70 (2012)

December 2, 2011

Page 4

Board and its claims bill carrier to secure approval of

payment of Three Million Dollars," and, if success ful, to

jointly support the passage of a claim bill in an amount

above its self - insured retention "to reach a payment of Three

M illion Dollars." The mediation agreement further provided

that the estate of Mr. Munson would accept $10,000 in

exchange for t he dismissal of Dr. Carter as a party.

Subsequently, on July 15, 2011, a consent final judgment

was entered against the North Broward Hospital District in

the amount of $3,000,000. Pursuant to the judgment, the

North Broward Hospital District was dir ected to pay Mr.

Munson's estate $200,000 within 30 days, and further

ordered to support the passage of a claim bill in the amount

of $2,800,000.

CLAIMANT'S POSITION : The North Broward Hospital District is vicariously liable for

the negligent acts of its employee, Ms. Lynn Parpard, which

include, but are not limited to: the erroneous assessment of

Mr. Munson's condition; the failure to designate Mr. Munson

as a high priority patient and ensure that he received timely,

appropriate treatment; and the fai lure to properly observe

Mr. Munson while he was seated in the waiting room.

RESPONDENT'S POSITION : The North Broward Hospital District supports the instant

claim bill.

CONCLUSIONS OF LAW: As provided in s . 768.28, Florida Statutes (2008 ), sovereign

immunity shields the North Broward Hospital District against

tort liability in excess of $200,000 per occurrence. See

Eldred v. North Broward Hospital District , 498 So. 2d 911,

914 (Fla. 1986) (holding s. 768.28 applies to special hospital

ta xing districts); Paushter v. South Broward Hospital District ,

664 So. 2d 1032, 1033 (Fla. 4th DCA 1995). Accordingly,

unless a claim bill is enacted, Mr. Munson's family will not

realize the full benefit of the settlement agreement reached

with the distri ct.

Under the doctrine of respondeat superior, the North

Broward Hospital District is vicariously liable for the negligent

acts of its agents and employees, when such acts are within

the course and scope of the agency or employment. See

Roessler v. Novak , 858 So. 2d 1158, 1161 (Fla. 2d DCA

2003). Ms. Lynn Parpard, t he triage nurse involved in Mr.

Muns on's treatment, was an employee of the North Broward

SPECIAL MASTERÓS FINAL REPORT Î SB 70 (2012)

December 2, 2011

Page 5

Hospital District acting within the scope of her employment.

Accordingly, Ms. Parpard's negligence is attributable to the

district.

Ms. Parpard had a duty to provide Mr. Munson with

competent medical care Ï namely, the proper assessment of

his condition, which required immediate medical treatment.

Tragically, however, Ms. Parpard breached her duty to Mr.

Munson by erroneously concluding that he was suffering

from a panic attack and failing to classify him as a high

priority cardiac patient. Ms. Parpard's negligence was a

direct and proximate cause of Mr. Munson's death.

LEGISLATIVE HISTORY: This is the first claim bill presented to the Senate in this

matter.

ATTORNEYS FEES: The Claimant's attorneys have agreed to limit their fees to 25

percent of any amount awarded by the Legislature in

compliance with s. 768.28 (8), Florida Statutes.

FISCAL IMPACT: Should this bill be approved, a portion of the claim would be

paid from the North Broward Hospital District's general

operating fund up to the limits of its self - insured retention

($1,000,000), less monies expended. The remaining funds

nece ssary to satisfy the claim bill would be provided by

Respondent's excess insurance coverage through CNA

Insurance. The CEO of the North Broward Hospital District,

Frank Nask, has attested that the payment of the instant

claim will not adversely affect the provision of healthcare

services to the residents of Broward County.

RECOMMENDATIONS: Fo r the reasons set forth above, the undersigned

recommend s that Senate Bill 70 (2012 ) be reported

FAVORABLY .

Respectfully submitted,

Edward T. Bauer

Senate Special Master

cc: Senator Ronda Storms

Debbie Brown , Interim Secretary of the Senate

Counsel of Record