First Responder Medical Malpractice Lawsuit in Texas Seeks $1 Million

Dallas, TXA recently-filed first responder malpractice lawsuit in Texas paints a heartbreaking story about a child whose death may have been prevented had more expert care been available at the emergency care facility to which the parents of Olivia Steinborn brought their critically-ill daughter.

The four-year-old, stricken with what turned out to be bacterial meningitis, was sent home by an inexperienced student doctor. Hours later, the little girl was dead.

The Dallas Morning News (11/10/17) reports that in August of last year, Dallas residents Bryan Steinborn and Juli Treadwell had taken Olivia to Excel ER, an independent, freestanding emergency care facility not situated with any hospital but located within a mile of the Steinborn and Treadwell home. Olivia was feverish – and while the fever had shown signs of improvement once at Excel ER, Olivia’s heart continued to beat rapidly and her breathing was seen as abnormal.

The medical malpractice lawsuit holds that Olivia should have been transferred to the nearest hospital. Instead, the child was administered fluids and sent home with her parents at 5am.

Five hours later, on the morning of August 7, 2016 Olivia was found unresponsive in her bed, her skin blue and cold. By the time Olivia was rushed back to the emergency care clinic less than a mile way, the child was in full cardiopulmonary arrest.

She did not survive.

The family blames Excel ER for improper staffing of their facility, amongst other claims in their first responder medical malpractice lawsuit. But they also name the doctor who first examined Olivia only to send her home. Co-defendant Brandon Baker Morshedi was in fact, at the time a medical resident and still in training to become a board-certified specialist in emergency medicine. In other words, the attending doctor was, in fact a student trainee practicing at the emergency care facility without direct supervision by a qualified physician, which the plaintiffs allege should have been in place.

The plaintiffs also assert they should have been notified of the attending physician’s status as a student. They were not, or so it is alleged.

The observations of two experts who reviewed Olivia Steinborn’s health record and autopsy report were submitted by the plaintiffs as part of their first responder medical malpractice lawsuit. Those experts noted that, in their view the standard of care was not met and the proper diagnosis of bacterial meningitis was missed.

Olivia’s symptoms upon entering the emergency room would have been “obvious (and frightening) to an emergency physician practicing the standard of care,” wrote Dr. Kenneth Corre, an emergency physician at Cedars-Sinai in Los Angeles, in a statement that was filed with the lawsuit.

Olivia’s blood work also showed a “grossly abnormal white count and platelet count which were indicative of an overwhelming bacterial infection,” wrote Dr. Armando Correa, a pediatric infectious disease specialist at Baylor College of Medicine in Houston whose statements were also included with the lawsuit.

The grieving plaintiffs are seeking $1 million in damages in compensation for the loss of their daughter. However, while both experts representing the plaintiffs agreed that the standard of care was not met, there exists a shortage of qualified ER doctors in the State.

“We don’t have enough emergency-trained specialists to staff every single shift 24 hours a day, 365 days a year,” said Dr. Cedric Dark, assistant professor of emergency medicine at Baylor College of Medicine, in comments published by The Dallas Morning News. Dark also added that medical residents “moonlight all the time, and many times it’s without supervision,” he said. Dark was not speaking directly to the Olivia Steinborn case, and instead spoke to The Dallas Morning News only in generalities.

The newspaper noted that in 2014 the American College of Emergency Physicians adopted a recommendation that all emergency departments – freestanding independents, or situated within hospitals – be staffed by “appropriately qualified emergency physicians.” Experts interviewed by the Dallas Morning News, however, note that the recommendation has not been widely adopted.

Additionally, in the State of Texas, statutes governing freestanding ER such as Excel ER require the presence of adequate medical and nursing personnel qualified in emergency care, including at the very least one physician duly qualified to initiate lifesaving measures, together with a minimum of one nurse trained in advanced cardiac life support, and someone with certification in pediatric advanced life support.

And yet, according to The Dallas Morning News, while freestanding ER facilities are required to have sufficient expertise available to stabilize a patient and send patients requiring a higher level of care to the hospital (through pre-existing transfer agreements), there is no requirement for an emergency medicine specialist to be on staff. What’s more, says the Dallas Morning News, any physician who has completed a minimum one year of residency in any particular practice discipline can apply for an independent license to practice, and work legally in any emergency room in the State of Texas without having to be an emergency medicine specialist.

The co-defendant in the first-responder medical malpractice lawsuit was in his third year of residency at UT Southwestern on the night he treated Olivia Steinborn.

The case is Juli Treadwell and Bryan Steinborn on behalf of the Estate of Olivia Steinborn, v. Excel ER, LLC d/b/a Excel ER Keller and Brandon Baker Morshedi, MD, Case No. DC-17-15398, filed November 8, 2017 in the District Court, for the Judicial District of Dallas County, Texas.