Appellate Court Upholds $4.6 Million Judgment for Albertville Family

The Minnesota Court of Appeals Monday affirmed a 2011 decision that awarded an Albertville family $4.6 million in damages after the mother of that family died soon after the hospital performed a cesarean section.

The decision ended nearly three years of legal proceedings for Robert Calcagno, the husband of the late Claudia Calcagno, who died the evening of Jan. 18, 2008, five hours after she gave birth to the couple’s son, Vico.

The three-judge panel, headed by Judge Dovre Bjorkman and including judges Heidi Schellahs and Thomas Kalitowski, said Monticello-Big Lake Hospital, now known as New River Medical Center, was negligent in the handling of Claudia Calcagno’s post-partum emergency, and actions taken by hospital staff were “a direct cause” to her bleeding to death the night of Jan. 18.

The decision states that the hospital’s appeal, which was filed on the grounds of an error during the judge’s instructions to the jury; a denial of the district court to conduct a new trial; and the definition of medical negligence, simply did not hold up.

The hospital accused the court of giving the jury “prejudicial” instruction. That was disputed, and ultimately rejected by the district court, and upheld by the appellate court.

The hospital also disputed that Drs. Timothy Olson and Jennifer Emery, who practice at Buffalo Clinic, were the parties at fault, in addition to the hospital. The district and appeals court did not agree, based on the facts given in court.

According to court documents:

Claudia Calcagno was admitted to Monticello-Big Lake Hospital for an induced delivery on Jan. 17, 2008.

Her labor was unsuccessful, and on Jan. 18 Dr. Timothy Olson, Claudia’s obstetrician, ordered a c-section.

Olson made the delivery, a healthy boy the couple named Vico.

Soon after delivery, Claudia began to hemorrhage. Nurses found a condition called “atony,” where the uterus muscle does not contract and continues to bleed.

Hospital staff contacted the on-call obstetrician, Dr. Jennifer Emery, at about 8:50 p.m. They reported Claudia was “bleeding heavily.”

Emery, according to her testimony, responded to a page and told staff to type and cross Claudia’s blood type and requested two units of blood. She made a request for a transfusion 20 minutes later, around 9:10 p.m.

However, staff still hadn’t transfused blood at 9:18 p.m. when Emery arrived. Staff told her the lab was “working on” the request, and because the hospital did not stock A-negative blood, which was Claudia’s blood type, no A-negative blood was available to use. At 9:30 p.m., Emery ordered two units of trauma blood, or type O-negative. It was nearly an hour after she had first been called by hospital staff alerting her to Claudia’s condition.

At 9:40 p.m., Emery ordered four units of red blood cells and four frozen plasma units for transfusion, as well as all the trauma blood the hospital had available.

Meanwhile, Claudia continued to bleed. Emery planned to treat with drugs and a possible surgical procedure, with a hysterectomy being the last result. She discussed that possibility with Claudia Calcagno.

By 10 p.m., Emery had talked with Claudia’s primary OB, Dr. Timothy Olson. Olson arrived and, too, requested all blood available, but the hospital informed the doctors they were out. The physicians were concerned the amount of blood lost was causing her remaining blood not to clot.

After 10 p.m., the doctors consulted about transferring to North Memorial because of Monticello-Big Lake’s lack of blood supply, and because a radiation procedure that could possibly aid Claudia could be done at the Robbinsdale hospital.

At 10:35 p.m., Olson and Emery transferred Claudia to an operating room where they did one surgical procedure and considered performing a hysterectomy, but did not because the lack of blood available for transfusion for Ms. Calcagno. They inserted a balloon tamponade in Claudia’s uterus, and prepared her for transport.

At 11:30 p.m., Claudia was transported via LifeFlight to North Memorial. Her condition “deteriorate” during the transfer. North Memorial physicians transfused blood and performed the hysterectomy. However, shortly after her arrival, she suffered a fatal cardiac arrest due to her blood loss.

Robert Calcagno also filed a civil complaint against the Buffalo Clinic and Drs. Emery and Olson. That complaint was settled prior to the complaint vs. Monticello-Big Lake Hospital and all claims against the doctors were dismissed.

In district court, Robert Calcagno’s attorney, Kathleen Flynn Peterson, built her case around “a medical malpractice involving a negligent failure to maintain adequate blood stock, procure emergency blood in a timely manner, and have blood available to treat an obstetrical emergency.”

Peterson told media outlets after the trial in Wright County that “Her doctors needed blood to save her life. It was as simple as that.”

Thursday, May 17, four days prior to the appellate court’s opinion, . The hospital said it is working to staff the OB unit with its own doctors and nurses before evaluating services.

“On May 25, 2012, New River Medical Center will no longer have enough qualified nurses to safely staff the obstetrical unit. Because the local OB/GYN physician group is no longer utilizing the obstetric services at New River Medical Center, deliveries have dropped dramatically causing a significant number of our Women’s Services team members to resign due to low patient volumes and uncertainty of the future. Without qualified staff and without OB/GYNs, New River Medical Center made the difficult decision to suspend obstetrical services until we are able to recruit providers and staff who will care for patients in our community,” the hospital said in a recently released statement.