$13.75 Million Verdict for Woman Who Lost Both Legs and an Arm After 14-Hour Sepsis Antibiotic Delay

Seletha Gartrell was 54, working full time, and by her lawyers' account leading an active life when she came to the emergency department at Aiken Regional Medical Centers on the morning of December 6, 2012. She was admitted at 9:34 a.m. with the classic signs of severe sepsis: a respiratory rate of 28, a heart rate of 155, blood oxygen at 89 percent, and a temperature of 103.1 degrees. Sepsis is a systemic response to infection that can spiral into septic shock and organ failure within hours, and the standard of care turns on speed. Fluids and broad-spectrum antibiotics are supposed to start fast.

According to the complaint as reported by the Aiken Standard, that did not happen. Gartrell was not seen by a physician until about five hours after she arrived. Antibiotics were ordered, then ordered again, but she did not actually receive the proper antibiotics until roughly 14 hours after admission, nine hours after the first order and three and a half hours after the second. Shortly after midnight on December 7 she went into cardiac arrest. A code was called and her pulse was restored, but her hands and feet began to mottle and show the signs of ischemia that follow when blood flow to the extremities collapses. She was transferred to the Medical University of South Carolina in Charleston, where surgeons amputated both legs above the knee, her left arm below the elbow, and fingers on her right hand.

Gartrell sued Universal Health Services, Inc., doing business as Aiken Regional Medical Centers, along with a physician and a nurse, in the Aiken County Court of Common Pleas. The case was tried before Judge Clifton Newman. As the litigation developed, her lawyers narrowed the focus from the initial diagnosis to what the nursing staff did over a two-day window, especially during stretches when no physician was present. The LexisNexis case report on the verdict summarized the theory: nurses administered potent drugs without following the doctors' orders and without telling the doctors they had done so, drugs that further reduced blood flow to her limbs, on top of inadequate fluid resuscitation and the giving of diuretics to a patient in shock.

The hospital's position, stated publicly after the verdict, was that Gartrell arrived with two life-threatening conditions, one of which caused her cardiac arrest, and that its nurses and physicians gave her care that saved her life.

The jury sided with Gartrell. Its verdict, entered March 1, 2017, found the hospital negligent and awarded $13.75 million: $10 million in economic damages, reflecting a lifetime of prosthetics, attendant care, and lost earning capacity for a triple amputee, and $3.75 million in non-economic damages. The Aiken Standard reported that the verdict form also recorded a finding, by clear and convincing evidence, that the hospital had been reckless, willful, or wanton, but no punitive damages were added to the compensatory award, and the LexisNexis report described punitive damages as declined. We could not reconcile those two accounts from the public record; what is not in dispute is that the total judgment was the $13.75 million compensatory figure.

Johnny Felder and Chad McGowan of McGowan, Hood & Felder, LLC tried the case for Gartrell, according to court records cited by the Aiken Standard. Felder called the number conservative given that his client had been left a triple amputee, and said he hoped the verdict would force the hospital to look hard at how medications are ordered and monitored in its emergency room and intensive care unit. Aiken Regional Medical Centers is owned by Universal Health Services, a publicly traded hospital operator. Neither the South Carolina Court of Appeals nor the Supreme Court has published an opinion in the case, and we found no reporting of a post-trial settlement, so the verdict appears to have stood as entered. The firm has described it as the largest personal injury verdict in Aiken County history.