## Facts

- LaVerne Alice Thompson, age 36, underwent elective gynecologic surgery (abortion and tubal ligation) under general anesthesia at Washington Hospital Center (WHC).
- A nurse anesthetist, supervised by an anesthesiologist, placed an endotracheal tube; plaintiffs alleged the tube was mistakenly placed in the esophagus, causing inadequate oxygenation.
- The surgeon observed abnormally dark blood during the procedure and alerted anesthesia personnel.
- Thompson suffered a drop in heart rate, went into cardiac arrest, was resuscitated, and sustained severe anoxic brain injury, leaving her permanently incapacitated.
- Plaintiffs alleged WHC was independently negligent for failing to supply end-tidal carbon dioxide (CO₂) monitors that could have detected misplacement earlier.
- Plaintiffs’ expert testified that use of end-tidal CO₂ monitoring was an emerging national practice and supported by professional literature.
- WHC’s anesthesiology chair testified he had requested the monitors and that lacking them would fail the national standard of care, while also stating there was no national standard specifically requiring monitors at the time.
- A jury awarded Thompson over $4.5 million and awarded Thompson’s husband $63,000 for loss of spousal consortium.
- The trial court entered judgment with an offset for a mid-trial settlement with individual anesthesia providers and granted summary judgment against consortium claims brought by Thompson’s mother, daughter, and granddaughter.

## Issues

1. Whether District of Columbia law recognizes loss-of-consortium claims by a parent, child, or grandchild for catastrophic injury to an adult family member.
2. Whether expert testimony and related evidence were sufficient to permit a reasonable jury to find WHC breached the applicable standard of care by not providing end-tidal CO₂ monitors.
3. Whether brief contact between plaintiffs’ expert witness and two jurors required a mistrial.
4. How the nonsettling hospital’s credit against the verdict should be calculated after a mid-trial settlement with other defendants (pro rata vs. pro tanto, and the amount of any pro tanto credit).

## Decision

- The court affirmed summary judgment against the mother’s, daughter’s, and granddaughter’s consortium claims as not cognizable under controlling District of Columbia precedent.
- The court affirmed denial of WHC’s JNOV motion, holding the evidence permitted a finding that a reasonably prudent tertiary care hospital should have provided end-tidal CO₂ monitoring and that WHC’s failure could constitute a deviation from the standard of care.
- The court affirmed denial of a mistrial, concluding the trial judge acted within discretion in finding the witness–juror contact innocuous and nonprejudicial.
- The court affirmed use of a pro tanto settlement credit and rejected WHC’s request for a pro rata allocation (and a larger credit), reasoning WHC had not preserved a basis for apportionment of the settling defendants’ fault.

## Legal Principles

- In the District of Columbia, courts will reject parental or filial loss-of-consortium claims when foreclosed by binding precedent.
- In medical malpractice, the standard of care and breach may be established through expert testimony and supporting professional literature; proof need not include numerical adoption rates or a formal mandate if the testimony provides an adequate factual basis for the jury’s inference.
- A hospital may have an institution-level duty to supply reasonably indicated monitoring technology when professional knowledge and competent expert testimony support that such equipment is expected of comparable facilities.
- Mistrial decisions based on alleged juror influence are reviewed for abuse of discretion; absent evidence of prejudicial impact, brief and unrelated contact does not require a mistrial.
- A nonsettling defendant seeking a pro rata reduction based on other tortfeasors’ fault must timely pursue procedures to obtain fault allocation; otherwise, the judgment is reduced only by an allowed pro tanto (dollar-for-dollar) credit.

## Conclusion

The court largely affirmed a substantial malpractice judgment, holding that the evidence allowed the jury to find WHC negligent for not providing end-tidal CO₂ monitoring, upheld the trial judge’s refusal to declare a mistrial, limited settlement credit to a pro tanto offset due to lack of preserved fault allocation, and reaffirmed that District of Columbia law does not recognize parental or filial loss-of-consortium claims in this context.


Washington v. Washington Hosp. Ctr., 579 A.2d 177 (D.C. 1990)