Jury Awards $268 Million After Medical City Gave a 13-Year-Old Girl a Fatal Propofol Overdose

In 1998, a 13-year-old girl with cerebral palsy was admitted to Medical City Dallas Hospital for what physicians described as a routine surgical procedure to reopen an airway that was gradually narrowing from scar tissue. The operation itself went as planned. The fatal error came afterward.

Following surgery, hospital staff administered the anesthetic propofol at a dose far above what was appropriate for the patient. Because of her cerebral palsy, the girl could not communicate the pain she was experiencing. Over the next two and a half days, her urine darkened progressively, from amber to tea-colored to dark brown to black, a visible sign that her kidneys were failing. Staff did not adequately respond to those warning signs. She died in the hospital.

Charla Aldous, working with co-counsel Steve Malouf, took the family's case to a Dallas County jury. The family sued Medical City and the treating physician. The physician's side settled before verdict. The hospital declined to resolve the case and went to trial.

At trial, the plaintiffs' team established that the dosage error triggered rhabdomyolysis, a condition in which muscle tissue breaks down and the cellular debris floods through the kidneys, ultimately causing renal failure. The hospital's failure to recognize and treat the warning signs over multiple days, the evidence showed, gave staff repeated opportunities to intervene that were not taken.

The jury returned a verdict of $268.6 million, which made Lawyers Weekly USA's top-10 verdicts list for 2000. As part of the post-verdict resolution, the hospital's chief executive was required to travel personally to the parents' home to deliver an apology. The hospital also agreed to run a five-year curriculum training its nurses on recognizing adverse drug reactions. Separately, AstraZeneca, the propofol manufacturer, added rhabdomyolysis to the drug's official list of adverse reactions in its package insert.