Federal Judge Awards $29.5 Million After Tripler's 19-Hour Delay Destroyed Infant's Intestines

On the evening of September 22, 2016, John and Laura Warren brought their one-month-old daughter to the emergency room at Tripler Army Medical Center in Honolulu. The infant's abdomen was distended and rigid, and her skin had turned blue from the belly button down. Shortly after she arrived, she stopped breathing and required resuscitation by staff.

Some members of the Tripler team recognized the warning signs of midgut volvulus, a condition in which a newborn's intestine twists and cuts off its own blood supply. In infants, volvulus is a surgical emergency: every hour without treatment destroys more intestinal tissue. Tripler did not perform the required imaging or initiate surgery. The family waited 19 hours. When the child was near death, staff finally called an ambulance and transferred her to Kapiolani Medical Center for Women and Children, where surgeons confirmed the diagnosis and operated.

The outcome was severe and permanent. By the time surgeons at Kapiolani reached her, roughly 90 to 95 percent of her small intestine had become necrotic. She underwent 14 surgeries over the following five months. Infections that developed during her hospitalization caused additional damage to her heart and brain. She cannot absorb nutrition by mouth and requires lifelong tube feeding through permanent ports in her body, with continuous care around the clock. Her father, John Warren, an Army veteran who had deployed to Afghanistan, left military service to provide that care full-time.

The family filed suit against the United States government under the Federal Tort Claims Act. A non-jury trial took place in August 2022 before U.S. District Judge Michael Seabright in the District of Hawaii. Loretta Sheehan of Davis Levin Livingston represented John and Laura Warren. At trial, the firm established that Tripler's staff had identified volvulus as the probable diagnosis, that confirmatory tests and surgical intervention were available, and that none were ordered for 19 hours, by which point the damage to the child's intestinal tract was irreversible.

Judge Seabright issued his findings in April 2023 and entered final judgment on May 23, 2023. The court awarded $29,479,308 to the Warren family, the largest medical malpractice judgment against Tripler Army Medical Center on record. No reduction of the award on appeal has been reported.