Zion v. New York Hospital: 1994-95

Plaintiff: Sidney E. Zion
Defendants: The New York Hospital, Maurice Leonard, M.D., Raymond Sherman, M.D., Gregg Stone, M.D., and Luise Weinstein, M.D.
Crime Charged: Medical malpractice resulting in wrongful death
Chief Defense Lawyers: Francis P. Bensel, Peter T. Crean, Luke M. Pittoni, and Keith C. Thompson
Chief Lawyers for Plaintiff: David Bamberger, Cheryl Bulbach, Judith Livingston, and Thomas A. Moore
Judge: Elliott Wilk
Place: New York City
Dates of Trial: November 10, 1994-February 6, 1995
Verdict: Doctors Sherman, Stone, and Weinstein found negligent; New York Hospital cleared of wrongdoing
Award: Doctors and hospital to pay Zion family $750,000 (later reduced to $375,000) for pain and suffering, $1 for wrongful death; no award for punitive damages

SIGNIFICANCE: The Libby Zion case led to legislation that has significantly changed the training rules for interns and resident physicians in hospitals nationwide. As a result of this case, most training programs have adopted a maximum workweek of 80 hours (formerly 100 hours), with one day off in every seven-day period. Resident doctors (the step beyond internship) must be more closely supervised, especially in the emergency room, with busy night duty relieved by "float" coverage—a system that permits one intern to catch up on sleep while another covers for him or her—and with fewer patients cared for by a single resident. The Zion case stands also as an example of how one person can compel a long-established institution—the medical infrastructure that encompasses hundreds of hospitals—to re-examine and overhaul its customs and practices.

On Thursday, March 1, 1984, Libby Zion, an 18-year-old freshman at Bennington College in Vermont, had been living at home in New York City for two months under the college's work-study program.

During the previous January, at the suggestion of her mother, Elsa, Libby had begun seeing a psychiatrist. He had prescribed an antidepressant drug, Nardil.

On this particular Thursday, complaining of a cold, Libby visited her pediatrician, who prescribed an antibiotic, erythromycin. Libby then saw her dentist, who extracted a decayed eyetooth and gave her Percodan pills to help alleviate any resulting pain.

The next day, not feeling well, Libby went home early from work. By that evening, she had a fever, and by Sunday afternoon she complained she was "burning up inside." Her mother took her temperature and found that it was 102. Elsa gave her daughter alcohol rubs and checked with the pediatrician, who said to continue the antibiotic. That evening, Libby seemed better and her parents went out to a party.

Around 10 P.M., Libby's brother Adam called his parents asking them to come home, saying Libby was "really bad." They found her skin flushed and her eyes dilated and apparently rolling. Her father, Sidney Zion, phoned Dr. Raymond Sherman, who advised taking Libby to the emergency room at New York Hospital.

There, Dr. Maurice Leonard, a second-year resident in charge of the emergency room, took a full medical history from Libby and her mother. When her parents were out of earshot, he asked Libby if she used marijuana. She said she often did, but not on that day. He asked about other medicines or illegal drugs, including cocaine. She denied taking any. The doctor and the emergency room nurse performed a two-hour evaluation including a chest X ray, cardiac exam, blood tests, and urinalysis. To help control her temperature, they gave her fluids through an intravenous (IV) line. They noted Libby's thrashing, compulsive arm and leg movements alternating with moments of calm. They recorded her dehydration and her temperature climbing to 103.5. Finally, Dr. Leonard turned his patient over to Dr. Luise Weinstein, the intern on duty on the private floors, and her supervisor, Dr. Gregg Stone, the second-year resident on duty. The doctors agreed on a tentative diagnosis of "viral syndrome" and admitted Libby to a semiprivate room.

Libby's agitated shaking continued. Twice her thrashing disconnected her IV. At 2:45 A.M., however, her parents, sensing that she was being cared for, went home.

At 7:45 A.M., Dr. Sherman called Sidney Zion and asked him to come to the hospital at once. While Sidney hurried to get ready, Elsa called Dr. Weinstein and learned that Libby had died at 7:30 that morning.