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August 6, 1987

Rita Geibel, Plaintiff
United States of America, Defendant

The opinion of the court was delivered by: TEITELBAUM


 Rita Geibel brought this medical malpractice action against the United States under the Federal Tort Claims Act (FTCA), 28 U.S.C. § 2671 et seq. The case was tried before the Court and for the reasons set forth below, judgment will be entered in favor of the United States.

 Geibel was born in 1921 and is a high school graduate. She is a married woman who has two living children. A son died at the age of sixteen, ten years ago, when he fell out of a tree house.

 During World War II, Geibel served overseas in the Women's Army Auxiliary Corps from 1943-1945. While in the service, Geibel was hit by a softball on her right leg during a game. Upon examination of the injury, varicose veins were discovered. When Geibel attempted to reenlist in 1946, she was rejected because of high blood pressure. In 1973, she was awarded a ten percent service-connected disability pension based upon high blood pressure.

 From January to February 1981, Geibel was a patient at the Butler Veteran's Administration Medical Center ("BVAMC") for treatment of high blood pressure, tearfulness and anxiety. Dr. Lon H. Preston, the admitting physician, prescribed several different types of anti-hypertension medication including, but not limited to, Hydrochlorothiazide and Inderal, in conjunction with a low salt diet. Geibel had never taken drugs prior to this hospitalization. She displayed an adverse reaction to much of the medication and an overall sensitivity to drug therapy. Because Geibel experienced nausea, vomiting, cramps, dizziness and sleeplessness, all medication was discontinued. When her blood pressure dropped, Dr. Preston discharged Geibel, but continued to monitor her condition on an outpatient basis. As an outpatient, Geibel's high blood pressure eventually required treatment with a daily dose of 25 milligrams of Hydrochlorothiazide and 10 milligrams of Inderal in the morning followed by 20 milligrams of Inderal at bedtime.

 In March, 1981, Geibel was admitted to The Mercy Hospital of Pittsburgh ("Mercy") for continuing pain on her left side which she claimed to have been experiencing since her introduction to drug therapy at the BVAMC. She underwent a gastroscopy which indicated three duodenal ulcers and a hiatal hernia. Geibel was treated for epigastric problems as well as inner ear problems. She continued taking 25 milligrams of Hydrochlorothiazide daily along with 20 milligrams of Inderal in the morning coupled with another 20 milligrams of Inderal at bedtime for high blood pressure.

 The hospitalization at issue in this lawsuit began June 30, 1981 when Geibel was admitted to the BVAMC for high blood pressure after complaining of severe vertigo for approximately one half of an hour. She was admitted to the hospital after being examined by a Dr. Abbatiello who detected a rash on her arms which, according to plaintiff's testimony at trial, the doctor believed to have been an allergic reaction to Hydrochlorothiazide.

 On July 1, 1981, Dr. Raj K. Marwaha, having been randomly assigned to the case, examined Geibel. She complained of the rash on her arms. At this point, the testimony of Geibel contradicts that of Dr. Marwaha. According to Geibel, Dr. Marwaha said, "There's no rash on your arms. Cut your fingernails. You're scratching yourself." The plaintiff further testified that upon examination of her feet, Dr. Marwaha found that she had athlete's foot between her toes and shouted, "Don't you ever wash your feet?" Questioning Dr. Marwaha's drug therapy, Geibel claims that her inquiries were met with a curt, "I am the Doctor."

 Dr. Marwaha, on the other hand, denied the abusive language. According to Dr. Marwaha, he informed Geibel that the rash was not "violent" enough to be an allergy, and that, in fact, he saw no rash. After examining her feet, Dr. Marwaha recalls having said, "There's some dirt between your toes." Dr. Marwaha testified that Geibel then snapped back with, "Do you think I'm dirty?" His response was, "Well, that's all right, don't worry about that." Dr. Marwaha went on to say that Geibel seemed to dislike anything he said and appeared to have difficulty understanding his English as it is tainted with an Indian accent.

 Dr. Marwaha increased the dosage of Hydrochlorothiazide and Inderal to 40 grams of Inderal twice a day and 50 milligrams of Hydrochlorothiazide daily. Geibel perceived the double dosage as negligent and "upsetting" conduct on the part of Dr. Marwaha. Dr. Marwaha testified that the increase of her prescribed medication was an effort to control her already high blood pressure.

 Geibel then complained to the hospital administration that Dr. Marwaha's care did not meet with her approval. Geibel voiced her displeasure at a meeting with the Chief of Medicine. In an effort to accommodate the patient, Geibel was thereupon returned to the care of Dr. Preston. The staff also suggested that Geibel undergo psychiatric and neurologic evaluation, which she declined.

 Geibel filed an administrative claim with the Veteran's Administration alleging that she was severely over-drugged on July 1, 1981 at the BVAMC. In her administrative claim, she described the nature and extent of her injury as "negligently over-drugged by the agents and/or employees of the Veteran's Administration which resulted in severe varicose veins, high blood pressure and total disability." ...

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