Dr. Fagel obtained a $4.25 million settlement on behalf of a nine-year-old boy who sustained severe hypoxic brain damage after going into respiratory arrest for over ten minutes following the improper removal of his endotracheal tube by medical staff. In October of 1994, the plaintiff was playing with a friend in a drain pipe that was part of an unfinished box culvert in the Yucca Creek flood control channel. The plaintiff climbed into the pipe and the other boy then started a fire in the pipe with sagebrush. Because the pipe had not yet been connected to a street drain, the opposite end of the pipe was closed off and the plaintiff was trapped. By the time the fire department arrived and pulled the plaintiff out, he was unconscious from smoke inhalation and carbon monoxide poisoning. He was transported to the Desert Hospital in Palm Springs and regained consciousness, but was then intubated, sedated and then transferred to the defendant hospital for oxygen treatments. After a few days, the plaintiff recovered from his initial injuries and was prepared for extubation by decreasing the sedation, allowing him to gradually awaken prior to the procedure. When the resident therapist removed the endotracheal tube, the plaintiff immediately turned blue and went into respiratory arrest. The resident attempted to re-intubate him over the next ten minutes but was unable to due to airway swelling. Finally, another resident therapist placed a smaller tube and the child was resuscitated. However, during the ten minutes it took to re-intubate him, the plaintiff suffered severe hypoxic brain injuries and is now in a persistent vegetative state.

The defendant medical center contended that all proper procedures were followed regarding the removal of the plaintiff’s endotracheal tube and that the boy suffered an unanticipated larygospasm, which caused his airway to close. The defendant also argued that the plaintiff’s brain injuries were caused by the initial smoke inhalation and carbon monoxide injury. However, Dr. Fagel proved that the defendant medical center failed to properly evaluate the airway injury and removed the endotracheal tube when there was clear evidence of airway swelling. Dr. Fagel discredited the defendant’s second claim by highlighting the fact that the plaintiff was alert and awake prior to the ET tube removal, so the earlier smoke inhalation and carbon monoxide poisoning clearly could not have been the cause of his current brain injuries. All in all, the plaintiff would not have suffered any significant injury if proper procedures had been followed.