ER Doc "Reckless" in Treating Girl's Deadly Diabetes Complications, Physician Says in Med Mal Trial

Posted by Arlin Crisco on Mar 31, 2016 9:10:05 AM


Dr. Jose Diaz testifies at trial over the death of Shannon Kelly from diabetes-related complications. Kelly's parents claimed Dr. Dudley Teel and the Indian River Memorial Hospital acted recklessly in tresting the child. 

Vero Beach, FL—A pediatric physician told jurors Wednesday he believed an emergency room doctor acted recklessly in treating a child’s diabetes complications, ultimately worsening brain swelling that led to her death, as trial continued in the suit against the ER doctor and hospital. Kelly v. Indian River Memorial Hospital, 2010-CA-073141.

Dr. Jose Diaz, a pediatric critical care physician, said he believed Dr.  Dudley Teel gave too much fluid too quickly to 12-year-old Shannon Kelly when she was admitted to Indian River Memorial Hospital’s emergency room suffering from new onset diabetes and diabetic ketoacidosis, or DKA, a complication that increases the acid level in the blood. Teel compounded that error, Diaz said, by failing to promptly give Kelly mannitol, a medicine designed to stop edema, or swelling, in Kelly’s brain.

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“She received management that did not follow the standard of care of any institution that has experience managing DKA patients,” Diaz said, noting Teel’s treatment was “reckless. It did not help her case.”

Kelly died two days after being admitted to Indian River Memorial Hospital’s emergency room suffering from DKA. Kelly’s parents, Terrance and Sandra Kelly, claim the hospital and its attending physician, Dr. Dudley Teel, lacked the resources to care for their daughter and recklessly treated her, causing fatal brain swelling.  

The defense contends Teel's treatment was appropriate to reduce the acid level in Kelly's blood and attempt to stabilize her condition. 

On Wednesday, Diaz, who treated Kelly after her transfer to the hospital at which Diaz practiced, told jurors Teel described Kelly as awake and alert in a phone call before the transfer. But Diaz said Teel’s medical records contradicted that description and instead indicated that her vision and memory were impaired, that she was confused, and suffered from high blood pressure. Diaz told jurors those symptoms were tell-tale signs that she suffered from brain swelling.

Diaz noted that, if Teel had described the symptoms listed on the medical records, Diaz would have recommended mannitol to treat the swelling. In DKA patients, “my worst fear, my worst complication, the most important cause of death, this is one thing I want to know: I want to know if [the patient] has any signs or symptoms of altered mental status,” Diaz said. “That [suggests] to me possible cerebral edema.”

Diaz acknowledged he believed Kelly already suffered from edema by the time she reached the Indian River Hospital but that Teel’s treatment contributed to worsen her edema and ultimately cause her death.

During a sometimes contentious cross-exam, Diaz acknowledged Kelly’s blood pH level at the ER was abnormally low and needed to be increased with a fluid infusion at some point during treatment.  

Diaz, who practices pediatric critical care medicine, but is not board certified in the specialty, also acknowledged other medical entries from Teel showed Kelly did not suffer from other tell-tale signs of edema, such as vomiting, incontinence, or lethargy.

Trial in the case will continue into next week.

Parties’ attorneys could not be reached for comment.

Email Arlin Crisco at

Related Information

Terrance and Sandra Kelly are represented by the Romano Law Group's John Romano and Corey Friedman and Swope Rodante’s Elizabeth Zwibel.

Dr. Dudley Teel and Indian River Memorial Hospital are represented by Hall Booth Smith's John Hall and Duane Cochenour and by Roy Watson. 

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Topics: Negligence, Medical Malpractice, Florida, Kelly v. Indian River memorial Hospital