Margaret Thomas, then 82 years old, came under Dr. VanTuinen's care in September 1999 following a "neurological event." Dr. VanTuinen prescribed Coumadin. Dr. VanTuinen then monitored Ms. Thomas' internalized normalized ratio (INR) and prothrombin time at least four times between January and April 2000. There was no indication that either her INR or prothrombin time was monitored between April 2000 and September 2000.
Ms. Thomas was admitted to Spectrum Hospital on Sept.14, 2000 with a prothrombin time of 90.6 seconds and an INR of 9.0, both of which are extremely elevated. She was admitted to Dr. VanTuinen's care, although a number of physicians participated in her care. This included Dr. Bodley, one of Dr. VanTuinen's partners who was taking call for him that night. At 2 a.m. on September 15, Ms. Thomas was given Levaquin, an antibiotic that is known to increase clotting time. The source of the order for Levaquin was in dispute, but it appears that it was made by Dr. Varma, a senior medical resident. At 2 a.m. her prothrombin time had increased to 98.3 seconds and her INR was 9.8.
Dr. VanTuinen first saw Ms. Thomas after her admission at 9 a.m. on September 15. He wrote in his plan that he intended to order Vitamin K, but this was never actually ordered or given. Ms. Thomas began to show signs of hemorrhagic shock at 1:25 p.m. that day. She was given Vitamin K and fresh frozen plasma on orders from critical care doctors at Spectrum, but she died shortly after 4:30 p.m. Suit was brought against Dr. VanTuinen and his group practice for medical malpractice by Ms. Thomas' estate. Dr. VanTuinen filed a motion for summary judgment on two grounds: first, plaintiff 's expert testified that Ms. Thomas was not salvageable by 9 a.m. on September 15, so there was nothing that Dr. VanTuinen could have done to save her; and, second, Dr. VanTuinen did not enter the order for Levaquin, nor was he responsible for supervising the person who did (Dr. Varma). The trial court granted his motion and dismissed the suit. This appeal ensued.