The case of Gomez v. Cabatic arose following the death of 6-year-old Claudialee Gomez Nicanor, who had a serious condition known as diabetic ketoacidosis. The defendant was Dr. Arlene Mercado, a pediatric endocrinologist, who was alleged to have failed to diagnosis that Claudialee had type I diabetes. During the period Mercado provided care for Claudialee she created handwritten notes. Following the child's death, the defendant received a request for those medical records. During the trial, it was determined that the doctor then typed the notes and disposed of the handwritten originals. The typed notes were allegedly “revised” to better aid her defense.
Claudialee initially saw her pediatrician Thelma Cabatic, who suggested she be seen by an endocrinologist due to her high blood sugar levels. Cabatic referred the family to Mercado, who she saw for three visits. Roughly one month after her last visit, Claudialee was sent home by the school nurse complaining of stomach pains. Shortly thereafter, the parents took her to the hospital. Three days later she died in the hospital, which the autopsy stated was from complications of diabetic ketoacidosis.
Claudialee's family brought actions of wrongful death and medical malpractice which were later combined. They believed that Mercado demonstrated care that was below the standards by not properly educating the family about diabetes, the symptoms involved, and never instructing the parents regarding at-home testing of blood sugar and ketones. During the period of care, Mercado never determined that the child had type I diabetes, rather believing it to be type II.
The jury determined that Mercado played a significant role in the child's death and demonstrated failures in diagnosing and treatment. The family was awarded $100,000 for economic losses, $400,000 for pain and suffering and they determined that punitive damages were applicable, which are designed to punish the defendant. A separate action was conducted to determine an award for punitive damages which ended up being a staggering $7.5 million. The justification for punitive damages was largely based on the doctor's alteration and destruction of the original medical records.
The matter was soon appealed with the defendant arguing that punitive damages were not appropriate in the matter because the concealing of records occurred after the child's death and did not cause death. The appeals court did not agree and affirmed the allowance of punitive damages. They explained that the true contents of the handwritten notes are uncertain; however, it was proven that the alteration and destruction was conducted in response to the plaintiff attorney's request for records.
Although the appeals court agreed they were applicable, they felt the punitive award was very excessive. They ordered that either a new trial be conducted or that the defendants pay $500,000 in punitive damages. The court's decision was based on a U.S. Supreme Court explanation that outlined three critical considerations for punitive damage awards:
- How “reprehensible” the misconduct was
- The difference between the plaintiff's “actual and potential harm suffered” and the damages award
- Awards in other comparable past cases