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Kevin was born on July 14, 1988. At about 10:45 p.m. on November 29, 1990, Kevin was seen in the emergency room of Hospital (D) by Dr. Terry Balagna. Kevin was injured at 8:30 or 9 p.m. by falling while jumping on the couch in the family living room. An abnormal breathing pattern was observed. Tests were conducted to discover the possibility of an infection or an electrolyte or metabolic problem. Cervical spine X-rays were taken at about 1:05 a.m. which appeared normal. Kevin was admitted. Balagna called Bonds, a pediatrician, to examine him. Bonds arrived at the hospital at about 1:45 a.m. on November 30, 1990. Kevin's temperature was 102 degrees. The history indicated Kevin had jumped off the couch, landed on his arm, walked to his mother, and gradually became limp after that. Bond noticed the child's breathing difficulties and that he was flaccid. He was moving his head. His neck was not tender. Among the possible reasons for his condition which Bonds considered were neurologic, traumatic, metabolic, infectious, or post-infectious problems. Because of the fever, she was leaning toward the infectious process diagnosis, and she did not consider a spinal cord injury. At 2:05 a.m., Bonds telephoned Fulbright (D) at his home. Fulbright (D) inquired if the child had a stiff neck. Bonds said she did not know, went to check Kevin's neck, and returned stating that his neck was stiff. Fulbright (D) suggested a spinal tap to determine whether meningitis, encephalitis, or something similar was involved. Bonds did not ask Fulbright (D) to treat Kevin, nor did Fulbright (D) commit himself to further involvement with Kevin. Fulbright (D) thought that there might have been child abuse but Bonds dispelled him of that notion. Fulbright (D) often received informal inquiries from other doctors asking questions and seeking suggestions. These inquiries do not include a request to see a patient, review a patient, or render an opinion, but only to discuss the case. He considered this a courtesy service for which he did not bill. He offered to make himself available because the other physician may be inhibited about asking him to see the patient due to the late hour or the marginal neurosurgical nature of the case. Bonds performed the spinal tap. Before leaving the hospital, she told a nurse to write an order in Kevin's chart 'to consult with Fulbright (D) to see in early a.m.' That note was posted to the chart, and the message was taken off the chart at 4:05 a.m. The message was never received by Fulbright (D). Ps never asked Fulbright (D) to treat Kevin, and he never saw, examined, or came to a diagnosis as to Kevin's condition. Fulbright (D) did not bill for any services to Kevin. Kevin was transferred to St. John's Hospital (St. John's) at 12 p.m. on November 30, 1990. Bonds' diagnosis was an infectious process called Guillain-Barre syndrome. At St. John's, a spinal cord injury was diagnosed. According to the affidavit of Dr. John Oldershaw, a neurosurgeon, the failure of Fulbright (D) to examine Kevin and the records before making a recommendation and failing to follow through after being consulted violated the Hospital's (D) rules and generally accepted standards of practice in the medical community.

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