IN THE DISTRICT COURT OF OKLAHOMA COUNTY
STATE OF OKLAHOMA
MINOO ARYAN, Individually and as Surviving Spouse and Next of Kin of NASER MASHAGH TOLOUIE, Deceased,
Plaintiff,
vs.
INTEGRIS HEALTH, INC.,
INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORPORATION, dba INTEGRIS SOUTHWEST MEDICAL CENTER,
ABBIE STEPHENS, D.O.,
SUSAN VARGHESE MATHEW, D.O.,
FAZAL ALI, M.D.,
ERIC W. METHENY, D.O.,
SAIF ULLAH FAROOQ, M.D.,
TREVOR DUDARK, D.O.,
PATRICK D HENSLEY, M.D.,
DANIELLE N. ROESLER, R.N.,
LUIS M. ALVA, D.O.,
YBET NIETO VARGAS, R.N., and CHRISTIAN A. SIMMONS, R.N.,
Defendants.
PETITION
COMES NOW the Plaintiff, Minoo Aryan, individually and as the surviving spouse and next of kin of Naser Mashagh Tolouie, deceased, pursuant to the Oklahoma Wrongful Death StatuteS, 12 O.S. §1053-54, for her causes of action against the Defendants, and alleges and states as follows:
1. Plaintiff, Minoo Aryan (hereinafter "Ms. Aryan"), individually as the surviving spouse (widow) of Naser Mashagh Tolouie, deceased, and as next of kin of the decedent, is filing
this action pursuant to the Oklahoma Wrongful Death Statute and is domiciled in Cleveland County, State of Oklahoma.
2. Defendant, INTEGRIS Health, Inc., is a domestic corporation with its principal place of business in Oklahoma County, State of Oklahoma. INTEGRIS Health, Inc. may be served through its registered agent: Brent Hubbard, 3001 Quail Springs Parkway, Oklahoma City, Oklahoma 73134.
3. Defendant, Integris South Oklahoma City Hospital Corporation, dba Integris Southwest Medical Center (hereinafter "Hospital"), is a domestic corporation with its principal place of business located at 4401 S Western Ave, Oklahoma City, Oklahoma 73109. Hospital may be served through its registered agent: Brent Hubbard, 3001 Quail Springs Parkway, Oklahoma City, Oklahoma 73134.
4. Defendant, Abbey Stephens, D.O., is sued in her individual capacity and at all relevant times was employed by or affiliated with Hospital. Defendant Stephens may be served at 18425 Groveton Blvd., Edmond, Oklahoma 73012.
5. Defendant, Susan Varghese Mathew, D.O., is sued in her individual capacity and at all relevant times was employed by or affiliated with Hospital. Defendant Mathew may be served at 5300 N. Independence Ave. #280, Oklahoma City, Oklahoma 73112.
6. Defendant, Fazal Ali, M.D., is sued in his individual capacity and at all relevant times was employed by or affiliated with Hospital. Defendant Ali may be served at 2501 Chaumont, Edmond, Oklahoma 73034.
7. Defendant, Eric W. Metheny, D.O., is sued in his individual capacity and at all relevant times was employed by or affiliated with Hospital. Defendant Metheny may be served at 7436 NE 116th Street, Edmond, Oklahoma 73013.
8. Defendant, Saif Ullah Farooq, M.D., is sued in his individual capacity and at all relevant times was employed by or affiliated with Hospital. Defendant Farooq may be served at 17516 Praire Sky Way, Edmond, Oklahoma 73012.
9. Defendant, Trevor Dudark, D.O., is sued in his individual capacity and at all relevant times was employed by or affiliated with Hospital. Defendant Dudark may be served at 16901 Barcelona Drive, Oklahoma City, Oklahoma 73170.
10. Defendant, Patrick D Hensley, M.D., is sued in his individual capacity and at all relevant times was employed by or affiliated with Hospital. Defendant Hensley may be served at 1500 W. Wilshire Blvd., Oklahoma City, Oklahoma 73116.
11. Defendant, Danielle N. Roesler, R.N., is sued in her individual capacity and at all relevant times was employed by or affiliated with Hospital. Defendant Roesler may be served at 6200 Blue Hills Court, Norman, Oklahoma 73026.
12. Defendant, Ybet Nieto Vargas, R.N., is sued in her individual capacity and at all relevant times was employed by or affiliated with Hospital. Defendant Vargas may be served at 224 W. Oak Avenue, Enid, Oklahoma 73701.
13. Defendant, Christian A. Simmons, R.N., is sued in his individual capacity and at all relevant times was employed by or affiliated with Hospital. Defendant Simmons may be served at 3408 Arcadia Drive, Yukon, Oklahoma 73099.
14. The amount in controversy exceeds Seventy-Five Thousand Dollars ($75,000.00).
II. JURISDICTION AND VENUE
15. This is a personal-injury, wrongful death, medical malpractice, and negligence lawsuit involving violations of the appropriate standards of medical and hospital care by Defendants. Defendants' breach of the relevant standards of care caused severe and permanent injuries, damages, and the wrongful death of Naser Mashagh Tolouie. This lawsuit is brought for
compensatory and punitive damages under the different causes of action alleged and asserted by Plaintiff. Plaintiff demands a judgment comprised of compensatory and punitive damages in excess of Seventy-Five Thousand Dollars ($75,000.00).
16. This Court has subject matter jurisdiction over this lawsuit, as district courts in Oklahoma have unlimited original jurisdiction of all justiciable matters, except as otherwise provided in Section 7, Article VII, Oklahoma Constitution. This constitutional provision does not, in any way, establish or suggest that this Court does not have subject matter jurisdiction over this lawsuit.
17. This Court has personal jurisdiction over all Defendants as Defendants are citizens of Oklahoma, have principal offices in Oklahoma, and/or transact substantial business in Oklahoma.
18. Venue is proper in Oklahoma County, Oklahoma because the incidents forming the basis of this lawsuit occurred at INTEGRIS Southwest Medical Center in Oklahoma County, Oklahoma. Moreover, at the time of such incidents and presently, Defendants have either resided in Oklahoma County, Oklahoma or have been situated in and had a principal office or principal place of business in Oklahoma County, Oklahoma. Additionally, the decedent, Naser Mashagh Tolouie, died in Oklahoma County, Oklahoma on April 20, 2024.
III. Factual Background and Statement of Facts
19. On April 18, 2024, at approximately 2:43 P.M., Naser Mashagh Tolouie, an 88-year-old male, presented to INTEGRIS Southwest Medical Center via emergency medical services with chief complaints of worsening shortness of breath and altered mental status. Upon arrival to the emergency department, Mr. Tolouie was placed on BiPAP respiratory support and admitted to the hospital at 5:01 P.M. under the care of Defendants.
20. Despite the patient's critical condition and known vulnerabilities—including advanced age, severe malnutrition, advanced dementia, communication barriers (non-English speaking with hearing and sight impairment), and baseline cardiac and renal compromise—Defendants administered morphine 4 mg intravenously at approximately 8:39 P.M. on April 18, 2024. This medication was ordered by Defendant Abbey Stephens, D.O., and administered by nursing staff, despite the patient's daughter and primary caregiver, Nazli Toloie, explicitly warning Defendants about Mr. Tolouie's opioid sensitivity and the medical risk of opioid administration. No informed consent was obtained. Additionally, a large 16 French Foley catheter was inserted against Ms. Toloie's objection, without regard for Mr. Tolouie's prostate history, causing unnecessary pain and urinary obstruction.
21. Following the morphine administration, Mr. Tolouie experienced predictable and preventable respiratory depression and worsening hypotension. A second dose of morphine 8 mg was administered intravenously at 1:02 A.M. on April 19, 2024. Mr. Tolouie's breathing became increasingly labored, his blood pressure declined precipitously, his carbon dioxide levels rose to 91 mmHg, and his urine output ceased, progressing to near-complete anuria (approximately 15 mL total output documented after initiation of dialysis). Defendants initiated vasopressor medications (dopamine) at 2:36 A.M. on April 19, 2024, in a reactive attempt to address the iatrogenic hypotension caused by their own opioid administration.
22. On the morning of April 19, 2024, Mr. Tolouie's condition continued to deteriorate due to Defendants' failures. Despite a STAT blood transfusion order placed at approximately 8:00 A.M. for critically low hemoglobin (6.0 g/dL), the transfusion was not administered until approximately 2:00 P.M.—a six-hour delay. Mr. Tolouie required emergency intubation at 12:06 P.M. due to severe respiratory failure directly precipitated by the opioid administration and
systemic collapse. During attempts to establish vascular access, Defendant Trevor Dudark, D.O., performed an unsuccessful right femoral (groin) central line insertion. This failed procedure caused a massive groin hematoma with marked subcutaneous and intramuscular hemorrhage (approximately 200-300 ml) and ongoing bleeding, ultimately contributing to hemorrhagic shock. Continuous renal replacement therapy (CRRT) was initiated over the objections of Ms. Toloie, who warned it was unnecessary and dangerous.
23. Throughout April 19 and into April 20, 2024, Mr. Tolouie experienced massive fluid overload, gaining approximately 20 pounds (from 95 pounds on admission to 112 pounds), representing an 18.35% increase in body weight and approximately 9 liters of fluid retention. This catastrophic fluid accumulation overwhelmed his heart and lungs, causing severe pulmonary edema and respiratory compromise. Defendants escalated vasopressor support to six different medications (norepinephrine, dopamine, phenylephrine, vasopressin, epinephrine, and angiotensin II), yet failed to adequately remove fluid or address the underlying groin hemorrhage. Mr. Tolouie developed shock liver with liver enzyme levels reaching 7,822, coagulopathy with prolonged clotting times, and multi-organ failure.
24. On the morning of April 20, 2024, approximately 44 hours after admission, Mr. Tolouie was found to have a critically low hemoglobin of 4.0 g/dL, a massively swollen and discolored right groin and thigh from the hematoma, and profound hemodynamic collapse despite maximal medical support. At 10:14 A.M. on April 20, 2024, Mr. Tolouie suffered pulseless electrical activity (PEA) cardiac arrest and died. The death certificate listed the immediate cause of death as hemorrhagic shock (12 hours onset to death), due to groin hematoma, coagulopathy, and shock liver, with contributing conditions including acute renal failure, sepsis, and pneumonia. Autopsy confirmed diffuse alveolar damage, aspiration pneumonia, fibrinous pericarditis, the right
thigh hematoma, and findings consistent with fluid overload and multi-organ failure as the pathophysiologic basis for Mr. Tolouie's death.
IV. FIRST CAUSE OF ACTION
MEDICAL NEGLIGENCE
25. To the extent relevant, Plaintiff restates and adopts by reference all previous allegations herein.
26. Defendants INTEGRIS Health, Inc., Integris South Oklahoma City Hospital Corporation dba Integris Southwest Medical Center, Dr. Stephens, Dr. Mathew, Dr. Ali, Dr. Metheny, Dr. Farooq, Dr. Dudark, Dr. Hensley, RN Roesler, RN Vargas, RN Simmons, and Defendants' agents and employees, acting within the course of and scope of their employment, were negligent in providing medical treatment and hospital care to Naser Mashagh Tolouie, causing injury and the wrongful death of Mr. Tolouie. As a direct and proximate result of said negligence, including but not limited to the following actions and omissions, Mr. Tolouie suffered severe injuries and death: Defendants breached their duty to Mr. Tolouie by 1) failing to provide competent and adequate medical diagnosis, treatment, and care, 2) administering morphine despite explicit warnings from the patient's caregiver regarding opioid sensitivity and medical risk, 3) ordering naloxone concurrently with morphine administration, demonstrating awareness of the danger while proceeding with the contraindicated medication, 4) inserting a large 16 French Foley catheter against caregiver objections and without regard for the patient's prostate history, 5) performing an unsuccessful right femoral central line insertion that caused massive groin hematoma and hemorrhagic shock, 6) delaying STAT blood transfusion by approximately six hours despite critically low hemoglobin, 7) failing to adequately monitor and manage fluid status, resulting in catastrophic fluid overload of approximately 20 pounds, 8) failing to prevent near-
complete anuria and multi-organ failure, and 9) failing to adequately train, supervise, and credential staff.
27. The individual physician and nurse Defendants were agents and/or employees of the corporate Defendants and were acting within the course and scope of their employment at all relevant times, making INTEGRIS Health, Inc. and Hospital vicariously liable under principles of respondeat superior and apparent agency for the acts and omissions of such physicians and nurses.
28. The negligent conduct of Defendants was the direct and proximate cause of Mr. Tolouie's injuries, pain and suffering, emotional distress, loss of enjoyment of life, medical expenses, and wrongful death. As a result of Defendants' negligence, Plaintiff has suffered the loss of consortium, companionship, affection, and society of her husband.
29. The negligent conduct of Defendants was done with reckless disregard or intentional malice in that Defendants administered morphine after explicit warnings of opioid sensitivity, simultaneously ordered naloxone demonstrating awareness of the danger, ignored family objections to medical interventions, and failed to respond to progressive deterioration. Such conduct was unreasonable under the circumstances and created a high probability of serious harm to Mr. Tolouie.
Wherefore, Plaintiff prays that this Court enter judgment against the Defendants on the First Cause of Action, and enter judgment for actual and compensatory damages, as well as pre- and post-judgment interest, costs, and attorneys' fees. In addition, Plaintiff requests a judgment for punitive damages in an amount to be determined, based upon the severity of the conduct and the wealth of Defendants, and any other relief the Court deems just and proper.
SECOND CAUSE OF ACTION
NEGLIGENT HIRING, CREDENTIALING, TRAINING, SUPERVISION, AND RETENTION
30. To the extent relevant, Plaintiff restates and adopts by reference all previous allegations herein.
31. At all times relevant to this action, Defendants INTEGRIS Health, Inc. and Integris South Oklahoma City Hospital Corporation, dba Integris Southwest Medical Center (collectively "Hospital Defendants"), hired, credentialed, trained, supervised, and retained the following physicians and nurses who rendered medical care to Naser Mashagh Tolouie: Dr. Abbey Stephens, Dr. Susan Varghese Mathew, Dr. Fazal Ali, Dr. Eric W. Metheny, Dr. Saif Ullah Farooq, Dr. Trevor Dudark, Dr. Patrick D Hensley, RN Danielle N. Roesler, RN Ybet Nieto Vargas, and RN Christian A. Simmons.
32. Hospital Defendants had a duty to hire qualified and competent physicians and nurses; conduct proper credentialing before granting privileges; provide adequate training and continuing education; supervise the medical care provided by physicians and nurses; maintain adequate staffing levels; implement and enforce policies and procedures to ensure patient safety; monitor physician and nurse performance and take corrective action when necessary; and retain only those healthcare providers who demonstrate competence and adherence to standards of care.
33. Hospital Defendants were negligent in their hiring of the above-named physicians and nurses.
34. Hospital Defendants were negligent in their credentialing of the above-named physicians and nurses.
35. Hospital Defendants were negligent in their training of the above-named physicians and nurses.
36. Hospital Defendants were negligent in their supervision of the above-named physicians and nurses.
37. Hospital Defendants were negligent in their retention of the above-named physicians and nurses.
38. As a direct and proximate result of Hospital Defendants' negligent hiring, credentialing, training, supervision, and retention of the above-named physicians and nurses, unqualified or inadequately trained and supervised healthcare providers rendered negligent care to Mr. Tolouie, causing his injuries and death.
39. Hospital Defendants' failures to properly hire, credential, train, supervise, and retain competent healthcare providers constitute reckless disregard for patient safety, thereby entitling Plaintiff to punitive damages.
Wherefore, Plaintiff prays that this Court enter judgment against the Defendants on the Second Cause of Action, and enter judgment for actual and compensatory damages, as well as pre- and post-judgment interest, costs, and attorneys' fees. In addition, Plaintiff requests a judgment for punitive damages in an amount to be determined, based upon the severity of the conduct and the wealth of Defendants, and any other relief the Court deems just and proper.
THIRD CAUSE OF ACTION WRONGFUL DEATH
40. To the extent relevant, Plaintiff restates and adopts by reference all previous allegations herein.
41. The negligent, reckless, and grossly negligent acts and omissions of Defendants, as detailed above, directly and proximately caused the death of Naser Mashagh Tolouie on April 20, 2024. Pursuant to 12 O.S. §1053, Plaintiff Minoo Aryan, as the surviving spouse (widow) of the decedent, is entitled to bring this action and to recover compensation for the decedent's pain and suffering from the time of injury until death; for the decedent's physical injuries and emotional distress; for the decedent's loss of enjoyment of life; and for his medical and funeral expenses.
During the 44-hour hospitalization, Mr. Tolouie experienced severe physical and emotional distress, including respiratory failure, pain from invasive procedures, hemorrhagic shock from the groin hematoma, catastrophic fluid overload, multi-organ failure, and the terror and suffering of his rapid decline. As the surviving spouse, Plaintiff has suffered the loss of her husband's companionship, love, support, and society.
42. As a result of Defendants' reckless disregard or intentional malice, Plaintiff is entitled to punitive damages against Defendants.
Wherefore, Plaintiff prays that this Court enter judgment against the Defendants on the Third Cause of Action, and enter judgment for wrongful death damages pursuant to 12 O.S. §1053, compensatory damages for all elements set forth above, pre-and post-judgment interest, costs, and attorneys' fees. In addition, Plaintiff requests a judgment for punitive damages in an amount to be determined, based upon the severity of the conduct and the wealth of Defendants, and any other relief the Court deems just and proper.
PRAYER FOR RELIEF
43. WHEREFORE, Plaintiff prays that this Court enter judgment in favor of Plaintiff and against all Defendants, and award the following relief:
a) Entry of judgment in favor of Plaintiff and against all Defendants;
b) Compensatory damages, including economic damages (medical expenses, burial expenses) and non-economic damages (pain and suffering, emotional distress, loss of enjoyment of life, loss of consortium);
c) Punitive damages in an amount sufficient to punish Defendants and deter similar conduct;
d) Pre-judgment and post-judgment interest as allowed by law;
e) Costs of suit and reasonable attorneys' fees, if recoverable;
f) Such other and further relief as the Court deems just and equitable.
Respectfully submitted,
______________________________
Pro Se Plaintiff
Minoo Aryan (Widow)
3703 Cedar Ridge Drive
Norman, Oklahoma 73072
