Ernest Soltwisch — known as Ernie — was old and sick. He had diabetes and osteoporosis. He'd had a stroke and had broken several bones after falling out of his wheelchair.
When he went to Bayonet Point Wound Care Center in May 2004, he was getting treatment for an ulcer on his foot that wouldn't heal. While inside a pressurized chamber, he started shaking. The staff was concerned enough to call for an ambulance.
Soltwisch was talking and moving his limbs when Pasco County paramedics rolled him out on a stretcher, according to witnesses' testimony in court documents. But after the short trip across the parking lot to Regional Medical Center Bayonet Point, he was screaming in pain about his right hip. It was fractured.
Soltwisch, who was 75, went on to have surgery and stayed in the hospital for 16 days. On top of his many other ailments, he developed a bacterial infection and on June 7, 2004, he died.
His widow sued Pasco County, alleging negligence on the part of the paramedics.
Michele Soltwisch's lawsuit says the hip fracture must have happened in the ambulance, and that sparked the chain of events leading to her husband's death.
The county fought the case, taking it to trial in 2008.
At the end, Circuit Judge Lowell Bray took the rare step of granting a directed verdict in favor of the county before the jury ever deliberated.
But this month, an appeals court sent the case back, overturning Bray and giving Mrs. Soltwisch another trial.
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She could not be reached for this story. Her attorney, J. Steele Olmstead, of Tampa, said the 77-year-old has fallen on hard times since her husband's death.
She has an apartment in New Port Richey but no phone, so he had to write her a letter to inform her of their victory in court.
"Her finances have gone down. Her health has gone down," Olmstead said. "She needs somebody to take care of her."
Doctors who treated Mr. Soltwisch had differing opinions about what went wrong, according to court documents.
Dr. Donald Vierling, who treated him at the wound care center, described what happened to Soltwisch inside the pressurized chamber as "upper body tremors but not active seizures."
His blood sugar was low, which may have caused the tremors, Vierling said in a deposition.
The staff brought Soltwisch out of the hyperbaric chamber, and at first he didn't speak. But he followed commands to move his eyes and lift his limbs.
Soltwisch, Vierling said, "basically seemed to be fine."
According to Olmstead, Soltwisch left the clinic with "no wide-eyed expression of pain, no high blood pressure, no raised pulse, no sign of any pain whatsoever." Moments later, at the ER: "They drop him off, he's screaming at the top of his lungs, 'Oh my God, my hip.' "
"The ambulance is full of equipment. This is a guy who's 6-foot-4 on a gurney or a stretcher that's built for an average-length person," Olmstead said. "They could have slammed him in there. He was frail but he was stable, according to his doctor."
One expert testified at the trial that Soltwisch's injury "occurred as a result of the transport by Pasco County's paramedics, not from a seizure or osteoporosis," the appellate court noted. And a registered nurse testified that Pasco County's paramedics did not meet the standard of care during the transport.
But another doctor who treated Soltwisch after he was admitted to the hospital had a different theory about the cause of his injury.
"When you have seizure disorders, all your muscles are contracting at the highest strength, you know, and you start banging and moving with your limbs all over without making account that there might be obstacles," Dr. Ivan Ramos said in a deposition. "There might be things in your way. You know, you may be … hitting your head or hitting your leg somewhere."
He added: "I think this man may have had a fracture when he had a seizure." Ramos said he didn't see any sign of an obvious injury — like bruises on his hip — when he examined Soltwisch.
There were 28 different contributing causes of death listed on Soltwisch's death certificate. Ramos said it was the combination of his many ailments that claimed his life. "This man was more ill than an ordinary person," he said.
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Judge Bray granted the verdict for the county because, he wrote, Mrs. Soltwisch's side failed to outright prove negligence by the paramedics or provide evidence from which a jury could infer negligence.
But the appellate judges said the opposite.
"We find … that Mrs. Soltwisch and the estate presented sufficient evidence from which a jury could conclude that Pasco County breached its duty of care to Mr. Soltwisch," they wrote.
An attorney for the county said Pasco's professional liability insurance is defending the case, and those attorneys will decide the next step.
Olmstead said he wants to take the case to trial again as soon as possible for Mrs. Soltwisch. There's a provision in the law to enable speedy trials for cases involving sick and elderly people.
Times staff writer Jodie Tillman contributed to this report. Molly Moorhead can be reached at firstname.lastname@example.org or (727) 869-6245.