Issue: Whether the court erred in the first ruling of Iturralde v.
Hilo Medical Center USA
● Who are the parties in this case:
plaintiff and defendant?
● What facts and circumstances
brought these parties to court?
● Is the court deciding a question of
fact—i.e., are the parties in
dispute over what happened?
Or is it a question of law—i.e., is
the court unsure which rule to
apply to these facts?
Rosalinda Iturralde, the personal representative of Arturo
Iturralde’s (Arturo) estate, is the plaintiff, whereas Dr. Robert
Ricketson and Hilo Medical Center (HMC) are the defendants.
Iturralde sued the defendant for medical malpractice that led to
a decline in health and her brother’s demise.
Arturo Iturralde sought medical care from HMC, complaining
of increasing body weakness, especially in his legs. Dr.
Ricketson diagnosed degenerative spondylolisthesis L4–5 with
stenosis. Iturralde was admitted to undergo spinal fusion
surgery to treat the condition. Dr. Ricketson scheduled the
operation in which he planned to implant M8 Titanium CD
Horizon Kit from Medtronic into Iturralde’s spine. However,
the titanium rods were missing during the surgery even though
HMC had ordered them from Medtronic. When the staff failed
to locate the rods, Dr. Ricketson resolved to implant stainless
steel screwdriver shafts instead. The plaintiff started physical
therapy the next day as ordered by the doctor, and the
screwdriver shaft snapped. The proper titanium rods were
implanted later, but Iturralde was not informed of the
circumstances of first and second surgery. Complications from
the corrective surgery caused dislodgement of the titanium
rods and a decline in the patient’s health until he finally passed
away (Find Law). The plaintiff accused the defendants of
negligence, breach of contract, and medical malpractice
(Pandit & Pandit, 2009). After the first ruling, the plaintiff
appealed because she felt the court erred in its judgment.
Feldmeyer, a nurse at HMC, informed Rosalinda, Iturralde’s
younger sister, about her brother’s surgery. She also delivered
the screwdriver shaft implanted in Iturralde’s spine to the
attorney’s office. Evidence that proved malpractice was
available, and the nurses testified against the defendants (Bal,
2008). Besides, the case is on appeal because the appellee
asserted that the Circuit Court erred. Therefore, the court is
deciding a question of law.
● Which facts of the case raise Iturralde claimed that the court was wrong to award different
issues? damages against HCL and Dr. Ricketson. In addition, the court
did not follow the jury’s instructions and failed in not holding
HMC to account for negligence and for infliction of emotional
distress.
HMC argued that the court failed to apply HRS § 663–10.5,
which stipulated that HCM’s liability should be offset with
Hawaii Orthopedics Inc.’s settlement of goodfaith .
● What are the non-issues? Involvement of Hawaii Orthopaedics Inc. in the case was a
non-issue (Law Nerds).
● Other Iturralde v. Hilo Medical Center USA is an appeal case.
 References

Bal, B. S. (2008). An introduction to medical malpractice in the United States. Clinical

Orthopaedics and Related Research, 467(2), 339–347. https://doi.org/10.1007/s11999-

008-0636-2

Find Law. (n.d.). Iturralde v. Hilo Medical Center USA. https://caselaw.findlaw.com/hi-

intermediate-court-of-appeals/1597588.html#footnote_4

Law Nerds. (n.d.). Learn the secret to legal reasoning. http://www.lawnerds.com/guide/irac.html

Pandit, M., & Pandit, S. (2009). Medical negligence: Coverage of the profession, duties, ethics,

case law, and enlightened defense – A legal perspective. Indian Journal of Urology,

25(3), 372–378. https://doi.org/10.4103/0970-1591.56206