A California appeals court has upheld a jury's award of $9.9 million in damages, including payments toward decades of continuing care, to a patient who suffered brain damage as a result of an accidental overdose from a morphine-filled pain pump.

Carly Ann Pritchard sued the home-nursing firm Coram Healthcare Corporation of Southern California for negligence for failing to provide a timely post-op visit on the day of surgery and for failing to maintain the morphine pump, oversights she believed caused "some or all of her brain damage," say court documents.

Ms. Pritchard suffered an ankle injury in March 2001, at age 24, while working at Disneyland in Anaheim, Calif. She underwent outpatient surgery in January 2002 to implant a spinal cord stimulator aimed at reducing lingering pain from the injury. In October of that year, she underwent a second outpatient procedure at the Newport Beach Headache and Pain Institute to reposition the stimulator's epidural lead.

A nurse from Coram, which was assigned to manage Ms. Pritchard's at-home follow-up care, hooked her up to a Baxter 6060 morphine pump in recovery at about 12:35 p.m. She was discharged that afternoon with physician's orders of twice-daily nurse visits for 7 days post-op.

Ms. Pritchard allegedly activated the pump's bolus dose 6 times between the time it was hooked up and 4 p.m., according to court documents. This caused the pump to lock out twice, which denied her doses of morphine above the prescribed amount. She reportedly took oral prescription medications from 2 bottles, snacked, talked on the phone and took a nap sometime after 4 p.m.

Her mother called Coram to ask when the visiting nurse would drop by that evening. A company representative advised her to rouse her sleeping daughter and said a nurse would arrive at approximately 10 p.m.

While Ms. Pritchard's mother did not raise any concerns during that conversation, she called 911 shortly before 8 p.m. when she could not wake her daughter. Paramedics arrived, found Ms. Pritchard unconscious and administered the morphine reversal agent Narcan. Transported to the local hospital, Ms. Pritchard was diagnosed with "hypoxic encephalopathy, a brain injury, secondary to morphine drip," court records state.

Ms. Pritchard filed lawsuits for product liability, negligence and medical malpractice against Coram, Baxter Healthcare Corporation, her physician and the Newport Beach Headache and Pain Institute. In March 2008, she settled with Newport Beach Headache and Pain Institute for an undisclosed amount, with Baxter for approximately $2 million and with her physician for $800,000.

A trial against Coram began in October 2008. The nursing agency suggested that Ms. Pritchard's brain injury was caused by her use of unauthorized drugs and alluded to her alleged stockpile of Vicodin and an accidental overdose in 2002. The firm also contended that a home nursing visit was not required until the day following her surgery since a Coram nurse cared for her at the time of discharge, and claimed its policies permit initial assessments to be conducted over the telephone in these instances. Coram also claimed it sent the pain pump used by Ms. Pritchard to Baxter and independent contractor Medical Specialties Distributor for routine maintenance.

The jury, however, awarded Ms. Pritchard approximately $9.9 million in damages, according to her attorney, Kenneth Sigelman, including a payment schedule to cover future costs of medical care through the year 2053. While Coram appealed the ruling, arguing that Ms. Pritchard's case lacked evidence linking the company's actions to her injuries and that the court erred by including some physician's testimonies, an appeals court rejected its case late last month.

Attorneys for Coram did not immediately return calls seeking comment.

Daniel Cook