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Wrongful Death. Clifford Kaltenbach vs. the St. Charles County Ambulance District. Filed Feb. 4; settled for $50,000 three weeks later.

I was at the St. Charles County courthouse Tuesday checking to see who's suing our governmental agencies and who they're suing. This lawsuit certainly grabbed my attention.

What happened? How did it get settled so quickly?

What I've learned is that the ambulance district, to its credit, was up front in immediately telling the plaintiff, Mr. Kaltenbach, that his wife of 61 years suffered a broken arm while being rushed to the hospital following a heart attack Aug. 10, 2009.

"The driver told me the minute I got into the emergency room," says Mr. Kaltenbach, who lives off Birdie Hills Road near St. Peters. "He apologized."

That often is not the case in matters like this, says Jeff Roseman, the St. Charles attorney who represented Kaltenbach.

"More often than not a defendant and the people at the medical facility try to hide the fact that something happened," he says.

But how did a broken arm become a wrongful-death lawsuit?

Because Violet Kaltenbach, 80 years old, died 20 days after the accident.

And, significantly, the St. Charles County chief medical examiner, Dr. Mary Case, determined the "immediate cause" of Mrs. Kaltenbach's death was the broken arm. That injury, according to the death certificate, complicated Mrs. Kaltenbach's other considerable health problems, including leukemia and heart disease.

Her husband says she also was in the early stages of Alzheimer's.

The fractured bones were never re-set, Kaltenbach says, because his wife was too feeble to undergo surgery. As a result, he says, she lived her final days in pain.

I've tried to piece together what happened to Mrs. Kaltenbach by talking to both sides. In addition, I looked at court records and obtained a copy of an accident report compiled by the Missouri State Highway Patrol five months after the incident.

Mrs. Kaltenbach did not want to go into the ambulance after suffering a heart attack at home. Once in the ambulance she removed an IV from her arm.

The ambulance was eastbound on Interstate 70, near Cave Springs, en route to St. Luke's Hospital. Its emergency lights were on.

At 8:45 p.m., an unknown vehicle cut in front of the ambulance, and the ambulance driver had to slam on the brakes at the moment the medic in the back was holding Mrs. Kaltenbach's arm in an attempt to start another IV.

The driver avoided a collision, but in burying the brakes not only was Mrs. Kaltenbach's arm broken, but the 41-year-old medic suffered a torn rotator cuff and would be off work for the next four months.

The only major point of disagreement is that Kaltenbach and his lawyer say Mrs. Kaltenbach was tossed off the stretcher.

"She told me that she fell," Kaltenbach says.

Martin Limpert, district spokesman, says she did not.

Regardless, says Roseman, patients shouldn't have to worry about being tossed about and injured en route to the hospital in an ambulance.

"It was our allegation that the ambulance was not under control and they did not have Mrs. Kaltenbach restrained at the time," Roseman says.

Kaltenbach, an 83-year-old World War II veteran, says he does not blame the driver or medic and is not bitter.

"I got nothing against the ambulance district," he says. In fact, he initially wasn't sure he wanted to talk about the matter because he didn't want anyone to fear calling the district in an emergency.

Kaltenbach said it was bad timing that the driver had to hit the brakes at the moment the medic was holding his wife's arm.

Roseman says he primarily dealt with the attorney representing the district's insurance carrier. The cap on damages for medical malpractice is $350,000.

The $50,000 settlement reflects several factors, Roseman says: concern a jury might see the matter as a case of a broken arm and not a wrongful death; Mrs. Kaltenbach had many health problems; she did not lose wages; and her medical expenses were not huge.

In addition, there was concern over the up-front cost of going to trial, as well as the health of Mr. Kaltenbach, who suffered a heart attack in 2004. He had been caring for his wife in their home.

"She took care of me when I was sick, and I took care of her when she was sick," he says. His daughter, who works full time, also lives in the home.

Of the $50,000 settlement, $25,737 went to Kaltenbach; $16,958 to his lawyer; and $7,305 to reimburse Medicare.

Bryan Kaemmerer, the ambulance district's attorney, says his client did not admit liability in settling the lawsuit. The district settled on the advice of the lawyer for the insurance carrier. A trial could easily have cost $100,000 in legal fees, Kaemmerer says.

The insurance carrier and Kaltenbach agreed to a settlement of $50,000 before the lawsuit was even filed.

The reason the case is a public record is that all wrongful-death settlements must be approved by a judge.

Limpert says that from the district's perspective the legal summary — wrongful death lawsuit settled by the district for $50,000 — looks far worse than what actually happened.

"People see that and they think, 'Oh my God! What did they do to kill that poor woman?'" he says.

Nevertheless, he says, "It was unfortunate. It's a shame."

Steve Pokin is a columnist for the Suburban Journals. He can be reached at or by phone at 314-821-1110, ext. 704. His column is on Facebook at