1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

IN THE UNITED STATES DISTRICT COURT

DISTRICT OF ARIZONA, TUCSON DIVISION

MANUEL CUEN, as surviving son of ARMIDA 

HERRERA; C.C., a minor, by and through his 

next friend, ADELA HERRERA; V.C., a minor, 

by and through her next friend, RIGOBERTO 

CAMPOY,

Plaintiffs,

vs.

UNITED STATES OF AMERICA

Defendants.

Case No.: 

COMPLAINT 

(Wrongful Death-Medical 

Malpractice) 

Assigned: Hon. 

Plaintiffs, by and through their counsel undersigned, for their cause of

action, allege as follows:

1. At all times material hereto, plaintiffs MANUEL CUEN, C.C, a 

minor, and V.C., a minor, were residents of Pima County, Arizona. 

2. Plaintiffs are the natural children of Armida Herrera, deceased.

LOUIS HOLLINGSWORTH, SB #011534 / PCC #26935

MICHAEL F. KELLY, SB #022911 / PCC #65747

lhollingsworth@hollingsworthkelly.com

mkelly@hollingsworthkelly.com

 THE MARKAM GROUP, INC., P.S.

421 W. RIVERSIDE, SUITE 1060

 SPOKANE, WASHINGTON 99201

509.747.0902

 FAX: 509.747.1993

MARK D. KAMITOMO, SB #031768

Mark@markamgrp.com

ATTORNEYS FOR PLAINTIFFS

-1-

Case 4:15-cv-00512-RCC Document 1 Filed 10/28/15 Page 1 of 9
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

3. All events described herein occurred in Pima County, Arizona.

4. At all times material hereto, based on information and belief,

defendant UNITED STATES OF AMERICA was acting by and through its 

agent, J. MANUEL ARREGUIN, M.D. (“ARREGUIN”), a physician practicing 

medicine in Pima County, Arizona and deemed to be a federal employee for the 

purposes of 42 U.S.C. § 233(c) and 28 U.S.C. § 2679(d).

5. This Court has jurisdiction over the parties pursuant to 28 U.S.C. 

§1346(b).

6. Plaintiffs allege that they have exhausted all of their administrative 

remedies and have satisfied the claim and notice requirements of the Federal 

Tort Claims Act.

7. Venue is proper in the United States District Court of Arizona, 

Tucson Division, as all parties are located in Pima County.

8. On or about January 4, 2013 through January 12, 2013, defendant 

provided medical services to Armida Herrera through its employee/agent DR. 

ARREGUIN as follows:

9. On January 4, 2013 around 12:57 p.m., Armida Herrera (mother to 

plaintiffs Cuen, C.C. and V.C.), age 35 years old, presented to Tucson Medical 

Center emergency room nine days postpartum due to vaginal bleeding. 

Approximately half an hour prior to her admission to the emergency room, Ms. 

Herrera went to the bathroom and while using the bathroom, she experienced 

-2-

Case 4:15-cv-00512-RCC Document 1 Filed 10/28/15 Page 2 of 9
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

vaginal bleeding sufficient to fill the toilet with blood. She called 911, and EMTs 

estimated her blood loss at that time to be about a pint.

10. Upon arrival in the emergency room, Ms. Herrera was described as 

“cool and clammy” and was complaining of abdominal pain. At, or around 1:02 

p.m. the physician noted the following:

a. Her uterus was contracted, hard, and at the level of the umbilicus.

b. She was also noted to have moderate to severe abdominal pain and 

tenderness in the mid-lower abdomen without evidence of rebound.

At or around 1:29 p.m. Ms. Herrera’s condition was described as one that

did not “warrant continuous monitoring” in the ER. At, or around 1:40 p.m., Ms. 

Herrera was described as follows:

a. Calm and cooperative;

b. Ability to rise in a single moment;

c. No loss of balance with steps;

d. Cramping pain (10/10).

At or around 1:20 p.m. an intravenous line was started. At or around 1:46 

p.m. Ms. Herrera was given morphine in a dose of 4.0 mg IV and Zofran 4.0 mg 

IV. At some time after 2:00 p.m. Ms. Herrera was taken to radiology for an 

ultrasound examination. At or around 2:52 p.m. the following was documented:

a. Her fundus was at the umbilicus;

b. The cervix appeared stenotic:

-3-

Case 4:15-cv-00512-RCC Document 1 Filed 10/28/15 Page 3 of 9
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

c. Evidence of bright red blood from the vagina;

d. Recommended that she be taken to the operating room;

e. Dr. Arreguin was on call for the group and would do surgery;

f. Clots coming from cervix;

g. His diagnosis was hematometra and anemia from blood loss.

Dr. Arreguin was timely informed of these findings yet failed to timely 

evaluate Ms. Herrera. At or around 3:08 p.m. the ultrasound results were as 

follows:

a. Uterus enlarged and 20 cm in length;

b. Myometrium was thinner than expected for the patient’s clinical 

presentation [<2 cm];

c. Endometrial canal was filled with a large amount of amorphous 

material measuring 8 cm- most likely a large hematoma;

d. Findings were consistent with a large hematoma within the endometrial 

canal;

e. The findings were discussed with Dr. Ottman at 3:15 p.m.

At or around 3:12 p.m. Ms. Herrera stated that she would like more pain 

medications. At or around 3:13 p.m. Ms. Herrera was given morphine 4.0 IV for 

pain. At or around 3:16 p.m. a telephone call with Radiology where radiology 

reported that Ms. Herrera’s uterus was larger than average and that she had a 

-4-

Case 4:15-cv-00512-RCC Document 1 Filed 10/28/15 Page 4 of 9
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

hematoma. She was given a 3rd dose of morphine 4.0 mg IV at, or around 3:17 

p.m.

Dr. Arreguin called at or around 3:37 p.m. and said that he would come 

and see the patient and that she should be admitted to the hospital under him so 

that he could perform a D&C (dilation and curettage) procedure, however Dr. 

Arreguin deviated from the accepted standard of obstetrical care by delaying his 

evaluation of Ms. Herrera until 5:45pm (an additional 2 hours and 8 minutes).

At or around 5:45 p.m. Dr. Ottman ordered that Ms. Herrera be typed and 

screened for 2 units of blood and that a coagulation profile be obtained. Ms. 

Herrera was already demonstrating signs consistent with hypovolemia (low 

blood volume) and her blood studies indicated an abnormal PT (prothrombin 

time) and an abnormal fibrinogen. Despite Ms. Herrera’s high risk clinical 

condition and her increased risk for extensive hemorrhage, as exemplified by 

her “large intrauterine hemorrhage,” her enlarged uterus, and abnormal blood 

studies, Dr. Arreguin further delayed the surgical management of Ms. Herrera’s 

hematometra. This delay was a violation of the standard of care.

At or around 8:10 p.m. RN Harden documented the following: Ms. 

Herrera’s boyfriend came to say that Ms. Herrera had agonal breathing; the 

patient’s color was poor; Dr. Ottman said that patient was possibly having 

seizures; patient was placed on a nonrebreathing mask at 15 L/min; patient was 

breathing on her own.

-5-

Case 4:15-cv-00512-RCC Document 1 Filed 10/28/15 Page 5 of 9
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

As a result of Dr. Arreguin’s failure to timely evaluate and treat Armida 

Herrera’s hematometra, she sustained a cardiac arrest at or around 8:12 p.m., a 

code was called, and RN Jones documented the following: Increased bleeding; 

patient nonresponsive; face/lips/conjunctiva – pale; patient hooked up to 

defibrillator pads and connected to monitor. Ms. Herrera was intubated and 

defibrillated due to ventricular fibrillation at, or around 8:16 p.m. At, or around 

8:24 p.m. she was placed on a ventilator.

At, or around 10:00 p.m., after it was too late, Ms. Herrera was finally 

taken to the operating room and at 10:10 p.m. Dr. Arreguin and Dr. Gaziano 

began surgery. At, or around 10:59 p.m. a total abdominal hysterectomy was 

started. Ms. Herrera never regained consciousness and died 8 days later.

Dr. Arreguin fell below the standard of care in care, treatment and 

evaluation of Armida Herrera including, but not limited to, his delay in taking her 

to surgery, which should have occurred immediately upon learning of her 

abnormal presentation. Earlier medical including surgical management by Dr. 

Arreguin would have prevented Armida Herrera’s death. An autopsy performed 

January 16, 2013 demonstrated the following:

a. History of massive uterine hemorrhage and hematometra with D & C 

and subsequent abdominal hysterectomy;

b. Diffuse hypoxic ischemic encephalopathy;

c. Infarcts in the basal ganglia and cerebellum;

-6-

Case 4:15-cv-00512-RCC Document 1 Filed 10/28/15 Page 6 of 9
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

d. Mild acute pancreatitis;

e. Hepatic congestion;

f. Acute myocardial infarction-posterior septal;

g. Right fallopian tubal abscess with E. Coli and Enterococcus;

h. Diffuse peritonitis;

i. Acute bronchopneumonia;

j. E. Coli sepsis.

11. At all times material hereto, defendant UNITED STATES OF 

AMERICA and DR. ARREGUIN held out to the public, and in particular, Armida 

Herrera, that they were equipped, qualified, and prepared to receive the public, 

and in particular, Armida Herrera, for treatment and care, and that they 

employed and maintained skilled and competent physicians, nurses, and, in 

general, competent help otherwise in the conduct and operation of said health 

care provider facilities.

12. At all times material hereto, defendant UNITED STATES OF 

AMERICA and DR. ARREGUIN had a duty to provide Armida Herrera with the 

services of competent, qualified, and licensed health care providers, to properly 

diagnose her conditions, to render competent advice and assistance in the care 

and treatment of her health, and to properly and timely perform medical or 

surgical procedures and to render the same in accordance with the standards 

-7-

Case 4:15-cv-00512-RCC Document 1 Filed 10/28/15 Page 7 of 9
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

of care in the community. Armida Herrera relied upon defendant’s covenant to 

provide competent care.

13. Armida Herrera suffered injuries and death as a direct and 

proximate result of the negligence and medical malpractice of defendant

UNITED STATES OF AMERICA through its employee/agent DR. ARREGUIN.

14. The actions, omissions and failures of DR. ARREGUIN and 

defendant UNITED STATES OF AMERICA in their medical care and treatment 

of Armida Herrera constitute medical malpractice as defined by A.R.S. § 12-

561.

15. Plaintiffs suffered loss of normal care, comfort and companionship 

of their mother, Armida Herrera, mental and emotional anguish, pain, grief and 

sorrow; and loss of past and future financial support, benefit and services which 

might reasonably have been expected from decedent.

WHEREFORE, in view of the foregoing, plaintiffs pray for judgment 

against defendant as follows:

1. For compensatory damages as and for the costs incurred for 

funeral and burial expenses as a result of the death of Armida Herrera; for loss 

of love, affection, companionship, care, protection, grief, sorrow, anguish, 

stress and mental and emotional suffering already experienced in the past and 

to be experienced in the future; for past and future economic loss; and for past 

and future loss of earnings of Armida Herrera in a fair and reasonable amount; 

-8-

Case 4:15-cv-00512-RCC Document 1 Filed 10/28/15 Page 8 of 9
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

2. For all costs incurred herein; and

3. For such other and further relief as the Court deems just and 

proper.

DATED this 28rd day of October, 2015.

 HOLLINGSWORTH KELLY, PLLC

By: /s/ Michael F. Kelly_____________ 

Louis Hollingsworth

Michael F. Kelly

John F. Kelly

Mark D. Kamitomo

3501 N. Campbell Ave. Ste. 104

Tucson, AZ 85716

(520) 882-8080

lhollingsworth@hollingsworthkelly.com

mkelly@hollingsworthkelly.com

jkelly@hollingsworthkelly.com

421 W. Riverside Ave. #1060

Spokane, WA 99201

(509) 747-0902

mark@markamgrp.com

Attorneys for Plaintiff

-9-

Case 4:15-cv-00512-RCC Document 1 Filed 10/28/15 Page 9 of 9