This article is about the young mother patient in the Season 2 episode The Mistake. For the newborn in the episode Unplanned Parenthood, see Kayla. For the asexual patient in the episode Better Half, see Kayla (wife)
Kayla is helping at her daughters Dory and Nikki's talent show. She is fixing a tear in one of her daughters dresses, one of them tells her to hurry up. Kayla asks her what it is that she is so worried about, the girls tell Kayla that a girl named Sally is going to make fun of them because her mom bought her a dress at some fancy clothes store named Bloomingdale's, and Kayla had to make their dresses. Kayla reminds them of a song that they were listening to the other night-"Respect" by Aretha Franklin-She tells them that Aretha didn't have much money growing up in Detroit, but now she is one of the best singers ever. She tells her that if Sally's mean to them again, she will key her daddy's new convertible, but of course Dorie and Nikki don't know what that means. Kayla's daughters Dorie and Nikki start singing their song on stage, it appears to be going well. Kayla is in the audience watching her daughters, Kayla starts sweating and takes some pills, but starts screaming in agony with stomach pain.
The next morning, Kayla goes to the clinic at Princeton-Plainsboro with multiple joint and stomach pain. Dr. Foreman was called in for a neurological consult. He does tests to check Kayla's cerebral coordination. Kayla's brother is there complaining about how long Kayla had to wait to see a doctor. Dr. Foreman reminds them it would have been a better idea to come into the emergency room the previous night, but the brother says that it was impossible for her to find someone to take care of her daughters. Foreman finds out that there is some uveitis - the iris of her eye is inflamed, which in the worst case can mean blindness. However was enough to get Dr. House interested in the case.
Dr. Cameron thinks that gonorrhea is a possibility. Dr. Foreman thinksthat it's polyarticular, so it may be RA. Dr. Cameron reminds him that RA normally hits small joints but this has affected her knee. Dr. Foreman suggests Takayasu's arteritis. Dr. House tells his team to get a sed rate and serologies. Dr. Cameron says that it might not just be her arteries but it could be all her blood vessels, which would mean vasculitis. Dr. Chase feels that stomach pain indicates Behcet's disease, in which Kayla would have oral or genital sores. House tells Dr. Chase to check for them as punishment for spilling his Vicodin.
While Chase is examining her, Kayla tells him that she hates hospitals. Dr. Chase tells her that when he was twelve he had his tonsils removed, and he got to skip school, got lots of ice cream and it made him want to be a doctor. Kayla tells Dr. Chase that her mom died when she was eight so she spent months at Princeton General befor her mom died of delerium tremens. Dr. Chase told her about his own family history with an alcoholic. Kayla had some ulceration that seemed to confirm Behcet's. Chase gave her some prednisone, an antacid and he ran a pathogen test on her arm that takes twenty-four hours to confirm. He also told her that any doctor could check it.
However, Kayla showed up without an appointment the next day to see Dr. Chase. Without even going into an exam room, Dr. Chase tells Kayla that the pathology test is positive for Behcet's. He tells her to go see Nurse Previn to get an appointment with Dr. Brustin in rheumatology. Chase tells her that Behcet's is very treatable and that she is going to be fine. Kayla then told Dr. Chase that she took the medicine he gave her but her stomach still hurt. Dr. Chase tells her that it could be stronger than they thought or it could be acid reflux from the prednisone. He prescribed her a stronger antacid. As she is leaving, she is about to ask Chase something but she decides not to, and Dr. Chase didn't ask her anything more about the stomach pain.
Dr. Chase later figured out that as she was leaving she was going to tell him about blood in her stool, which could indicate a bleeding gastric ulcer. He called her an hour after she left the clinic. However, the paramedics brought her in claiming that she was vomiting massive amounts of blood. The paramedics tell Chase that it must be a bleeding ulcer, Dr. Chase uses an endoscope to look for it. He finds bubbling that's just a bad ulcer. Dr. Foreman tells him to use some more saline. He cauterizes it, but her blood pressure drops just as Dr. House arrives. He tells Dr. Chase to look at the stomach again. Dr. Chase looks again and finds another ulcer, which has perforated. They rush her to an operating room. The surgeon managed to suture the perforation, but part of her stomach contents had leaked into her bloodstream, causing sepsis and the infection further lowered her blood pressure, damaging her liver and kidneys.
Dr. House didn't believe Dr. Chase when he said the patient was fine two hours before as an ulcer that bad would have been symptomatic. He asked if the patient had complained of stomach pain and, when Dr. Chase confirmed she had, he asked whether he had done a full examination. When Dr. Chase said it was only a follow-up visit and the patient didn't tell her about any blood, he admonished Dr. Chase for failure to ask whether the patient had diarrhea or blood in the stool - routine questions that would have caught the ulcer in time. Dr. Chase said it was only a small mistake, but Dr. House corrected him - mistakes are as important as their consequences.
Dr. Cameron tells Kayla's brother that the kidney damage isn't so bad, but the liver damage is more worrisome because there's no dialysis for livers. The brother asks if Kayla loses a liver she can get a transplant. Dr. Chase says that they can put her on a list, but Kayla's brother asks if he could give her some of his liver. Dr. Cameron tells him that the surgeons won't operate unless the donor has had a long time to weigh the decision. The brother says that he could get a liver from the black-market. Suddenly, Kayla starts having constant stomach pain and Dr. Chase finds a clot on the ultrasound monitor. Dr. Cameron tells the nurse to call the operating room and prepare her for an embolectomy. Dr. Chase orders a CBC, PT and liver panel
Dr. House applied for a transplant, but Dr. Cuddy refused saying they can't list a woman that sick, particularly when she also has vasulitis and kidney damage. House convinces Cuddy to get her the on the list by saying that if the family sues because Dr. Chase forgot to ask a standard question about stomach pain the hospital will sued for so much it will be turned into condos and many other sick people will die waiting outside the condos for medical care. Dr. Cuddy approved it, but there were no livers immediately available.
Kayla was moved to the top of the liver transplant list but her blood type, AB negative, is very rare and she was unlikely to get a donor. Kayla's brother asks how long she can live for, and Dr. Foreman tells him probably another day or two. The brother tells them that he is donating his liver, he says that he is a perfect match. Dr. Foreman asks how he got checked out so fast. The brother tells him that he knows a guy in medical testing and he paid him to rush it. There is still the issue of the fact that no transplant surgeon will do the surgery until the donor has had time to weigh the decision. But House goes to Dr. Ayersman and attempts to bribe him with $20,000, but Ayersman makes $600,000 a year so he doesn't really need it. He was also worried about lowering his success percentage. Dr. House then tells Ayersman that he knows that he is cheating on his wife and sleeping with series of nurses, most recently Nurse Cutler in radiology. Dr. Ayersman agrees to do the transplant. Dr. House tells him that he is the worst transplant surgeon in the hospital, but he is the only one who is currently cheating on his wife. Because the brother had rushed his tests they were able to get him and Kayla into surgery that afternoon. Dr. Ayersman performed the live-donor transplant. He resected the right lobe, hepatic vein and hepatic artery of the brother's liver, and transplanted it into Kayla. The operation was a success.
Kayla and Sam continued to receive routine care. Two months later, July 24, she came back for an exam. While Chase was giving her the exam he asks how her daughters are. Kayla tells him that Dory had her first crush which was cute, and then her first sort of break-up which was not so cute. Kayla's temperature was 99.3F. Dr. Chase asks if she's been coughing, Kayla tells him no. Dr. Chase asks if it hurts to urinate, Kayla says no. Dr. Chase tells her that immunosuppressants block fever so she shouldn't have one at all. He orders a chest x-ray. She spiked a higher fever an hour later, and her AST and ALT were up, showing that she was rejecting the liver. Dr. Chase thinks that it's just an infection. One of her blood cultures is growing out streptococcus, she's dehydrated and her hematocrit is much higher than normal. He explains the high transaminase readings on stress. The brother comes in looking for Dr. House, asking why he hasn't seen his sister. Dr. Chase tells him that they're talking about her right now. The brother thinks that it could be hep B or hep C and if they give her interferon then she will be okay. Dr. House asks why he knows so much about hepatitis and notices the brother is flushed. He wonders why the brother is hiding the fact he's sick. He notices the brother has a tattoo and asks if he has had hep C for a long time. The brother admits it, but says it hasn't been active in years. Dr. Foreman realizes that he paid the lab tech to say that he was clean because they would not have approved a transplant from a hepatitis patient due to the risk of infection. Dr. House tells his team to get an MRI for the brother and Kayla. Dr. House tells Sam that he thinks she got cancer from him.
The brother had an undiagnosed hepatoma, part of which was transplanted into Kayla. It developed much faster in her because she was immunosuppressed. Dr. House had realized the hepatitis had caused liver cancer because although high hematocrit usually only means dehydration, it occasionally indicates cancer. They were able to operate on the brother before it mestastizied. Kayla had already started rejecting the liver and they couldn't give her another transplant because of the cancer.
However, before she checked out, her brother found her a second liver off the black market. There was a doctor in Mexico City who was going to do the surgery. Dr. Foreman and Dr. Cameron convince Dr. Chase to go into Kayla's room and "be the good guy". Dr. Chase admits to Kayla that he made a mistake; he wasn't as blunt as he should have been about her odds of surviving the second transplant. Dr. Chase tells her that the stress of the travel, the operation and even then, the cancer will make it unlikely that she will survive. He tells Kayla that his dad died of lung cancer, and although he saw him a couple of months before it happened, they never talked about it. Dr. Chase didn't even know until his father was dead. He warns her that she is going to die alone thousands of miles away from her children. Kayla is convinced not to go ahead with the operation. Her brother reminds her that if she goes home than that means he killed her. But Kayla reminds him that he gave her three more months and when they found her cancer, they found his.
A week later Kayla died at home.
A few months later, Dr. Chase was sued for Kayla's death. He recounts the story of what happened to Kayla to Stacy. The brother sued because Chase told him that he had a hangover on the night he forgot to ask the question and that was why he made the mistake. However, Dr. House instead found out that Dr. Chase was depressed and distracted because his stepmother had just called him about the death of his father.
Dr. Chase and Dr. House were both disciplined over the case by the hospital's ad hoc committee. Dr. Chase had his hospital privileges suspended for a week due to the mitigating circumstances surrounding his father's death, and Dr. House was required to be supervised by another doctor for a minimum of one month for allegations of blackmail and failure to meet with patients. Dr. Cuddy appointed Dr. Foreman as Dr. House's supervisor.