Emergency Medicine Malpractice, Failure to Diagnose Malpractice, Dental Malpractice, Anesthesiology Malpractice
Cases compiled fromwww.verdictslaska.com; Editorials by Rose Clifford, RN, editor
© The Medical-Legal News 2007
• Defense verdict: A female plaintiff, age 40, was 27 weeks pregnant when she went into premature labor. She was admitted to a hospital where her doctor attempted to stop her labor. The fetus suffered cardiac decelerations and an emergency c-section was warranted. The on-call anesthesiologist decided to use spinal anesthesia for the procedure. Under the anesthesia, the mother became hypotensive and went into respiratory arrest. She was resuscitated and intubated. The baby was delivered safely, but the plaintive spent the next few days in intensive care. The plaintiff claimed that she developed short-term memory deficits. The plaintiff also claimed that the respiratory arrest was caused by the spinal anesthesia, which was inappropriate because of a fluid overload in the plaintiff’s lungs. The defendant claimed that the mother was a high-risk patient because of her premature labor and age, and the fact that she was obese, diabetic, had a history of smoking and had a short neck. Johntee and Johntee v. Jefferson, Los Angeles . Defense experts: Dr. Julian Gold, Dr. Michael Gold, Dr. David Paster.
RC: Based on the facts reported, the defense verdict seemed most likely because spinal anesthesia is an appropriate choice in a high risk patient, respiratory arrest is a known risk of spinal anesthesia, the respiratory arrest was immediately recognized and treated appropriately. As a result the plaintiff suffered no permanent damages.
• Plaintiff verdict: $1 million. Beginning in 1997 the plaintiff’s decedent began to have occasional periods of severe pain in his chest, neck and arms. Over time, these incidents increased in severity and in 1999 the decedent visited a cardiologist, Dr. David L. Williams.
A stress test was administered, which the decedent failed. No follow-up was ordered. The decedent’s pain attacks did not stop and a few months later he returned to the same doctor. He underwent a cardiac catheterization that revealed a 50 percent stenosis of the left anterior descending artery. The doctor, however, did not tell the decedent that his pain was cardiac in origin. Five years later, in 2004, while playing tennis, the decedent had nausea, tightness in his chest and pain radiating down his left arm. He blacked out and CPR was administered. The same cardiologist saw the decedent and diagnosed vasovagal syncope. The decedent died a few months later from an MI. The plaintiff maintained that tests and a better evaluation should have been done in 2004. Nyberg v. Williams, et al. Volusia Co., Fla. Plaintiff expert: Dr. Neil J. Freeman.
RC: Based on the medical sequence of events and resulting test results it seems unlikely that a prudent cardiologist would not have performed an adequate work-up and reasonably diagnosed a cardiac problem. As a result of his failure to perform an adequate cardiac work-up the patient died.
• Plaintiff verdict: $1.8 million. An elderly gentleman underwent a successful triple coronary artery bypass. The next day he developed an atrial fibrillation. The plaintiff converted and remained in normal sinus rhythm for 24 hours and was discharged three days later. About three days after discharge the plaintiff suffered a massive stroke, which has left him permanently partially paralyzed. He needs 24-hour care, suffers from dementia, depression and mobility problems. Bergeron v. Dartmouth-Hitchcock Clinic, Merrimack Co., N.H. Plaintiff expert: Dr. Ralph Hutchings.
RC: The plaintiff allegation of premature discharge and physician failure to prescribe appropriate medication to prevent stroke seemed reasonable, and except for the malpractice, was preventable.
• Plaintiff arbitration award: $300,000. A 60-year-old woman had been seeing her family dentist since the 1960s. Over the years the woman had developed chronic progressing periodontitis, but the defendant dentist never told her, treated the disease nor referred her out for treatment. The defendant never took full mouth X-rays nor probed for pocketing depth or bone loss. In 2003 the plaintiff visited another dentist and it was determined that all of her upper teeth would have to be extracted. The defendant claimed that he did refer the plaintiff to specialists, that she was noncompliant and that the plaintiff had poor oral hygiene. Tice v. Heald, Washtenaw Co., Mich.
RC: The common defense of plaintiff noncompliance does not overshadow facts of evident failure over decades to take X-rays, treat a progressive disease or refer to a specialist.
FAILURE TO DIAGNOSE
• Plaintiff settlement: $400,000. A 13-year-old child suffered repeat headaches. In 2002 while at a camp the child’s vision became distorted and she suffered from severe headaches. She died the next day. She died as a result of a brain bleed caused by an undiagnosed aneurysm or other venous malformation. The plaintiffs claimed that the physician failed to properly assess, manage or investigate the headaches. The plaintiff further claimed that a neurological exam and MRI or CT scans could have detected the condition. The defendant, Dr. Keith Staiman, claimed he had done neurological exams and scans, but that they would not necessarily have detected the condition. The doctor also claimed that the condition may not have been treatable, and that the headaches were episodic in nature. Blumenthal v. Staiman, et al. Nassau Co., N.Y. Plaintiff expert: Dr. Allan Hausknecht.
RC: Defense claims of having performed a neurological examination and that not ordering an MRI or CT scan because they would not have necessarily detected the condition does not seem reasonable in view of the death.
• Plaintiff settlement: $6.9 million. A 19-year-old woman was hit by a motor vehicle. She was transported to a hospital and reported that she had severe pain in her lower back. On the third day of her hospitalization she became paraplegic. The plaintiff claimed that she sustained fractures of the lower back which were not diagnosed despite her complaints of severe low back pain. The plaintiff is wheelchair bound and suffers from incontinence. The defendants claimed that the paraplegia was caused by the auto accident and that earlier treatment would not have prevented it. Orlowski v. New York City Health and Hospitals Corp., et al. Queens Co., N.Y. Plaintiff experts: Dr. Jonathan Vapnek, Dr. Jeffrey S. Kaplan, Dr. Dr. Robert Goldberg, Dr. Thomas Kolb, Dr. Marc Salzberg, Dr. Alain Lotbiniere, Dr. Jack Stern.
RC: Defense claims of paraplegia resulting from the initial trauma seems unlikely in view of a three-day hospital stay after being struck by the motor vehicle where there were complaints of severe low back pain and no evidence of paraplegia. Failure to diagnose compression fracture of the thoracic spine seems a more likely cause of damage.
• Plaintiff settlement: $650,000. A woman went to a hospital with complaints of shoulder and neck pain after an auto wreck. X-rays were taken and were deemed to be normal by the ER doctor. The next day the X-rays were read by a radiologist who reported an emerging lung nodule. The radiologist noted that an evaluation should be done to include full AP and lateral chest films. A copy of this report was sent to the woman’s primary doctor who saw her two weeks later. The doctor failed to order any X-rays or other studies. The woman returned to her doctor on several occasions over the course of several months, but no studies were performed. The woman died of lung cancer about two years after her original X-ray. The plaintiffs argued that there was a failure of communication, and the fact that the decedent lived for two years indicated that she could have been successfully treated. The defense claimed that the lung cancer was already too far advanced at the time of the initial X-ray. Anonymous v. Anonymous, Essex Co.,Mass.
RC: The defendant doctor failed to follow up on the radiologist’s recommendation for additional chest X-rays when he noted an emerging lung nodule on routine X-rays.
• Plaintiff settlement: $4.35 million. A nine-year-old boy began having repeated seizures and fainting spells. After various doctor visits he was always sent home without any cardiac tests. He had a massive heart attack and suffered brain damage from a lack of oxygen. The plaintiff will be bedridden for the rest of his life. The child was deaf and autistic, and the defendants claimed that the child’s disease was so very rare that it was impossible to diagnose, and that the plaintiff’s inability to communicate his condition contributed to the failed diagnosis. John Doe v. Anonymous Healthcare System, Alameda Co., Calif.
RC: Taking a history from an autistic child who cannot hear is next to impossible — all the more reason why a responsible doctor would order cardiac tests.
• Plaintiff settlement: $1.15 million. A 54-year-old woman went to her doctor in 2002, 2003 and 2004 for her annual mammograms. In her 2002 mammogram there was evidence of radiographic changes near the areola of a breast. No biopsy was ordered. In 2003 the annual mammogram showed increased densities again. They were classified as benign calcifications by a radiologist. Again, no biopsy was ordered. In 2004 the plaintiff found a lump during a self exam. Her doctor performed a biopsy which revealed an aggressive malignant tumor. The cancer by this time had spread to her lungs, liver and chest. The defendants asserted that the interpretations of the 2002 and 2003 mammograms were reasonable, and that no biopsy was warranted. Jane Doe. v. John Roe [Doe?], San Francisco Co., Calif. Plaintiff expert: Dr. Frederick R. Margolin.
RC: The plaintiff allegations were failure to properly interpret the mammograms, failure to perform breast biopsy and failure to diagnosis breast cancer. Radiographically, there appeared to be progressive changes.
Plaintiff settlement: $115,499. A woman visited a medical center with a rosacea condition on her cheek. The woman was seated in a special chair wearing special goggles. A nurse then began treating her skin with a new laser device. The woman began to complain that she felt a hot sensation. The nurse continued to use the laser in spite of repeated complaints from the patient of extreme heat. The plaintiff sustained second-degree burns and scars because of hot water leaking from the device. The defendant doctor and medical group insisted that the device’s manufacturer was at fault. The laser manufacturer insisted that its equipment was in good order. The plaintiffs argued that her treatment should have ceased after her initial complaints of pain. A settlement was reached with the manufacturer paying $85,500 and the doctor and his group paying $29,999. Anonymous plaintiff, defendant and device manufacturer, Los Angeles .
RC: The nurse should have stopped the procedure after the first complaint of extremely hot sensation and investigated the potential cause of pain.
Plaintiff verdict: $684,800: A woman, age 26, presented to a hospital complaining of vaginal bleeding. The woman was not complaining of pain, and no fetal heart tones were detected. An ultrasound revealed an empty uterus, and the patient was discharged with instructions to see her OB/GYN in a few days. Before her scheduled doctor visit, the woman went to the ER of another hospital complaining of abdominal pain. A urine test showed that she was pregnant. She was given instructions to see her doctor the next day. The woman was found dead in her apartment later in the day due to bleeding from a ruptured ectopic pregnancy.Walker and Strange v. Hawkins, et al, Jefferson Co.,Texas . Plaintiff experts: Dr. Joseph DeRosiers, Dr. Ira Mickelson.
RC: The emergency room doctors failed to diagnose the ectopic pregnancy and treat appropriately, resulting in the woman’s death.
• Plaintiff settlement: $1 million. A middle-aged man was treated for flu in the ER of the defendant hospital. He was sent home with an antibiotic. His blood test was available three days later and showed streptoccocus viridians, which causes inflammation in heart valves. The ER doctors never informed the plaintiff or his primary care doctor of the test results. The results were discovered seven weeks later when the man complained to his doctor of low-grade fever and malaise. He was hospitalized, and five days later suffered from a stroke. Ricker v. Hunterdon Medical Center, Hunterdon Co., N.J.
RC: The ER physician failed to inform the patient or his primary treating physician of the blood culture results showing streptococcus viridans that lead to a stroke. The stroke caused residual weakness of the patient’s left leg, and he has to use a cane and leg brace.
• Defense verdict. The plaintiffs’ decedent, age 60, presented to an ER with shortness of breath, low blood pressure and cyanosis. Respiratory distress was diagnosed and the man was incubated, given antibiotics, fluids and was monitored. He died four hours later. The plaintiff claimed that not enough was done to treat the decedent: treatment should have started earlier and different antibiotics should have been used along with plasma and platelets. The defense argued that the man was very ill with multiple problems and had minimal chance of survival. Roman v. Conetta, et al, Queens Co. N.Y. Defense experts: Dr. Bruce Farber, Dr. Mark Silberman.
RC: Complicated medicals make cases very defensible.