Compiled from www.verdictslaska.com; Comments by Rose Clifford, RN, LNCC, editor
© 2009 The Medical-Legal News
• $3.5 million settlement during trial. The plaintiff’s decedent, age 30, went to an emergency room in March 2002 with dizziness, shortness of breath and chest pain that occurred when she walked. The decedent reported that the symptoms had begun one day earlier. The decedent underwent an EKG, which produced normal results. Her blood pressure and vital signs were also within normal limits. A resident diagnosed a muscle strain. Toradol was administered and Naprosyn was prescribed. The decedent was told to return in one week, but to return to the ER immediately if she had persistent chest pain. The chest pain returned after two days and she was taken to the ER, but she died before she could be treated. The initial autopsy report indicated that death was due to atherosclerotic cardiovascular disease. The medical examiner subsequently determined that the death could have been due to sarcoidosis, but still maintained that the death was due to atherosclerotic cardiovascular disease.
The plaintiff claimed that the disease could have been treated before death occurred. The plaintiff claimed that the defendants failed to perform tests that would have revealed the decedent’s cardiovascular disease. The plaintiff maintained that despite the normal EKG results, blood-enzyme tests should have been performed, which would have revealed abnormalities that would have necessitated admission to the hospital and a cardiology consult.
The defense maintained that death was due to sarcoidosis and that the decedent’s symptoms made the muscle strain diagnosis reasonable.
According to a published account, a $3.5 million settlement was reached with the hospital. The matter was discontinued as to Dr. Jones. Plaintiff experts: Allan Schechter, MD, emergency medicine, Scarsdale, N.Y.; Mark Schiffer, MD, cardiology, New York. Defense experts: Stephen Factor, MD, pathology, Bronx, N.Y.; Phillip Gelbeer, MD, emergency medicine/internal medicine, New Hyde Park, N.Y.; Allen Gribetz, MD, internal medicine, New York; Anthony Mustalish, MD, emergency medicine, New York.
Estate of Tamika Cromwell v. North General Hospital and Samuel Jones, M.D., Kings County (N.Y.) Supreme Court, Index No. 6754/03.
• RC: The issue in this case was very simple. The patient presented with classic textbook complaints of dizziness, shortness of breath and chest pain upon exertion. An EKG was ordered and performed, but the hospital failed to do cardiac enzyme studies that would have revealed abnormalities precipitating hospital admission and a cardiology consult. Failing to diagnose atherosclerotic cardiovascular disease in a 30-year-old female will have devastating results as a patient of this age will not have developed collateral circulation. Any blockage to the cardiac vessels will lead to death of cardiac muscles.
• Defense verdict. The plaintiff’s decedent, age 60, went to an ER with complaints of severe abdominal pain. He was evaluated, treated and released by physicians under contract to the defendant, Alliance Emergency Group. He returned to the ER several hours later and was again examined and released. Several days later the decedent was found dead in the sleeper berth of his tractor-trailer truck.
The plaintiff claimed that the death was due to complications associated with pancreatitis. The plaintiff contended that the abdominal pain was due to a stone obstructing his common bile duct and that the defendants failed to timely diagnose and treat the obstruction.
The defendants claimed that the death was due to an adverse reaction caused by Toradol, pointing to the fact that there was no evidence of a recent obstruction and no stone was found during an autopsy.
According to the Georgia Trial Reporter, a defense verdict was returned. Plaintiff experts: Marlon L. Priest, MD, emergency medicine, Birmingham; James Andrew Sumner, MD, emergency medicine, Washington, D.C.; Ian S. Grimm, MD, gastroenterology, Chapel Hill, N.C. Defense experts: Christine M. Carr, MD, emergency medicine, Isle of Palms, S.C.; Stephen A. Colucciello, MD, emergency medicine, Charlotte, N.C.
Estate of Larry Hamilton v. Alliance Emergency Group, Dekalb County (Ga.) State Court. Case No. 04A 16712.
• RC: Cases involving death are always “iffy” if there is no autopsy. With an autopsy, the cause of death must correlate to the complaint filed. The consultant should always check that the cause of death supports the malpractice theory and ultimate injuries.
• Defense verdict. The plaintiff’s decedent, age 32, went to the emergency room at Hendersonville Hospital with complaints of vomiting, nausea and fever. Her leg was also in pain and was tender to the touch. She was seen by Dr. Kevin Hattaway, who performed blood work and other tests. The decedent was discharged home. Three days later the decedent was taken to the ER of another hospital and was diagnosed as being in shock from necrotizing fasciitis. The woman died.
The plaintiff claimed that Dr. Hattaway and hospital nurses failed to diagnose an infection. The plaintiff claimed that if the infection had been diagnosed, intravenous antibiotics could have been begun and the decedent would have survived.
The defendants claimed that the evaluation given to the decedent was appropriate in light of her presentation and that the death was due to the nature of the infection.
According to the Tennessee Jury Verdict Reporter a defense verdict was returned. An appeal was pending. Plaintiff experts: David Wharton, MD, emergency medicine, Chattanooga, Tenn.; William Petri, MD, infectious disease, Charlottesville, Va.
Estate of Candace Farris v. Kevin Hattaway, et al., Sumner County (Tenn.) Circuit Court, Case No. 25050.
• RC: Infection cases are hard to prove. In this case the doctor examined the patient and blood work was performed. If the patient had an infection at the time, the doctor would have seen indications of it in the blood work on the exam. The fact that a 32-year-old did not come back to the emergency department for three days is difficult to overcome and should be a “red flag” to a consultant. With a devastating infection such as necrotizing fasciitis, the jury is not going to believe the ED doctor missed it at the time of the patient’s first ER visit. The patient most likely developed it after discharge and failed to come back to the ED.
• $342,251 verdict. The plaintiff, age 51, underwent a total abdominal hysterectomy and salpingo-oophorectomy in July 2000 performed by the defendant, an obstetrician/gynecologist. Within 39 hours after the surgery the plaintiff was noted to have elevated creatinine, indicting ureteral obstruction.
The plaintiff contended that the defendant had sutured the left ureter during the surgery, causing ureteral obstruction, which required multiple corrective surgical procedures in order to avoid permanent kidney damage. The plaintiff did not suffer any permanent urological damage, but she underwent numerous procedures, including ureteroneocystostomy to implant a ureter into the bladder, replacement of a neprostomy tube, multiple stent placements and stent removal surgeries.
The defendant argued that there was no evidence of a suture in the ureter and if a suture was the cause of the obstruction it was a known complication of the surgery. According to Cook County Jury Verdict Reporter a $342,251 verdict was returned.
Cantrell v. Merchant, Cook County (Ill.) Circuit Court, Case No. 02L-8971.
• RC: This case would be a close call in terms of actually filing it. Why? There were no permanent damages. Nicking, transecting or suturing a ureter is a known risk and complication of the surgical procedure. It is the attorney’s final decision as to whether to file a claim. Obviously the attorney thought the multiple procedures to re-implant the ureter in the bladder were sufficient for moving forward. This would be a type of case in which to keep costs to a minimum, as the verdict amount could be low, or nothing.
• Confidential settlement with hospital/$2.9 million settlement with U.S. for physician. The plaintiff, age 45, began to experience pneumonia in the lower portion of her right lobe, pleuritic chest pain, shortness of breath, respiratory difficulty, a productive cough and chills in late October 1997. The symptoms persisted and about a week later the plaintiff’s primary care physician, Dr. Ikhinmwin, hospitalized the plaintiff. The plaintiff was admitted to Hamot Medical Center. The following evening hospital nurses observed that the plaintiff was suffering anxiety. Dr. Ikhinmwin ordered continual administration of Ativan. During the ensuing 12 hours nurses administered several doses of the drug. The following morning the plaintiff suffered cardiac arrest. She was revived, but suffered a second cardiac arrest about 45 minutes later. She was again revived, but she suffered brain damage, which is now residual. The plaintiff lost circulation of her arms and legs and ultimately required above-knee amputations of both legs. She is bedridden and will require medical care for the rest of her life.
The plaintiff alleged negligence in the administration of medications and failure of the hospital to properly train the nurses.
Prior to trial, an undisclosed settlement was reached with the hospital, according to a published account.
The plaintiff claimed that she was suffering from hypoxia and pneumonia-induced respiratory distress and that a sedative was inappropriate. The plaintiff also claimed that the hospital did not have proper policies and procedures regarding the administration of medication and that its staff was not properly trained to address patients who presented symptoms that were similar to the plaintiff’s.
The defendants noted that the plaintiff had liver disease and generalized debilitation due to alcohol abuse, as well as having had previously suffered delirium tremens during hospitalized treatment of alcohol withdrawal. The defendants also claimed that her symptoms after this hospital admission indicated that she was again suffering delirium tremens and that Ativan was an appropriate treatment fort delirium tremens.
During the course of litigation, Community Health Net filed for bankruptcy protection.
The plaintiff and the government subsequently agreed to a $2.9 million settlement. Plaintiff experts: Susan Dye, RN, nurse practitioner, North East, Pa.; Marie A. Savard, MD, internal medicine, Wynnewood, Pa.; Theresa Wheeling, MD, physical medicine, Erie, Pa. Defense experts: Philip C. Buescher, MD, pulmonology, Baltimore; Paul E. Collier, MD, plastic/reconstructive surgery, Sewickley, Pa.; Samuel Miranda, Jr., RN, nurse practitioner, Schnecksville, Pa.; Steven R. Peikin, MD, gastroenterology, Philadelphia.
Lee, by the Family Trust, her GAL v. Ikhinmwin, Community Health Net and Hamot Medical Center, U.S. District Court of Pennsylvania, Western District at Erie, Case No. 03-185.
• RC: In evaluating the merits of this case, one would consider the young age of the plaintiff and her presenting signs and symptoms. She presented with early signs of pneumonia and was admitted to the hospital one week after symptoms first appeared. She had shortness of breath and respiratory difficulty. Twenty-four hours after admission she developed symptoms that were reported to the doctor by the nurse as “anxiety.” The first question is: “Was this related to her prior history of tremors from alcohol abuse or was this a sign of hypoxemia?” Initial evaluation of the record should focus on anxiety versus hypoxia.
A second issue is whether the Ativan was appropriately mixed and administered continuously, the appropriateness of the administration of several doses and whether the plaintiff was properly monitored during the administration of the drug. The damages (two cardiac arrests, brain damage and loss of circulation of limbs necessitating amputations) alone warrant a comprehensive evaluation. The damages would appall a jury — an individual walks into a hospital for pneumonia and comes out without her legs or normal brain function.
• $1 million award. The plaintiff’s mother died at the defendant hospital while undergoing a routine procedure. When the funeral director came to pick up the body about 38 hours later, the funeral director found the body in a major state of decay. Embalming could not be performed.
The plaintiff alleged mental distress from the inability to have an open casket service for his mother’s funeral. The plaintiff claimed that his distress was compounded by the fact that he had bipolar disorder and suffered schizophrenic tendencies. The plaintiff claimed that the hospital was negligent in its failure to keep the body refrigerated.
An earlier trial had concluded with a mistrial. The defendant conceded liability at this trial, but claimed that the condition of the mother’s body did not impact the plaintiff’s psychological condition.
A jury returned a $1 million verdict.
Gilson v. Westchester Square Medical Center, Bronx County (N.Y.) Supreme Court, Index No. 7757/03.
• RC: Psychological trauma cases are difficult to pursue because the damages are not quantifiable. It is hard for the jury to “see” mental distress. The fact that the hospital admitted negligence in the first trial was advantageous to the plaintiff, but it still ended in a mistrial.