by Mark Bauman | Oct 10, 2018 | Medical Malpractice, Philadelphia, Successes
Tracie A. Vizza and paralegal Lexi Romney recently obtained a defense verdict on behalf of an obstetrician/gynecologist (OB/GYN) in the Philadelphia County Court of Common Pleas. The matter involved a patient who had undergone a caesarean section and presented to the hospital several days after her discharge with complaints of intermittent fever, purulent drainage from her incision, nausea, loose stools and lightheadedness. The patient was first evaluated and examined by a medical student and a resident physician. At the time of her evaluation, although there was drainage from the incision, the area was not warm, red or swollen. Additionally, the patient was not exhibiting a fever. The resident physician probed the incision which showed that it was a superficial wound. A culture was taken and sent to the lab. The resident physician also irrigated the incision area with saline fluid until it was clear. The defendant, the attending OB/GYN, also examined the patient and probed the area. The patient was diagnosed with a superficial wound infection. As there were no signs or symptoms of a systemic infection, Bactrim DS, a broad spectrum antibiotic, was prescribed. The patient was advised to call, or return to the hospital, with any worsening symptoms.
Thereafter, the patient had continued purulent drainage from the wound area over the course of the next couple of days. Although it was alleged that the patient and her mother contacted the hospital, at no time was the defendant informed of these calls and/or worsening symptoms. Two days after her presentation to the hospital, the culture report showed that the wound was infected with a bacteria known to be susceptible to Bactrim DS. The culture report also suggested that an infectious disease specialist be consulted. The defendant physician was also not advised of these findings.
The following day the patient presented to a different hospital at which time it was noted that the antibiotics failed and the infection had worsened. The patient was hospitalized for several days as she required a debridement procedure and IV antibiotics to treat the worsened infection.
Plaintiff alleged that the defendant should have prescribed a different antibiotic and had he done so, the patient would not have required the debridement procedure. The defense argued that the broad spectrum antibiotic given was appropriate as bacteria causing the infection was not known until the culture grew out greater than 24 hours later. Further, the defense argued that a broad spectrum antibiotic which treats MRSA was required as MRSA is common in recently hospitalized patients and is highly resistant to may antibiotics, including the penicillin based antibiotics, which plaintiff’s expert testified was appropriate. The defense presented expert testimony by experts in OB/GYN and infectious disease. These experts established that the defendant acted within the standard of care and that the appropriate antibiotic was prescribed. After deliberation, the jury returned an unanimous verdict, finding that the defendant’s care and treatment of the plaintiff was not negligent.
by Mark Bauman | Oct 8, 2018 | Medical Malpractice, Other Venues, Successes
Marshall L. Schwartz and Brett M. Littman obtained a defense verdict on behalf of an internal medicine physician, an infectious disease physician, and a hospital following an eight-day jury trial involving allegations that the physicians failed to appropriately treat sepsis caused by fungal infection, which allegedly caused the death of a patient.
The case involved a 55 year-old female who presented for consultations with an oncologist and surgeon after being diagnosed with advanced bladder cancer. She also had a long-standing medical history of strokes and other chronic problems. Before the patient decided to undergo treatment, she was emergently admitted to the hospital with altered mental status, fever, and other potential signs of sepsis, which likely came from the urinary tract. The defendants treated the patient with antibiotics, and she improved to the point that she was able to be discharged. Soon after her discharge, however, the patient’s symptoms returned, and she was readmitted. She was again treated with antibiotics, but her course worsened. She suffered a heart attack and deteriorated before passing away.
Plaintiff alleged that while the defendants successfully treated the patient for her bacterial infection, they ignored the fact that the patient also had a fungal infection, which could not be treated with antibiotics. Rather, the patient required anti-fungal medications, which she should have received as early as the first admission. To support this contention, they argued that the defendants should have taken into account a pathology report that showed that a clot found in the patient’s urine was made up of both fungus and bacteria, and that the defendants should have considered a urine culture that showed fungus.
The defense argued, with the support of an infectious disease physician, that the earlier findings of fungus were merely incidental and did not require treatment. Once the defendants found actual evidence of a fungal infection in the form of a positive blood cultures, they immediately took the appropriate action, which included treatment with anti-fungal medication. The defense successfully argued that by the time it was appropriate to treat the patient, her condition had become so dire that her death was inevitable and not caused by any alleged negligence.
After deliberations that spanned three days, the jury found that the internal medicine physician was not negligent. The jury also found that while the infectious disease physician and hospital acted negligently, that negligence was not a factual cause of any injuries. The result of these findings was a defense verdict.
by Mark Bauman | Jun 28, 2018 | Medical Malpractice, Philadelphia, Successes
Heather Hansen and paralegal Beth Carson recently obtained a defense verdict on behalf of a podiatrist in a case involving allegations of failure to timely diagnose melanoma. The plaintiff brought suit against two podiatrists, his primary care physician, and a vascular surgeon/wound care physician. The case proceeded to trial against the two podiatrists and the primary care physician, only.
The plaintiff initially presented to his primary care physician with complaints of a pigmented lesion on his right great toe. He was referred to podiatrist A for further evaluation. Podiatrist A diagnosed a pinched callus which he debrided. At a follow-up visit, Podiatrist A told the patient that he had a bone spur (seen on x-ray) that was likely contributing to the callus formation. The patient never returned to Podiatrist A. For about seven months, plaintiff performed self-care to his wound and kept it covered with a band aid. He then returned to his PCP because his toe was not healing. A wound culture was performed and plaintiff was prescribed oral and topical antibiotics. He was also referred to podiatrist B.
When plaintiff presented to podiatrist B, he advised that his toe had not healed since being debrided by Podiatrist A and that he had increased pain with elevation. Podiatrist B examined the toe and described a non-pigmented ulceration. A MRI was ordered to rule out a possible bone infection and returned negative. Based on the complaint of pain on elevation, Podiatrist B referred plaintiff to a vascular surgeon to rule out other potential causes of poor wound healing. Plaintiff never returned to podiatrist B. Several months later, plaintiff was diagnosed with amelanotic melanoma.
At trial, plaintiff presented expert testimony from specialists in podiatry, family medicine, and oncology. He argued that each defendant was negligent in failing to perform a biopsy to rule out malignancy or ensure that a biopsy was performed.
Following a seven-day trial, and over 15 hours of deliberations, the jury returned a verdict finding Podiatrist A 25% negligent, the PCP 25% negligent, and Podiatrist B not negligent. The jury assessed 50% comparative negligence against plaintiff.
by Mark Bauman | Apr 27, 2018 | Medical Malpractice, Philadelphia, Successes
Marshall L. Schwartz recently obtained a defense verdict on behalf of two cardiologists in a nine-day jury trial involving allegations of a failure to properly monitor a patient’s Coumadin usage following a cardiac catherization, as well as an alleged failure to recognize neurologic signs and symptoms prior to the patient suffering a hemorrhagic stroke.
This case involved a patient who had a longstanding medical history of coronary artery disease, hypertension, diabetes, deep vein thrombosis and pulmonary embolism, and who had undergone gastric bypass surgery multiple times for morbid obesity. He also had been taking Coumadin for several years due to his risk factors for stroke. The patient presented to his cardiologist with symptoms of shortness of breath, and was advised to have a cardiac catherization which was scheduled to take place a few days later. The patient was also instructed to stop taking his Coumadin prior to the procedure. The cardiac catherization was performed without incident, and the patient was instructed to resume taking his Coumadin, follow up with the cardiology practice in a week, and have his Coumadin levels monitored by his primary care provider.
About a week after the patient was discharged from the hospital, he was seen for a follow up appointment with a practitioner at the cardiology practice. The practitioner found that he was neurologically intact. Two days later, he followed up with his primary care provider who historically monitored his Coumadin levels. His blood levels were in range, and he was instructed to continue the same Coumadin dosage that he had been taking since the procedure. Then, about ten later, the patient began to experience symptoms of stroke. His primary care provider ordered an MRI of the brain that revealed a left temporal hemorrhage. Ultimately, the patient was diagnosed with a stroke, however, no surgical intervention was necessary.
The defense successfully argued that although the patient suffered a stroke, it was not the result of any action, or inaction on behalf of anyone in the cardiology practice. In support of this argument, an expert cardiologist and nurse practitioner were called to testify and supported this defense.
After deliberation, the jury returned a unanimous verdict, finding that the defendant physicians’ care and treatment of the plaintiff was not negligent.
by Mark Bauman | Apr 17, 2018 | Chester County, Medical Malpractice, Successes
Michael O. Pitt and paralegal Elizabeth Carson-Nave recently received a defense verdict on behalf of a urologist in the Chester County Court of Common Pleas. The matter involved a 60-year old male who underwent robotic-assisted radical prostatectomy for treatment of prostate cancer. There were no complications to the surgery. On the evening of the surgery, the patient lost consciousness briefly and this was attributed by a hospitalist as a likely vasovagal response. An EKG was obtained and was abnormal, but unchanged from a pre-operative EKG study. The patient was transferred from the medical-surgical floor to telemetry for closer monitoring.
Over the next two days, the patient had a distended abdomen along with several bouts of nausea and vomiting attributed to a post-operative ileus. Additionally, labs were drawn each morning and the patient’s hemoglobin level was observed to drop from 11.6 on the date of surgery, to 10.0 on post-op day one, and then to 8.8 on post-op day two. The patient’s pulse, blood pressure, oxygen saturations and urine output remained normal. After taking a walk around the unit in the early afternoon of post-op day two, the patient complained of indigestion, suddenly lost consciousness and coded. Resuscitative measures were unsuccessful. On autopsy, the medical examiner found 900 mL of blood in the patient’s retroperitoneum, as well as moderate to severe three-vessel coronary artery disease that was previously undiagnosed. Per the medical examiner, the patient’s cause of death was coronary artery disease in the setting of complications of prostatectomy.
The decedent’s spouse filed suit under the Pennsylvania Wrongful Death and Survival Acts. Plaintiff alleged that the urologist failed to recognize the falling hemoglobin levels as a sign of active internal bleeding that caused decreased oxygen carrying capacity to the heart and her husband’s untimely death. Plaintiff presented expert testimony by a urologist and a cardiologist who claimed that had the urologist ordered a cardiology consult, CT scan of the abdomen, and serial blood draws, the patient would have received a blood transfusion and lived.
The defense presented testimony by experts in urology and critical care. These experts established that the urologist acted within the standard of care, and more specifically, that a blood transfusion was not indicated in the patient because his vital signs were stable and his hemoglobin level never fell below 8.0. Additionally, evidence was presented that the patient’s death was not caused by reduced oxygen carrying capacity from blood loss, but rather, that the patient died from a sudden cardiac arrhythmia.
Following approximately 8 hours of deliberations, the jury returned a verdict in favor of the urologist.
by Mark Bauman | Jan 26, 2018 | Medical Malpractice, Philadelphia, Successes
Heather Hansen and paralegal Lexi Romney recently received a defense verdict on behalf of an orthopaedic surgeon in Philadelphia County. A 65-year-old woman presented to the orthopaedic surgeon with knee pain. MRI demonstrated a non-displaced occult fracture of the distal femur. The patient was prescribed a long leg brace, instructed to remain non-weightbearing, and told to follow up with her primary care physician for purposes of anticoagulation to help prevent deep vein thrombosis. The orthopaedic surgeon contacted the patient’s primary care physician about his recommendations. Later the same day, the patient’s primary care physician contacted her on the telephone and discussed the options of using Coumadin or increasing her Aspirin dose from 81mg daily to 325mg daily. The patient chose to increase her dose of Aspirin.
Thereafter, the patient continued to follow up with the orthopaedic surgeon who noted that she was on anticoagulation per her primary care physician. The patient continued to go to work, but despite receiving a walker, she found it too difficult and preferred to use a wheelchair obtained by her husband. She did not tell the orthopaedic surgeon or her primary care physician that she was not using the walker.
Several weeks after her diagnosis, the patient started having nausea, vomiting, diarrhea, sweating and shortness of breath. Eventually, an ambulance was called to her home. After being loaded in the ambulance, the patient became unresponsive and coded. Resuscitative measures were unsuccessful. An autopsy reported the cause of death as pulmonary embolism, deep venous thrombosis, and immobility following femur fracture.
The patient’s husband brought suit against the orthopaedic surgeon and the primary care physician alleging that they were negligent by failing to ensure that adequate anticoagulation and deep vein thrombosis prophylaxis was provided. At trial, plaintiff presented expert witness testimony that Aspirin, an antiplatelet medication, was not standard of care and that an anticoagulant, such as Coumadin, should have been prescribed to the patient. The defense also presented expert witnesses who testified that the use of Aspirin was acceptable for this patient under the guidelines for anticoagulation set forth by the American College of Chest Physicians and the American Academy of Orthopaedic Surgeons. After a seven day trial, the jury found in favor of the defendants.
