Directed Verdict Obtained on Behalf of Orthopedic Surgeon

by | May 19, 2014 | Medical Malpractice, New Jersey, Successes

Heather Hansen recently obtained a directed verdict in favor of an orthopedic surgeon in the Superior Court of New Jersey-Atlantic County. 

The plaintiff had sustained a work-related knee injury and had an arthroscopy prior to seeing the defendant orthopedic surgeon.  After failing conservative therapy, the defendant orthopedic surgeon performed a  total knee replacement.  In the months thereafter,  plaintiff’s pain and function progressively improved and radiographs  showed a  well-positioned total knee replacement.  However, plaintiff sought the opinion of  another orthopedic surgeon for complaints of pain.  Plaintiff alleged that surgeon commented that while plaintiff had excellent alignment and range of motion of the knee, he thought there may be an elevated joint line or a patella baja (an abnormally low lying patella).  He later performed an arthroscopic debridement with resection of scar tissue.   

Plaintiffs alleged that the defendant orthopedic surgeon negligently performed the total knee replacement by elevating the joint line which caused a patella baja.  It was the defendant’s position that the surgery was appropriately performed and that there was no elevation of the joint line. 

After the plaintiffs presented their case at trial, Ms. Hansen moved for a directed verdict, and successfully argued that plaintiffs’ liability expert provided only net opinions and did not provide the requisite testimony needed to establish that the defendant’s care and treatment of the plaintiff deviated from the standard of care.  The Court agreed with Ms. Hansen’s arguments and granted the motion for a directed verdict. 

Superior Court Reverses Jury Verdict in Cardiologist’s Favor Following Appeal

by | Apr 11, 2014 | Medical Malpractice, Other Venues, Successes

Paul E. Peel recently prevailed on an appeal to the Superior Court of Pennsylvania from a judgment entered against an interventional cardiologist, his employer, and several affiliated entities.

In Emery v. Groh, M.D., et al., the plaintiff’s decedent was referred to the defendant cardiologist to undergo a diagnostic cardiac catheterization.  Prior to undergoing the procedure, the patient advised the doctor that he was allergic to nickel.  The doctor informed the patient that his treatment options included stenting of the artery and noted that it was not possible to choose an exact course of treatment without knowing the patient’s specific anatomy or taking into account his clinical situation.

Due to his allergy, the patient initially objected to the implantation of a stent containing nickel.  However, after additional discussion with his wife and the doctor, the patient agreed to undergo the catheterization procedure and gave written consent to have a stent implanted if it was necessary.

After receiving the patient’s consent, the cardiologist performed the catheterization.  During the procedure, the doctor implanted a stent containing nickel into one of the patient’s coronary arteries.

Over the next several years, the patient complained of experiencing rashes and itching in the area where the stent was placed.  He and his wife later commenced an action against the defendants alleging that the doctor failed to obtain his informed consent to undergo the catheterization and breached the standard of care by implanting a stent containing nickel in his artery.  The case proceeded to trial and resulted in a jury verdict in the plaintiffs’ favor.  Following the entry of judgment, the defendants filed an appeal to the Superior Court of Pennsylvania.

On appeal, the defendants asserted that the trial court erred in denying the defendants’ motion for judgment notwithstanding the verdict because the plaintiffs failed to present sufficient medical expert testimony to meet their burden of proving that the cardiologist caused the patient any harm.  Specifically, the defendants contended that the plaintiffs’ medical expert failed to link the cardiologist’s alleged misconduct to the patient’s purported injuries.

After considering the parties’ arguments on appeal, the Superior Court concluded that the lower court erred in denying the defendants’ motion for judgment notwithstanding the verdict.  In reaching this decision, the Superior Court held that the plaintiffs’ medical expert failed to testify with sufficient medical certainty that the cardiologist’s alleged tortious conduct caused the patient’s injuries.  The Court noted that, throughout trial and in his expert report, the plaintiffs’ expert proffered the opinion of the patient, not his own, regarding causality.  Moreover, the Court aptly noted that the plaintiffs’ expert actually acknowledged at trial that he was not sure whether the nickel stent implanted in the patient really caused the symptoms of which he complained.  Consequently, the Superior Court reversed the entry of judgment in the plaintiffs’ favor and directed the entry of judgment for the defendants.

Defense Verdict on Behalf of Internal Medicine Physician in Chester County

by | Mar 28, 2014 | Chester County, Medical Malpractice, Successes

Dan Ryan and Christine N. Dantonio recently obtained a defense verdict in favor of an internal medicine physician in the Court of Common Pleas of Chester County, Pennsylvania, in a case involving claims under the Wrongful Death and Survival Acts following the suicide death of the plaintiff’s wife. 

The decedent, a Certified Registered Nurse Practitioner, knew the defendant physician from working with him in the past.  In January, 2010, she sustained multiple fractures to her pelvis from a fall in her home.  Following admission to the hospital, the decedent was transferred to a skilled nursing facility where she requested that the defendant physician treat her.  She made good progress and was discharged from the skilled nursing facility in early March.  Thereafter, the decedent began to experience incapacitating pain in her left buttock and groin areas.  She was subsequently diagnosed by her gynecologist as having pudendal neuralgia, a painful neuropathic condition that is caused by inflammation of the pudendal nerve.  When she returned to the defendant physician in April, the medication Neurontin was prescribed to help with the decedent’s pain, and this medication was slowly titrated up.  In early May, the decedent complained of some depression secondary to her pain, in response to which the defendant physician prescribed the anti-depressant Lexapro.  Subsequently, another physician recommended that the Lexapro be increased and that the pain medication Ultram be added.  The defendant physician agreed and made the necessary adjustment to the decedent’s medications.  However, the decedent developed the side effect of hand tremors, and therefore, the doses of Lexapro and Ultram were decreased.  Plaintiff’s pain continued, eventually requiring the Ultram to be discontinued in favor of a narcotic pain medication.  During this time period, the decedent had no obvious signs or symptoms of severe depression or suicidal thoughts.  Tragically, she took her own life on May 27, 2010.

It was alleged that the defendant physician negligently increased the risk of harm to the decedent by failing to warn her and her husband of the potential side effects of Neurontin; significantly, its association with an increased risk of suicidal ideation and behavior.  Plaintiff further alleged that the defendant physician deviated from the standard of care when he failed to discontinue Neurontin following the decedent’s complaints of depression and hand tremors, failed to send the decedent for a psychiatric evaluation, failed to refer the decedent to a pain management specialist, and by prescribing a “dangerous mix” of medications. 

Defendants presented expert testimony that the use of Neurontin was appropriate, as was its combined use with Lexapro, Ultram, and Vicodin to treat the incapacitating nerve condition suffered by the decedent.  The jury was also presented with evidence that the decedent was proactive in her own care and was seeking out specialists all over the country for treatment of her condition.  However, the decedent quickly learned that even with aggressive therapy and/or surgery, there was no guarantee of a cure.  Given the lack of severe depression or suicidal thoughts by the decedent, it was argued that the decedent’s tragic demise was the result of her realization that she would never be able to return to her prior life as a Certified Registered Nurse Practitioner, wife, and mother. 

The jury deliberated for approximately two hours and returned an 11-1 verdict in defendant’s favor, finding that the defendant physician’s treatment of the decedent did not deviate from the standard of care, and therefore, he was not negligent.

Defense Verdict on Behalf of Neurologists and Nurse Practitioner in Philadelphia County

by | Nov 20, 2012 | Medical Malpractice, Philadelphia, Successes

Daniel F. Ryan, III and Michael O. Pitt obtained a defense verdict in favor of defendant neurologists and a nurse practitioner in a medical malpractice action in Philadelphia County. 

In February 2009, plaintiff’s decedent, a 25 year old female, presented for a follow-up visit for treatment of migraine headaches.  At that time, the patient reported experiencing headaches six days per week.  She also had an extensive psychiatric history, including severe depression and inpatient admissions for suicidal ideation. 

At the first office visit in February 2009, the nurse practitioner ordered a three day, consecutive course of DHE infusions, in accordance with the attending neurologist’s plan established at the patient’s last visit in December 2008.  On the morning of the second infusion, the nurse practitioner noted the patient to be lethargic, having difficulty keeping her eyes open and was hypotensive.  The nurse practitioner changed that patient’s medications to ensure less sedating effects.  At the time of discharge, around 3:00 p.m., the patient’s vital signs and gait were normal.  At approximately 6:00 p.m., the decedent went to her bedroom and was not seen by any family member for the remainder of the evening.  The next morning, she was found deceased in her locked bedroom.  Toxicology results, included the autopsy report, concluded that the decedent died as a result of an overdose of Prozac and Effexor taken in the hours before her death. 

Plaintiff argued that the patient was suffering from multiple medication toxicity following her second day of infusion therapy and that the standard of care required the patient to be sent to the emergency room for evaluation and possible admission.  Also, plaintiff was critical of the fact that the patient had not been seen by an attending physician on either day of her infusions. 

The defense expert neurologist testified the nurse practitioner appropriately ordered infusion therapy for the patient, in accordance with the plan established by the attending neurologist.  The decedent exhibited no signs or symptoms of medication toxicity on the second day; rather, as the day progressed, she became more alert and her vital signs normalized.  The expert also confirmed that none of the medications given to her during her infusion could have caused her levels of Prozac and/or Effexor to be raised above therapeutic levels.  The defense argued that the plaintiff’s decedent took either an accidental or intentional overdose of medications. 

After deliberating less than an hour, the jury returned a verdict in favor of the defendants.   The jury concluded that neither the defendant neurologists, nor the nurse practitioner whom they supervised, breached the standard of care and were not negligent.

Defense Verdict in Favor of Internist in Failure to Diagnose and Treat Lung Cancer Case

by | Aug 20, 2012 | Medical Malpractice, Philadelphia, Successes

Dan Ryan received a defense verdict in a case in the Court of Common Pleas of Philadelphia County in which the Plaintiff, the estate of a deceased patient, alleged that an Internist failed to diagnose and treat the patient’s lung cancer. The patient ultimately died from stage three lung cancer. The Plaintiff asserted that the Internist should have ordered follow-up studies as a result of abnormalities suggested on a July 1999 chest x-ray. According to Plaintiff’s expert, if the physician would have performed timely follow-up studies, the patient’s lymph node involvement would not have been as extensive and he would have had a better chance of prolonged survival.

On June 14, 1999, the patient, a 53-year-old male, presented to his Internist’s office after an illness and complained that he was light-headed, had cramping and diarrhea and had a temperature of 102 degrees, The patient denied any dyspnea on exertion or hemoptysis. The patient’s history was significant for cigarette smoking and interstitial lung infiltrates but indicated to the Internist that he had stopped smoking in 1995. The Internist had the impression that the patient had an upper respiratory infection that was probably viral in nature. He ordered a chest x-ray and blood work. The blood work was normal. The chest x-ray, performed on July 8, 1999, revealed a patchy infiltrate in the right lower lobe, which the Internist felt was consistent with the patient’s symptoms.

On July 20, 1999, the patient returned for a follow-up visit. He did not have any shortness of breath, sputum or cough. His weight was stable and his lungs were clear. At the next office visit on November 16, 1999, the patient complained of hemoptysis. A chest x-ray was immediately ordered, which revealed a right hilar mass with post-obstructive atelectasis and infiltrate, most suspicious for carcinoma. The Internist promptly referred his patient to a pulmonary specialist. A non-small cell carcinoma of the lungs was eventually diagnosed with positive lymph nodes. Despite treatment and due to the virulent nature of the tumor and the significant node involvement, the patient died less than one year later, in October of 2000.

After a six-day trial and 2 ½ days of jury deliberation, the jury returned a unanimous verdict finding that the Internist was not negligent in their treatment of his patient.

Defense Verdict for Neurosurgeon in Montgomery County

by | Aug 20, 2012 | Medical Malpractice, Montgomery County, Successes

Heather Hansen obtained a defense verdict for a neurosurgeon in Montgomery County. The plaintiff alleged that the neurosurgeon negligently performed a complete laminectomy with foraminotomy procedure on her, thereby injuring her spinal cord. Although the plaintiff awoke from surgery with a Brown-Sequard Syndrome, the defense contended that the operation was performed appropriately and that there was no evidence in the medical records to suggest that the neurosurgeon caused the plaintiff’s injuries. The defense also noted that the plaintiff’s medical expert had not ruled out all other possible causes of the plaintiff’s injury, such as spinal stroke. After deliberating for less than an hour, the jury returned a verdict in the defendant’s favor.