Defense Verdict on Behalf of Hospital in Case involving Fall at Physical Therapy after Hip Replacement

by | Jan 31, 2019 | Hospital Liability, Philadelphia, Successes

Anthony P. DeMichele recently obtained a defense verdict on behalf of a hospital in the Philadelphia County Court of Common Pleas. The matter involved a patient who fell while undergoing physical therapy two days after a right total hip replacement. As a result of the fall, the patient fractured the right hip that had just been replaced and underwent another surgical procedure to repair the fracture. Of note, at the time of the original hip replacement, the patient was markedly disabled and required a live-in aide to help with activities of daily living.

At the time of the fall, the patient was ambulating with a walker while the physical therapist had her hands on the patient and an aide followed them closely with a wheelchair. Plaintiff alleged that both the physical therapist and the wheelchair follow were not positioned correctly. The defense argued that the physical therapist had hands on the patient and was in the correct position when the patient fell. The defense also argued that the wheelchair follow was positioned correctly within inches of the patient and that the fall was an unfortunate accident. The defense presented experts in physical therapy and orthopedic surgery, who confirmed that the care was within the standard of care and that the patient’s current limitations were not a result of the fall and fracture.

After deliberating, the jury returned a verdict in favor of the hospital, finding that its care and treatment of the patient was not negligent.

Defense Verdict for OB/GYN in case involving Wound Infection after Caesarean

by | 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.

Defense Verdict on Behalf of Philadelphia Hospital in Wound Care Matter

by | Oct 8, 2018 | Hospital Liability, Philadelphia, Successes

Marshall L. Schwartz and Lisa J. Peters recently obtained a defense verdict in a medical malpractice case on behalf of a hospital following a four-day jury trial in Philadelphia County.
In December of 2013, the plaintiff was transferred to the critical care unit of defendant hospital for significant pericardial effusion with tamponade physiology. The plaintiff presented with a stage II wound on admission and was discharged with same. Plaintiff’s experts argued that the wound was not properly cared for during admission, resulting in the worsening of the wound and continued treatment subsequent to discharge, including surgical debridement.

The defense maintained that proper care and treatment was provided and that the plaintiffs significant comorbidities, most significantly, end stage renal disease and diabetes, are what contributed to her inability to heal; not the care of the defendants.

After approximately two hours of jury deliberation, the jury found in favor of the defendants.

Defense Verdict on Behalf of Internal Medicine Physician and Infectious Disease Physician

by | 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.

Defense Verdict on behalf of Podiatrist in Philadelphia County

by | 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. 

Defense Verdict on Behalf of Two Cardiologists in Philadelphia County

by | 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.