What We're Working On

Here's a quick sampling of the kinds of medical malpractice cases we're working on today—and every day.

Emergency Room ER Malpractice (Arkansas) – Failure to Diagnose Aortic Dissection

A 19 year old male college student awoke at his parent’s home in the middle of the night with intense chest pain. His mother, an experienced nurse, discovered his blood pressure to be extremely elevated. As there was a family history of early-age cardiac deaths in the family, she quickly took her son to the ER at a major Arkansas hospital. No blood labs, radiology, or tests were performed other than an EKG. The abnormal blood pressure was reproduced and the family cardiac history was noted. Nevertheless, the ER personnel felt that such a young patient could not truly be having pain of cardiac source. He was discharged with a generic diagnosis of costochondritis (chest wall pain). Maalox and a GI cocktail was prescribed under the assumption that his pain was GI in nature.

Almost 60 days later, the young man was found deceased on the living room couch at his college apartment by friends. An autopsy revealed a massive aortic dissection had ruptured. The autopsy further revealed that the tearing of the major artery was chronic and had been in existence for some time. In other words, it could have been caught and surgically repaired had the ER personnel just ordered a simple chest x-ray. An x-ray will reveal signs of an impending aortic dissection some 60-80% of the time.

 

Family Practice / PCP Malpractice – Failure to Diagnose Pulmonary Embolism (Texas)

A 15-year-old girl experienced irregular periods and sought help. Her mother took her to a local clinic and saw a nurse practitioner that prescribed Ortho Tri-Cyclen, an estrogen-based oral contraceptive that can help to control irregular periods. About 2 months later, the girl began to experience shortness of breath. At the same clinic, she was seen by a family medicine physician that was on-call. The doctor noted symptoms including shortness of breath, dull chest pain on deep inspiration, and a dry cough. The patient reported no congestion or sore throat. Despite these classic symptoms of pulmonary embolism as well as a recent history of oral contraceptive use, the physician diagnosed the child with a viral-based upper respiratory infection. No medication was prescribed and the patient was simply written a note to skip PE class.  No tests were ordered to investigate the possibility of clotting or embolism. The symptoms did not resolve. Several days later, while her mother was at work, the child experienced respiratory failure and collapsed alone in her bathroom. She had called her mother for help minutes before. The mother found her child unresponsive and frantically telephoned EMS. Despite best efforts at a local ER, the child was pronounced deceased. An autopsy revealed a large pulmonary embolism.

 

Radiology Malpractice (Texas) – Failure to Detect Bowel Ischemia in Pediatric Patient

img-leftnav-injuryA newborn baby girl suffered some congenital problems requiring stomach surgery. She recovered well. At age 4, she began having intense abdominal pain and nausea. Her concerned parents took her to a hospital ER in south Texas. An abdominal x-ray was ordered and read as normal. The family was discharged. The following day, the child’s pain was worse and she began looking discolored. She was returned to the same ER, where it was found that her belly was distended. A CT scan revealed bowel ischemia and an obstruction.

After being transferred to a nearby hospital capable of performing pediatric surgery, the little girl’s abdomen was surgically opened and explored. The bowel was found to be necrotic due to lack of sufficient blood flow, caused by an obstruction. She crashed during the surgery and ultimately passed away.

 

Malpractice (Arkansas) - Failure to Timely Diagnose Spinal Abscess – Paralysis 

A 50 year old man presented to a major hospital in a state of diabetic ketoacidosis (DKA). He also complained of severe back pain in his mid-back. He had also battled infectious boils on his skin in the previous weeks. The attending physician ordered an MRI of the lower back as well as mid back (lumbar and thoracic). However, the order was not followed and only the lumbar back was imaged. Subsequent hospitalists did not notice that the order was not completed. A couple of days later, the patient began to lose sensation in his legs. Another scan was eventually ordered but, unfortunately, only imaged the lower back. By failing to image the mid back, physicians missed the fact that the man suffered from a collection of infected pus and fluid in his thoracic spine, which was compressing and damaging his spinal cord. By the time the patient was finally transferred to a higher level of care, it was too late to save his neurological function. He is now unable to walk, uses a wheelchair, and is unable to return to work as a manager at a national department store chain.

 

Radiology Error (Arkansas) – Failure to Diagnose Ischemic Cerebral Stroke

A 19 year old female college student developed a massive headache and collapsed at her sister’s home. She was taken to a local hospital that advertises its specialty as a “stroke hospital.” The girl’s symptoms included one-sided facial droop and an inability to speak. An ER physician ordered a CT scan of her brain. The radiologist interpreted the scan and reported no abnormal findings. The girl and her family spent the next few days at the hospital while she was accessed as a possible psychiatric patient. Nothing seemed to help. Eventually, and at the family’s request, an MRI was performed which revealed a large ischemic cerebral stroke caused by a blood clot. A second-look at the original CT scan from the ER confirmed that the large clot was actually visible by the naked eye. The failure to recognize the clot by the radiologist resulted in a lost opportunity to administer a stroke medication called tissue plasminogen activator, or t-PA, which can reverse a stroke if given to a patient within a few hours of onset of symptoms. The patient, now age 20, wears a leg brace for support, has neurological impairment, and is unable to drive. She has heroically returned to college to take a few hours of classes but her original career goals have been diminished. Her life’s trajectory has irreversibly changed.

 

Anesthesia Negligence  (Mississippi*)

A man in his 30’s suffered severe heart failure. His cardiologist decided to surgically insert an implantable cardioverter defibrillator (ICD). The device would monitor the man’s heart and deliver an electrical shock to “re-start” it should it stop or begin beating irregularly. The surgery was planned with an anesthesiologist. The anesthesia team unfortunately decided to employ very minimal strategies for monitoring vital signs during the procedure. They used an anesthetic that tends to reduce blood pressure. The patient arrested near the conclusion of the surgery and though the physicians tried, they could not easily resuscitate him. The anesthesia team used a poor choice of “crash-cart” medications. The patient passed away. Rather than acknowledging their poor choices, the anesthesia team chalked up the death to the patient’s pre-existing heart problems.

 

Negligent Management of Labor / Failure to Detect Placental Abruption (Arkansas)

At a rural hospital, a pregnant patient arrived at the ER around 5:30 am complaining of bleeding. She was near-term for her pregnancy. A physician was called to the hospital. He ordered an ultrasound despite clear evidence of a placental abruption. The ultrasound took a while but indeed later verified the abruption, meaning that the placenta had come loose and was freely bleeding into the area around the baby. It also meant that the baby was getting a vastly diminished blood supply. The patient was rushed to deliver the baby. Delays occurred. Once the baby was delivered, he had gone too long without oxygen from his mother’s blood. He tragically passed away shortly after birth. 

 

* Marc Stewart Law, PLLC currently represents clients in Mississippi and Tennessee as well, working with local counsel in their counties.