Reprinted with permission from Medical Malpractice Verdicts, Settlements and Experts, Lewis Laska, Editor, (800) 298-6288.
Breast Malignancy Dismissed as Cyst
A 23-year-old woman called the defendant obstetrician/gynecologist’s office in July 2003 and reported to the receptionist that she had found a lump in her breast; it had been present for two months, she said, with possible dimpling. She asked to be seen immediately. Upon receiving the patient’s message, Dr. M. told the nurse to instruct the patient to wait until her next scheduled appointment, two weeks away; she also declined to schedule a mammogram.
At the patient’s scheduled appointment, Dr. M. performed the standard gynecologic examination and needed to be reminded to examine the lump before the patient left her office. Dr. M. diagnosed the lump as a cyst and told the patient it was nothing to worry about. No testing was performed, and no follow-up was recommended. Dr. M. did not document her findings in the patient’s record, nor did she note any self-reminders to reevaluate the lump at a later date.
The patient subsequently became pregnant and was seen in the defendant’s office on 16 subsequent occasions without further evaluation or testing for the breast lump.
After the delivery of her child, the patient noted that the lump had become larger and painful. When she could not be seen by Dr. M., she was seen by her partner, Dr. P., in February 2005. Dr. P. found a suspicious mass and immediately ordered a mammogram and ultrasonography, which confirmed the presence of a 4.0-cm mass. Biopsy the next day led to a diagnosis of breast cancer. Through positron emission tomography and CT later that week and an additional biopsy, it was found that the cancer had metastasized to the patient’s liver.
She underwent 10 rounds of chemotherapy, a lumpectomy, a complete hysterectomy, and radiation treatment. She was given no chance for a cure, however.
The defendant denied any negligence, maintaining that the lump brought to her attention in July 2003 was not the same lump found in 2005. Even if the lump in 2003 had been found to be cancerous, the defendant argued, it had probably metastasized by that time, making any delay in treatment of no consequence.
A jury awarded $23.6 million to the plaintiff, which included $11,750,000 for the plaintiff’s husband.
Reaction to Radiologic Dye Blamed for Stroke Symptoms
An elderly woman presented to a hospital emergency department (ED) with left-side weakness and slurred speech; a stroke was suspected. The defendant ED physician evaluated the patient and made a diagnosis of an allergic reaction to a dye she had been given during IV pyelography the previous day. The patient was given diphenhydramine and discharged.
She returned to the ED the following day with indisputable symptoms of a stroke: left-side weakness affecting her hand and leg, diminished speech, and loss of bladder control.
The plaintiff alleged negligence in the failure of the ED physician to diagnose the stroke at her first visit.
The defendant claimed that in light of the plaintiff’s constellation of symptoms at the first visit, his diagnosis of an allergic reaction was reasonable. The defendant argued that the stroke had occurred after the patient’s first visit and that she would not have been a good candidate to receive tissue plasminogen activator therapy.
The jury was unable to reach a unanimous verdict, and the parties agreed to accept a less-than-unanimous verdict. The jury returned an eight-to-four verdict in favor of the defendant, and a defense judgment was entered.
Possible Fluid Overload for Child With Complex Medical History
A 7-year-old girl was brought into a hospital emergency department (ED) with congestion and several episodes of vomiting. Born prematurely, she had a history of hydroencephalitis requiring a ventriculoperitoneal shunt. As an infant, she had also experienced spastic cerebral palsy, developmental delays, and a chronic lung condition. She had spent her first three years in a hospital’s pediatric ICU.
At the ED, the child was examined by a PA, who then consulted with the ED physician. Pneumonitis, bronchiolitis, mild dehydration, and viral illness were diagnosed, with possible early-stage pneumonia. The child was sent home after being given 800 mL of IV normal saline infusion with 900 mg of ceftriaxone.
About two hours later, she was found by her father not breathing. She was taken back to the ED, where she was pronounced dead.
The plaintiff claimed that the child’s death was due to fluid overload, which caused pulmonary edema. The plaintiff also claimed that the ED staff failed to properly treat her complex medical condition or to monitor and observe her for a reasonable time.