Medicolegal Issues

Malpractice Chronicle


 

Reprinted with permission from Medical Malpractice Verdicts, Settlements and Experts, Lewis Laska, Editor, (800) 298-6288.

Radiation Error After Surgery for Acinic Cancer
A woman in her 50s discovered a growth in her left parotid gland. Although the mass was not thought to be malignant, she elected to have it removed. Biopsy results led to a diagnosis of acinic cancer.

The patient underwent 13 radiation treatments with the defendant, a radiation oncologist, before it was discovered that the defendant had been radiating the right parotid gland instead of the surgical site at the left parotid gland.

The plaintiff claimed that radiation to the right parotid gland destroyed its ability to function, leaving her with a permanent dry mouth and diminished sense of taste. She also claimed that loss of the gland has caused oral and digestive health problems. The defendant admitted negligence in treating the wrong side of the patient’s face but disputed the damages in question.

According to a published report, a $250,000 verdict was returned.

Link Overlooked Between MSSA and Osteomyelitis
A teenage boy, born with sickle cell anemia, experienced vaso-occlusive crises once or twice each year. During these episodes, he would be treated with morphine, oxycodone with acetaminophen, and/or acetaminophen with codeine, along with IV hydration.

At age 16, the boy was admitted to the defendant hospital with a fever; he received a diagnosis of pneumonia, based on a chest x-ray. Of three blood cultures that were performed, one yielded positive results for methicillin-sensitive Staphylococcus aureus (MSSA). The patient underwent four days’ IV therapy with triple antibiotics, followed by a 10-day supply of oral antibiotics to be taken following discharge.

The next month, the patient was readmitted for three days at the defendant hospital with a three-week history of back pain. Six days after his second discharge, the boy returned to the defendant hospital, complaining once again of back pain. He was hospitalized for eight days. During both hospitalizations, the plaintiff was treated with pain medications and IV hydration.

A week after his return home, the patient developed excruciating pain; he was unable to walk and became short of breath. He was taken to a different hospital, where x-rays and MRI revealed a fracture and collapse of the T7 vertebra. He underwent surgical repair with insertion of a plate and screws. Following a needle biopsy performed on day 8 of this hospitalization, a diagnosis was made of osteomyelitis of the spine. A biopsy revealed MSSA of the same type found in the boy’s blood culture during the initial admission. He was hospitalized for six weeks.

The plaintiff alleged negligence in the defendant’s failure to make a timely diagnosis of osteomyelitis. He claimed that osteomyelitis should have been considered when the blood culture was reported, and that his last discharge from the defendant hospital should not have occurred because he was unable to walk. The plaintiff claimed that he will develop arthritis as he grows older and will be at higher risk for lung and heart problems.

According to the defendant, the plaintiff reported that his pain had continued to decrease before his third discharge, that he was walking in the hallways of the defendant hospital before that discharge, and that he was able to walk into the nondefendant hospital. The defendant further claimed that the plaintiff’s discharge instructions after each hospitalization included follow-up at a hematology clinic, but he did not comply. The defendant also claimed that the plaintiff had severe osteoporosis secondary to sickle cell anemia, that his chronic illness was associated with a reduced life expectancy, and that any lung or heart problems that might develop would be the result of sickle cell anemia, not osteomyelitis.

A settlement of $925,000 was negotiated.

Long Wait for Diagnostic Testing
In May 2001, a 38-year-old Arizona man developed fever, chills, muscle aches, and cough. His family physician made a diagnosis of pneumonia. Late that summer, the patient developed headaches and a variety of other symptoms, including pain in the cervical spine, weight loss, and intermittent fevers. By October, the man was also complaining of fatigue, headaches, fever, and an unintended 20-lb weight loss. He was seen by a neurologist in November.

In early 2002, the patient was experiencing persistent headaches and vomiting and additional weight loss. One day in February, when the man was unable to find his way home, he went to a hospital. After being triaged, he was taken to his family physician by his wife. The plaintiff was seen by an internist two weeks later.

In March, the plaintiff went to a large, not-for-profit teaching hospital, where he was seen by a physician assistant. He was then seen by a rheumatologist in April.

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