Reprinted with permission from Medical Malpractice Verdicts, Settlements and Experts, Lewis Laska, Editor, (800) 298-6288.
Insufficient Monitoring for Cancer Patient With Pneumonia
A 53-year-old woman who was undergoing chemotherapy for breast cancer received a diagnosis of pneumonia from her oncologist, who prescribed antibiotics for her to take at home. When the patient had no response to the antibiotics, her oncologist admitted her to the hospital under the care of the defendant internist. The oncologist and the internist agreed to call in a pulmonologist to provide assistance in treating the woman’s pneumonia.
She did not respond well to the antibiotics administered in the hospital and experienced respiratory distress. The defendant internist called in and ordered a nonrebreather oxygen mask. The nurses contacted the pulmonologist, who stated that since the patient was at 100% oxygenation, there was no need for him to come in to see her.
The internist called in again and was told by staff that the patient’s condition was stable. Her spouse visited with her until 10 pm. Staff nurses checked on her at 2 am.
At 4 am, the decedent was found dead on the bathroom floor. An autopsy confirmed that she had died of bronchopneumonia.
The plaintiff claimed that the defendant violated the standard of care by not seeing the decedent after her respiratory crisis and by not transferring her to the ICU for oxygen monitoring. The defendant argued that he had ordered oxygen monitoring but claimed that the nursing staff failed to follow his order. The defendant further contended that he had requested the pulmonologist to examine the decedent after her respiratory crisis.
The plaintiff settled with the hospital for an undisclosed amount prior to trial. According to published reports, a defense verdict was entered.
Complications From Laparoscopy—or Preexisting Condition?
A woman in her 30s had a long history of abdominal surgeries, beginning with a ruptured appendix and serious infection at age 8. She complained of abdominal pain throughout her teens and underwent additional surgeries in 1991 and 2002.
The plaintiff was seen by the defendant surgeon in March 2003 regarding her abdominal complaints. A decision was made to perform a laparoscopic cholecystectomy in April. Shortly after the surgery, the defendant left town.
The next morning, the plaintiff experienced “bileish” discharge. The defendant returned that evening and advised her that a second surgery would be needed to repair a suspected bowel perforation. The surgery was performed that night.
The plaintiff was discharged a week after the initial surgery but continued to have problems. She was hospitalized a few days later, then transferred to another hospital under the care of other physicians, at her husband’s request. She was left with a nonhealing abdominal wound and lesion.
The plaintiff claimed that she was not an appropriate candidate for surgery and that the procedure should not have been performed laparoscopically. Further, the defendant’s medical license had been placed under a mandatory restriction, and she charged that this fact should have been disclosed to her.
The defendant claimed that the plaintiff had insisted on a laparoscopic procedure and argued that bowel perforations and other complications are known risks of such an operation. The defendant claimed that the plaintiff’s current problems were related to her preexisting history of abdominal problems.
According to a published report, a defense verdict was returned.
Impaired Blood Flow to Injured Leg Goes Untreated
A few days after being struck by an automobile in a parking lot, a Massachusetts woman presented to her primary care physician’s office, where she was seen by the defendant nurse practitioner. The NP noted a large abrasion on the patient’s left leg with some purulent drainage, as well as a large bruise on her back. The woman reported that her left leg felt cooler to the touch than her right leg.
She was instructed to go to the emergency department (ED) if she experienced any worsening pain, numbness, or tingling. Two days later, the patient was seen again by the defendant NP, during which visit she repeated her complaint of coolness in her left leg. She also told the NP that her leg was becoming progressively colder toward her foot and toes and that her toes were slightly discolored.
The woman was given an appointment to see the primary care physician the following week. When he examined her, the physician noted some swelling in the plaintiff’s left lower leg and found that her left great toe and second toe were dusky in color. She had palpable but diminished pulses in the left leg, compared with the right. The patient was given an appointment to see a surgeon.