Thursday, August 16, 2012

Failure to Diagnose Pulmonary Embolism Lawsuit

As a follow up to my last post on the current standard for evaluating patient's with suspected pulmonary embolism, I am going to discuss the case of Kilburn v. Aliquippa Hospital, et al. which was brilliantly handled by attorneys Veronica Richards and Sandra Neuman of Richards & Richards.

This was a Pennsylvania wrongful death/medical malpractice action in which the estate of a 35-year-old man claimed that the defendants failed to timely recognize and failure to treat the symptoms of pulmonary embolism following knee surgery and hospitalization. This matter is a little different than my last article as this deals more with failure to diagnose versus proper diagnostic testing.

The plaintiff claimed that the failure to timely diagnose and treat the embolism resulted in the decedent's death. The defendants in the case included Aliquippa Community Hospital, the emergency room physician who treated the decedent at the hospital and the decedent's primary care physician who saw the decedent two days later. The defendants maintained that their diagnosis and treatment was reasonable under the circumstances. The defense also argued that there was no evidence that treatment with the blood thinner, Heparin, would have prevented the decedent's death, as claimed by the plaintiff- a standard defense argument applied to almost all cases.

The plaintiff contended that the decedent exhibited many of the classic symptoms of a pulmonary embolism upon presentation to the emergency room, including shortness of breath, chest tightness, increased pulse and increased respirations. Despite these symptoms, the plaintiff claimed that the decedent was misdiagnosed by the defendant emergency room physician as having an anxiety attack and was sent home. Two days after being discharged from the emergency room with what the plaintiff claimed was an incorrect diagnosis, the decedent presented to the defendant primary care physician. The plaintiff claimed that the primary care physician also failed to immediately diagnose the pulmonary embolism and instead diagnosed acute coronary syndrome.

The plaintiff argued that the decedent had recently undergone knee surgery and hospitalization which placed him at high risk for pulmonary embolism. The plaintiff's experts opined that the defendants should have conducted a blood test, as well as, other diagnostic procedures, including D-dimer and VQ-scan, which would have diagnosed the pulmonary embolism. The plaintiff's medical experts testified that the delay in diagnosing and treating the decedent's pulmonary embolism caused the decedent to suffer an acute massive pulmonary embolism that caused his immediate death three days after he was seen by the defendant primary care physician. Timely treatment, including administration of the blood thinner, Heparin, would have given the decedent an excellent chance of survival, according to the plaintiff's experts.

The decedent was employed as a carpenter and was survived by his wife. His projected loss of future earnings was $ 600,000.

The defendant emergency room physician maintained that he made a reasonable diagnosis of anxiety, based on the symptoms exhibited by the decedent at the time he presented to the emergency room. The defendant's emergency medicine expert opined that the decedent's symptoms were consistent with anxiety. The defendant primary care physician argued that the decedent's symptoms, at the time he was examined by this defendant, were consistent with acute coronary syndrome. The defendants also asserted that treatment with Heparin would not have made a difference in preventing the decedent's death.

The jury found the defendant emergency room physician and Aliquippa Community Hospital 35% negligent and the defendant primary care physician 65% negligent. The jury awarded the plaintiff $ 1,264,396 in damages.

This verdict was the fourth largest medical negligence award ever rendered in the typically conservative venue of Beaver County. The decision was rendered after the jury heard lengthy testimony from multiple expert witnesses over the course of nine days. The case was distinguished by the fact that the decedent was only 35-years old at the time of his death. The plaintiff introduced statistical information that when promptly diagnosed and treated, pulmonary embolisms have a 92% chance of successful treatment. This evidence may have negated defense claims that administration of blood thinners would not have made a difference in preventing the death.

The jury assigned most of the responsibility for the death (65%) against the primary care physician who saw him two days after his discharge from the emergency room and three days before his death. The jury apparently believed that by this point in time, the decedent's symptoms were more profound and warranted an even more urgent investigation for potential pulmonary embolism.

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