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Settlement for seven figure confidential sum against two obstetricians for brain damaged baby as a result of the negligent use of a vacuum extractor during caesarean section at Hudson County, New Jersey hospital.
Our client went into the hospital to have a scheduled c-section for what was to be her third child. She delivered her two older children via c-section as well. When the caesarean incision was made to deliver the baby, the obstetrician encountered scar tissue. Rather than carefully cut through the scar tissue, the obstetrician and his assistant decided to use a vacuum extractor, attach it to the baby's scalp to extract the baby through the incision. Unfortunately, the obstetrician placed the vacuum extractor cup on the wrong part of the baby's skull, and the incision was just too small and the baby's scull was fractured as it passed through the incision. The baby had massive bleeding in her bran and a bulging anterior fontanelle on her head. The baby ended up with severely diminished intelligence, ability to communicate, and ability to walk. It was expected that she would need care for the rest of her life. The two obstetricians that were in the emergency room each claimed that it was the other physician that did the c-section and used the vacuum extractor and that the other obstetrician was a liar. The case settled while jury selection was in progress.
$3 million settlement for pedestrian run over by a bus
On a clear and dry winter morning, in 2008, shortly before New Year’s Eve, our 59 year old female client was hit by and run over by a bus, as she was crossing Flatbush Avenue in Brooklyn, NY on her way to work at a nearby church where she had been employed for 16 years as the caretaker. She was crossing the street in the crosswalk with the green light in her favor when she was struck by the Defendant bus driver who made an illegal left turn from Atlantic Avenue onto Flatbush. The bus driver completely ignored the sign indicating that left hand turns were not allowed at that intersection. At the moment of impact, our client was hit by the front of the bus. She was then dragged down beneath the front wheel. FDNY reports from that day reveal that eyewitnesses called 911 to report that a female was “pinned underneath the wheel.”
The female had to be “extricated and disentangled,” from beneath the bus with the aid of air bags. Once extricated, our client was emergently transported to a nearby hospital where she endured weeks of debridments and surgeries. Her left leg sustained a severe degloving injury, meaning that multiple layers of skin and tissue were ripped off, exposing the bone. She also suffered a fracture of the left tibula and fibula, a fractured left clavicle and fractured pelvis. During the hospital stay, our client underwent fifteen (15) different procedures including skin grafts to the damaged leg. Upon leaving the hospital, our client underwent several months of rehabilitation. During the rehabilitation she had to re-enter the hospital for a two part surgery for the insertion of a rod into the left lower leg. She is now able to walk short distances with the aid of a quad cane. She walks with a moderately severe limp and has significantly limited range of motion in the left ankle and knee. Her leg continues to have a mangled appearance. She has been unable to return to her job as the church caretaker.
Our office sued the bus driver as well as the bus Company, whose operating authority was later revoked by the Federal Motor Carrier Safety Administration, because of an unfit safety rating.
The case settled for $3 million dollars. The case was handled by Christina Ctorides of our office.
Settlement for confidential sum for Bergen County, New Jersey woman who ended up paralyzed from neck down.
Our client's cardiologist placed her on coumadin, an anticoagulant or blood thinner, because she had an irregular heart beat called atrial fibrillation. When she was placed on coumadin for the first time in her life, her reaction to the coumadin being very erratic with her INR (the blood test used to measure whether there was a therapeutic level of coumadin in the blood) varied greatly from week to week, despite the fact that she took the medication religiously. Then on the third occasion that the cardiologist measured her INR, it was too low, which meant that the coumadin was not therapeutic. He then told her to take double the dose and return in two weeks instead of one week. She did not return two weeks later because ten days later, she was admitted to Hackensack University Medical Center where she was found to have an INR of over 11, a clear overdose. In the emergency room, she could barely move her legs. An MRI of her brain and spine revealed that she had bled into the epidural space in her cervical spine. This bleeding in the neck compressed her spinal cord to the point that she ended up paralyzed from the neck down despite the fact that neurosurgeons operated to try to relieve the pressure. She lived for thirteen months in a nursing home in terrible pain. She would spend most of her days and nights moaning in pain. Her suffering was finally ended when she died from terrible infected bed sores. She was survived by two adult daughters. The cardiologist settled for his medical malpractice insurance policy limits.
Settlement for a Sum Subject to Confidentiality for an 82-year-old woman who died in a nursing home as a result of the nursing home staff refusing to come to her assistance.
This lawsuit was filed in Bergen County, New Jersey on behalf of the only daughter of an 82-year-old widow who died at a local hospital as a result of both negligent and intentional acts of the staff of a Bergen County nursing home/rehabilitation facility. CLICK HERE TO READ FULL DETAILS
$850,000.00 settlement for wrongful death for negligent administration of anesthesia in an unlicensed surgery center in Passaic County, New Jersey.
This lawsuit was filed in Bergen County, New Jersey for the widow and two adult daughters of a 50-year-old taxicab driver who went to an unlicensed, one-room surgery center in Passaic County, New Jersey to have a procedure performed on his prostate for benign prostatic hypertrophy. CLICK HERE TO READ FULL DETAILS
Settlement for Confidential Sum for failing to diagnose lung cancer
This patient was a 61-year-old man who had to chest x-rays incidental to other procedures and was never advised that the x-rays revealed a mass in his lung. CLICK HERE TO READ FULL DETAILS
Settlement for Confidential Sum for failing to treat deep vein thrombosis, resulting in pulmonary embolism and death in a nursing home
This patient was an 83‑year‑old woman who had gone into a rehabilitation facility/nursing home for rehabilitation after having undergone total knee replacement at a Bergen County, New Jersey hospital. CLICK HERE TO READ FULL DETAILS
Settlement for Confidential Sum for a falldown and fractured femur in nursing home
The case, which settled for a confidential sum in the high six figures, involved an 87-year-old mother of four children who was widowed who went into a Hudson County Nursing Home after having femoral-popliteal bypasses on both legs to reestablish circulation. CLICK HERE TO READ FULL DETAILS
$600,000 Settlement for Nursing Home Malpractice
The case, which settled for $600,000.00 before trial, involved a 98 year-old woman with dementia who was wheelchair-bound and was an in-patient in the long term care section of Bergen County, New Jersey. CLICK HERE TO READ FULL SETTLEMENT
$4.5 million dollar confidential settlement on behalf of a brain damaged infant
Our firm recently entered into a confidential settlement with several New York physicians in the sum of 4.5 million dollars on behalf of a brain damaged infant and his mother. The child was severely injured at birth when his mother's doctors failed to properly monitor the progress of her labor. The doctors failed to recognize that a caesarian section was necessary and as such caused the baby to suffer oxygen deprivation. As a result, our infant client was brain damaged and suffers from cerebral palsy and spastic quadraplegia.
$1.8 million confidential settlement for failure to timely diagnose our client's Ewing's Sarcoma
Recently, our firm entered into a confidential settlement in the sum of $1.8 million with various New York physicians who failed to timely diagnose our client's Ewing's Sarcoma, a bone cancer which appeared in his femur. The most common areas in which Ewing's Sarcoma occurs are the pelvis, femur, humerus and the ribs. Our client complained over a period of months about leg pain which was not properly addressed. A CT Scan of the patient's femur was misread. During the period of the delay, the bone cancer grew and spread to his lungs and other portions of his body.
ONE MILLION FIVE HUNDRED THOUSAND DOLLAR SETTLEMENT
MEDICAL MALPRACTICE FOR FAILING TO TIMELY DIAGNOSE
RETINOPATHY PREMATURITY IN AN INFANT RESULTING IN COMPLETE BILATERAL BLINDNESS
This case was filed in Superior Court of New Jersey, Hudson County, in September of 2005. The defendants committed malpractice by failing to timely order a screening examination for Retinopathy Prematurity for a premature infant in the neo-natal intensive care unit between 4 to 6 weeks after the child was born resulting in complete bilateral blindness. A timely eye examination by an ophthalmologist would have permitted the child to receive timely laser surgery in both eyes that would have provided him with a 50% chance of having vision. The defendant doctors in the case took the position that even with timely diagnosis and treatment, this premature infant was going to go blind anyway.
Retinopathy of Prematurity (“ROP”) is a progressive condition that affects the retina of premature infants. Because they are born prematurely, these infants have only partially-developed retinas, just like their lungs and other organs that are underdeveloped. ROP occurs when the blood vessels in the retina grow abnormally and rise up towards the front of the eye into the vitreous. If left untreated, this condition can progress in over 60% of the infants who develop it, resulting in detachment of the retina and blindness. It is theorized that the sicker the babies are in their prematurity, the more likely they are to develop ROP. It used to be assumed that ROP resulted from exposure to excessive levels of oxygen that these babies needed in their incubators so that they did not suffer brain damage. At present, that theory is in doubt. More than half of the infants born at 28 weeks gestation develop some degree of ROP. Certainly, the more premature an infant is, the more likely they are to develop ROP. ROP is easily diagnosed by a timely examination by an ophthalmologist between 4-6 weeks after birth in a premature infant. An examination earlier than four weeks is likely to result in missing the condition altogether because it will have not have yet developed. The disease is divided into five stages with sub-divisions in those stages. It is also distinguished by the zone of the retina where it appears. Stage I, II, and III generally receive no treatment. Stage III plus requires treatment. Plus disease refers to the tortousity of the blood vessels in the retina. The American Academy of Pediatrics published revised guidelines in 2001 stating that every premature infant had to be seen by an ophthalmologist between 4-6 weeks after birth.
If caught on a timely basis, ROP is treated with laser surgery similar to the laser surgery many diabetics with Diabetic Retinopathy is treated. Timely diagnosis of treatment of ROP leads to salvage of vision. However, there is still a chance that even with timely treatment, blindness can result.
SETTLEMENT AMOUNT SUBJECT TO CONFIDENTIALITY FOR NURSING HOME MALPRATICE AGAINST A NOTED NEW JERSEY NURSING HOME FOR FAILING TO PREVENT THE PATIENT FROM SUFFERING BEDSORES
A Forty-Three year old man who was married and the father of two children was transferred to a Northern New Jersey nursing home in June of 2003 after he spent a month in the hospital for having suffered pneumonia and needing to be on a ventilator in order to be able to breathe. The patient recovered from his pneumonia but still was ventilator dependant and needed to be weaned off and needed rehabilitation because he was so weak and deconditioned from being bedridden for over a month. The patient was also obese. The patient came to the nursing home without any bedsores whatsoever upon admission. After just five days at the nursing home, the patient had a bedsore in his sacral area, which is the lower back/upper buttocks. The nursing home staff then failed to properly treat the bedsore and properly provide nutrition to the patient such that his bedsore progressed to a Stage III before he needed to be transferred to a hospital because he was so malnourished to the point where he could not even breathe appropriately. The staff at the hospital immediately documented that the patient had a Stage III bedsore, which unfortunately progressed to Stage IV. The patient spent another month in the hospital to then be discharged home where his wife, who weighed only 120 lbs., was able to take care of him and turn him.
The nursing home’s defense of the case was that the patient actually came in with the beginning of a bedsore as was claimed by both the Director of Nursing and the Nursing Home Administrator. Both of the witnesses for the defendant also claimed that the patient was too obese to be able to be turned. Turning the patient at least every two hours helps prevent bedsores occurring because of pressure.
The nursing home’s defense of the case fell apart when Goldsmith Ctorides & Rodriguez, LLP was able to track down the nurse that checked the patient’s skin when he was admitted from the hospital to the nursing home. This nurse testified truthfully that the patient had no bedsores coming into the nursing home but was just at high-risk for developing one. The nurse also testified that although the patient may have been obese, the nursing staff at the nursing home are trained specifically on how to appropriately turn someone who is very overweight. In addition, the patient’s wife testified that she could turn the patient on her own without the assistance of anybody even though he weighed several times what she weighed. The wife explained that just using proper leverage permitted her to be able to turn her husband.
$700,000.000 Settlement for Negligent Dye-Study Test for Intrathecal Pain Pump Manufactured by Codman & Shurtleiff
This office settled for $700,000.00 a claim for a 73 year-old man and his wife relative to the negligent performance of a dye study to determine if an intrathecal pain management pump manufactured by Codman & Shurtleiff was functioning appropriately. Codman & Shurtleiff was not a defendant in the law suit. The defendants in the law suit were the pain management physician that performed the dye study test along with the scrub technician and circulating nurse that assisted with the procedure and the surgery center where the procedure was performed. The 73 year-old male with the implanted intrathecal drug delivery pump had undergone ten back surgeries previously and suffered from failed back syndrome, which was limited to severe back pain that was controlled by the pain pump that administered Morphine and Bupivicaine on a continuous flow into the patient’s intrathecal space. After the performance of the dye study, the Patient went into a coma only to wake up the following day with very limited ability to move his legs. He was able to recover to the point where he could take a few steps with a rolling walker but would otherwise have to be wheel chaired bound. He also lost control of his bladder. There were two different theories of liability in this matter depending on whom you believed of the defendants’ conflicting testimony. Either the damage was caused because the defendant pain management physician inadvertently injected an amount of Morphine and Bupvicaine into the bolus pathway of the pain pump in an amount equal to what the patient would receive during the course of an entire twenty-four hours. Alternatively, the defendant physician claimed that he never intended to inject the bolus of Morphine and Bupvicaine and that it was injected only because the scrub technician under the supervision of the circulating nurse handed him the wrong syringe, which was unlabeled, and he then proceeded to inject the bolus of Morphine and Bupvicaine instead of administering saline into the bolus pathway of the drug-delivery device.
$675,000.00 Settlement for Methotrexate Overdose
An 82 year old patient went to a nursing home near the Jersey Shore for rehabilitation after having been hospitalized for three weeks for a heart condition that was successfully managed with medication. The patient, who was a widow and mother of three adult daughters, also suffered from rheumatoid arthritis for which she took 10 milligrams of Methotrexate once a week on Tuesdays. She had taken this medication for decades without complications and had done very well with her rheumatoid arthritis as a result. The patient fully expected to return to her own home where she lived independently.
Unfortunately, once admitted to the nursing home, the patient received Methotrexate every day for six straight days. This is despite the fact that the order on the medication administration record stated very clearly “10mg pill of Methotrexate once a week on Tuesdays”. It appears that on each day, a different nurse gave out the medication when she shouldn’t have.
When the nursing home discovered its nurses’ errors with Methotrexate, they decided not to contact the patient’s doctors or transfer the patient to the hospital for 24 hours. After 24 hours went by, one of the patient’s daughters insisted that the patient be transferred to the hospital because she looked so ill. When the nursing home transferred the patient to the hospital, the nursing home failed to include any information that this patient had been on Methotrexate or that they believed that she had suffered an overdose of Methotrexate. Instead, they put in as reason for transfer that she had a potential reaction to medication without specifying which one. Of course, the patient was on several medications.
The end result for the patient was that she suffered pancytopenia. This is a condition used to describe when the patient’s bone marrow shuts down such that the patient’s bone marrow is no longer producing more red or white blood cells or leukocytes. Because 24 hours had gone by since the Methotrexate had ceased being administered, it was already too late to give the patient the antidote for Methotrexate. She spent the next six days dying a very painful death where sores opened up all over her body, and she slowly began to suffocate because there were not enough red blood cells to carry oxygen to her organs.
Settlement for $625,000.00 for Wrongful Death as a result of medical malpractice from negligent incisional hernia repair surgery leading to bowel perforation, sepsis and death.
The case involved the 60 year old married father of two adult children who went in to Jersey City Medical Center for surgery to repair an incisional hernia. A hernia is a hole in the lining of the muscle covering the abdomen. A tear occurs in the lining that permits part of the colon to pop through the hole. This patient underwent a laparoscopic hernia repair surgery where small holes are made to insert instruments and a camera for the use in performing the surgery. During the procedure, the surgeon poked at least two holes into the colon and apparently did not realize that he had injured the bowel or did not check. The surgery was completed and the patient was sent home for two days. On the third day, the patient returned in terrible pain, short of breath and with an increased heart rate. It took 24 hours to determine that the patient actually had peritonitis and perforations in two different areas of the colon.
In addition to the surgeon’s negligence and injuring the colon during the surgery and failing to recognize that fact at that point when it would have been easy to repair with little likelihood of infection, when the surgeon went back in three days later and attempted to repair the colon. He only cut out the injured part of the colon and reconnected the two ends in two different sections. These surgical repairs were destined to fail because at that point, the patient’s belly was so infected. What the patient needed was two colostomies to allow time for the infection to heal in the belly and for the inflammation to die down before reconnecting the bowel.
Instead, the patient’s two reconnective pieces of bowel broke down and fell apart a week later requiring additional surgery where again, the surgeon tried to reconnect both sections of bowel. The following day, both sections of bowel broke down once again. This time, the surgeon performed one colostomy. However, he was not able to pull out the second section of bowel for a second colostomy because it had become bound with so much inflammatory scar tissue. Over the next day, the skin opened up, creating what is called an entero-cutaneous fistula, which is a connection between the bowel and the skin so that fecal matter was freely flowing out of the belly through the skin in one area.
The patient lasted in this condition for thirteen months never returning home from the hospital before he finally succumbed to his injuries. He had terrible pain and suffering in the hospital for 13 months before he died.
Medical Malpractice for failing to timely diagnose retinopathy of prematurity in an infant resulting in complete, bi-lateral blindness
This case was filed in the Superior Court of New Jersey, Hudson County, on May 7, 2004. The essence of the medical malpractice allegations involved in this case concern the failure of the defendants to timely order a screening examination for Retinopathy of Prematurity for the child between four to six weeks after birth resulting in complete, bilateral blindness. It is the position of the plaintiffs that a timely eye examination by an ophthalmologist would have permitted the child to receive timely laser surgery in both eyes that would have provided her with a 75% chance of having sight in both eyes.
It was the defense position that the child was too ill during the four to six week window to permit an ophthalmologic exam. In addition, it was the position of the defense that even with timely diagnosis and treatment, her chances of retaining vision were 60% at best. Finally, the defendants also alleged as a defense the doctrine of avoidable consequences in that the childs parents did not consent to surgical intervention when the child was in fact diagnosed, and hence, her parents gave up the last opportunity for their daughter to regain sight.
The medical malpractice allegations in this case involved the failure of the defendants to timely order a screening examination for retinopathy of prematurity while the child was in the intensive care nursery (also known as the NICU) at Defendant Jersey City Medical Center. Retinopathy of Prematurity (“ROP”) is a progressive condition that effects the retina of premature infants. Because they are born prematurely, these infants have only partially-developed retinas, just like their lungs and other organs are underdeveloped. ROP occurs when the blood vessels in the retina grow abnormally and rise up towards the front of the eye into the vitreous. Left untreated, this condition can progress in over 60% of the infants who develop it and result in detachment of the retina, leading to blindness. It is theorized that the sicker the babies are in their prematurity, the more likely they are to develop ROP. It used to be assumed that ROP resulted from exposure to excessive levels of oxygen that these babies need in their incubators so that they do not suffer brain damage. At present, that theory is in doubt. More than half the infants born at 28 weeks gestation develop some degree of ROP. Certainly, the more premature an infant is, the more likely they are to develop ROP. ROP is easily diagnosed by a timely examination by an ophthalmologist between 4 to 6 weeks after birth in a premature infant. Examination earlier than 4 weeks is likely to result in missing the condition all together because it will have not yet developed. The disease is divided into five stages with subdivisions in those stages. It is also distinguished by the zone of the retina where it appears. Stages I, II and III generally receive no treatment. Stage III plus requires treatment. Plus disease refers to the tortousity of the blood vessels in the retina. The American Academy of Pediatrics published revised guidelines in 2001 stating that every premature infant had to been seen by an ophthalmologist between 4 to 6 weeks after birth.
If caught on a timely basis, ROP is treated with laser surgery similar to the laser surgery that a diabetic with diabetic retinopathy is treated.
Timely diagnosis and treatment of ROP leads to salvage of vision. However, there is still a chance that even with timely treatment, blindness can result. With respect to the child , depending on whether you believe the plaintiffs’ expert ophthalmologist, Steven Rubin, M.D. of Long Island Jewish Medical Center, or defendants’ two ophthalmology experts, Miles J. Burke, M.D. of Cincinnati, Ohio, and J. Arch McNamara, M.D. of the University of Pennsylvania, Stefani Itara had a 25 to 42% chance of going blind even with timely treatment.
$800,000 Settlement for Failure to Diagnose Splenic Artery Aneurysm
This was an action pending in the EDNC Federal Court brought pursuant to the Federal Tort Claims Act under California Law for capped pain and suffering of $250,000 under California’s MICRA Law. Plaintiff was a in her early 30’s and 9 months pregnant when she experienced severe abdominal pain and was taken to Balboa Naval Hospital. She was diagnosed as having a possible rupture of the uterus and or placental abruption. She was taken to the delivery room where via a bikini cut incision a healthy baby was born. Upon entry into the uterus to deliver the child 1500 cc’s of blood was found by the resident obstetrician. Through the bikini cut an exploration of the uterus and lower abdomen was carried out and then an exploration of the upper abdomen was carried out. The source of the bleeding was not found and rather than convert the procedure to an open exploration and determine the source of the bleeding the patient was closed and sent to the recovery room for observation. Within 45 minutes of arrival in recovery she coded and bled out. She was taken back to the delivery room where an emergency exploration was carried out and the source of the bleeding was identified, a ruptured splenic artery aneurysm and her spleen and a portion of the pancreas was removed. In order to control the bleeding an emergency thoracotomy was performed. As a result of the thoracotomy the plaintiff sufferes from post thoracotomy pain syndrome and is disabled from work.
MEDICAL MALPRACTICE BY AN ANESTHESIOLOGIST FOR IMPROPERLY ADMINISTERING A NEUROLYTIC BLOCK OF THE CELIAC PLEXUS CAUSING PARALYSIS
The plaintiff, born October 23, 1962 was paralyzed at Level T-10 during an attempted neurolytic block of the celiac plexus on March 7, 2002. Her paralysis is permanent as a section of her spinal cord was permanently damaged by the alcohol meant to destroy her celiac plexus. The plaintiff is married and has three children.
In July 2001, the plaintiff was referred to the defendant anesthesiologist, a pain management specialist, by her internist for treatment of chronic pain due to pancreatitis and a stomach ailment. She underwent twelve (12) procedures of varying kinds by the defendant prior to March 7, 2002. It was the contention of the plaintiffs that the procedure itself, the neurolytic celiac plexus block, was improperly performed, that informed consent was not obtained, and that this procedure should not have been done on a patient such as the plaintiff.
Plaintiff’s expert pain management physician, who is also an anesthesiologist, rendered opinions regarding the deviations from the standards of medical care by the defendant. They included: failure to have a cogent treatment plan; lack of documentation of the patient’s understanding of the complex nature of her pain; failing to provide the patient with informed consent; administering multiple neurolytic celiac plexus blocks as well as other blocks in light of the fact that these therapies are highly invasive and include the risk of permanent paralysis and in addition, do not result in lasting relief of pain; an absence of a treatment plan that was appropriate for this patient; and the administration of the block itself was not handled appropriately based upon radiological films taken at the time of the procedure.
The defense contended that appropriate informed consent was obtained. The defense also contended that celiac plexus blocks may be used for intractable pain not associated with malignancy. It was the defense position that the plaintiff was a patient in whom celiac plexus blocks would provide a meaningful chance of relief from unrelenting severe pain with minimum side effects. It was strongly emphasized by the defense that paralysis is a very rare side effect or risk involved in this procedure.
The plaintiff testified that had she been advised that paralysis could occur as a result of the procedure, she would not have consented to have it performed.
$ 3,300,000.00 SETTLEMENT
Medical Malpractice Action Involving Ventriculoperitoneal Shunt Malfunction Venued in Passaic County, New Jersey
This was a medical malpractice action involving pediatric neurology and pediatric neurosurgery. The infant plaintiff, was born with spina bifida and an accompanying Arnold-Chiari malformation of the spine and accompanying paraplegia and hydrocephalus, among other less significant problems. Soon after birth, the child underwent surgery for the placement of a ventriculoperitoneal shunt. This shunt served to stabilize his hydrocephalus, a condition which, if left uncontrolled, would lead to severe brain damage or death. Even with the shunt in place and functioning, the child still had significant disabilities, including confinement to a wheelchair, bowel and bladder incontinence, brittle bones and some degree of learning disability. The parties disputed whether the child’s I.Q. fell within the lower range of normal prior to the malpractice having occurred.
The ventriculoperitoneal shunt did, unfortunately, malfunction from time to time and, when this occurred, the child’s parents would take him to defendant Hospital for evaluation by his neurological team. Ventriculoperitoneal shunt malfunction normally carries with it certain symptoms for which the parents were trained to be on guard.
In March 1992, the child's parents again noticed the symptoms of possible shunt malfunction. They immediately took the child to Hospital, where he was seen by his neurological team, including a pediatric neurologist and two pediatric neurosurgeon. Said defendants evaluated the functioning of the child's ventriculoperitoneal shunt, as they had in the past, by taking a CT scan of the brain to look at the size of his ventricles. Thus, the neurologist and neurosurgeons would compare the current CT scan to the prior CT scan to see if the ventricles had become larger in size. If that is the case, there is then evidence of shunt malfunction, and surgery is performed to repair the problem.
Unfortunately, in March 1992, this pediatric neurologist and pediatric neurosurgeons made a critical mistake in evaluating this child. The physicians compared a current CT scan to a CT scan that was taken at a time in the past when the child's shunt was also malfunctioning, and the ventricles were already enlarged. Thus, from the comparison of the two CT scans, it appeared that the ventricles in the child's brain had not increased in size. This led these physicians to erroneously conclude that the child's symptoms were not caused by a malfunction of his ventriculoperitoneal shunt. They failed to compare the March 1992 scan with a scan where the ventricles had collapsed down to a normal size. They also failed to correlate his symptoms with increased intracranial pressure due to shunt malfunction.
This mistake led to this child sitting in the Hospital for four days under observation. On the fourth day, the child first suffered what appeared to be a seizure, and he then had another episode in which he lost consciousness. On the same day, after these two episodes, it was finally noted on the CT scan that the ventricular size had increased. One of the pediatric neurosurgeons performed a shunt revision that evening.
The delay in diagnosing the malfunctioning ventriculoperitoneal shunt allowed the intracranial pressure to increase to such severity that the child’s brain stem was compressed, his brain herniated through the posterior fossa in the upper regions of his spine, and he suffered a bilateral occipital lobe infarction. The result of his injuries meant cortical blindness (blindness associated with dysfunction of the cortex region of the brain), left-sided spastic hemiplegia, which meant that he would only have the use of the right upper quadrant of his torso because he was already paralyzed from the waist down from birth, and severely diminished intelligence. All these injuries were permanent, except for the cortical blindness, which partially resolved itself. The child now has extreme difficulty with peripheral vision and has an uncorrected vision of worse than 20/200.
The plaintiffs had three medical experts. All three of plaintiffs' experts found the named defendants to have deviated from the standard of care in failing to diagnose the malfunction of this child's ventriculoperitoneal shunt in March 1992. All three found that it was a deviation from the standard of care to use a prior CT scan taken during a time when the ventricles in the brain were already enlarged in order to determine present enlargement of the ventricles and ventriculoperitoneal shunt malfunction.
For Medical Malpractice; Plaintiff v. 2 Unnamed Internists, 3 Unnamed Emergency Room Physicians, 1 Orthopedist, and 1 Radiologist.
This case was settled on March 5, 2002 just prior to jury selection. It was anticipated that the trial would last 6 weeks. The plaintiff, presently 50 years old, alleged that due to the negligence of 7 physicians who treated her over the course of 66 days, an epidural abscess was not diagnosed at level T5 in her spine, leaving her a paraparetic. Plaintiffs had six expert witnesses, and the 7 defendants, represented by 6 different defense counsel (2 of the emergency room physicians had the same counsel) had 13 expert witnesses. It was anticipated that there would be fact witnesses called as well.
Plaintiff alleges that as a result of the negligence of the seven defendant physicians over approximately two months, plaintiff ’s true condition of a bone infection (osteomyelitis) of the thoracic (chest-level) vertebrae of her spine and epidural abscess went undiagnosed and untreated. This condition compressed her spinal cord at chest level and resulted in permanent paraparesis. An epidural abscess is a collection or pocket of infectious material that develops in the spinal canal, which is also termed the epidural space. By the time the plaintiff did receive proper treatment on June 15, 1998, with spinal surgery, she was already paralyzed from the chest down. Plaintiff alleges that even if the surgery was anytime earlier during the day of June 15, 1998, this would have abated the paralysis from which the plaintiff presently suffers.
The plaintiff has had some recovery from her complete paralysis from the chest down that she experienced on June 15, 1998. The plaintiff has regained enough function and strength in her legs to be able to walk in physical therapy approximately 40 feet with a walker, by taking 10 feet at a time, and resting in her wheelchair in between the 10 foot segments. Therefore, she is considered a paraparetic and suffering from paraparesis rather than a paraplegic suffering from complete paralysis from the chest down. She has not regained full bladder control. The plaintiff ’s level of functioning at this point is permanent such that she will not experience any significant improvement into the future.
Plaintiff’s counsel was Goldsmith Ctorides & Rodriguez, LLP. This matter was to be tried by Rachelle L. Harz, Lee S. Goldsmith, and Francisco J. Rodriguez.
MEDICAL MALPRACTICE FOR FAILURE TO APPROPRIATELY INTERPRET ULTRASOUND
The infant born September 7, 1994, was found to have multiple congenital anomalies. A sonogram taken during the pregnancy at 22 weeks was read as normal by the Defendant radiologist and in fact, there were two significant abnormalities apparent on this ultrasound:
- no fluid was visualized in the fetal stomach during the examination; and
- the fetal head was abnormally small.
It was Plaintiffs’ position that the Defendant radiologist deviated from the accepted standards of medical practice as a radiologist interpreting the obstetrical sonogram in that he failed to diagnose either of the two abnormalities both of which are highly significant. The absence of fluid in the fetal stomach indicates either esophageal atresia or a neurological abnormality that prevents the fetus from swallowing normally. Small fetal head size puts the fetus at risk for mental retardation. If the Defendant radiologist had made the correct diagnoses on the sonogram, the mother and father would have had the option of aborting the pregnancy. The child, presently 7 years old, is mentally retarded, has a feeding tube as well as a tracheostomy. The child is wheelchair bound and requires full time care.
Rachelle L. Harz, Esq., of the law firm of Goldsmith Harz, LLP, represented the Plaintiffs
$1,980,000.00 SETTLEMENT, SEPTEMBER 1998
FOR WRONGFUL LIFE OF CHILD FAILURE TO PROPERLY PERFORM AND INTERPRET SONOGRAM
Mother of child had amniocentesis performed by her obstetrician due to advanced maternal age. A sonographer served as the ultrasound technician at the obstetrician's offices. Video tapes were maintained of the sonogram. The ultrasound was improperly performed and not interpreted appropriately by either the sonographer or the obstetrician. As a result the parent's of the child were not informed of the fetal abnormalities and were not given the appropriate option of an abortion. The parents would have chosen the abortion knowing the physical abnormalities of the child. The child, now five, will require care and be dependant upon others for the remainder of its life. The child was born with a midline facial defect, misplacement of the location of the eyes and nose, abnormalities of the lower extremities. The child has limited cognitive and communicative skills.
MEDICAL MALPRACTICE FOR FAILING TO APPROPRIATELY INTERPRET ULTRASOUND AND DIAGNOSE HOLOPROSENCEPHALY
The infant plaintiff was born on February 28, 1997. Because of concerns regarding the infant plaintiff’s development, his pediatricians ordered an MRI of the brain on October 7, 1997. Following this imaging study, the interpreting neuro-radiologist indicated that the MRI examination demonstrated findings characteristic of holoprosencephaly.
It was the plaintiffs’ contention that, had the ultrasound images of the September 25, 1996 sonogram, taken at a gestational age of approximately 16.5 weeks, been appropriately taken and interpreted, the holoprosencephaly would have been detected, the significantly poor prognosis with respect to mental function would have been explained to the parents, and they would have had the option of aborting the pregnancy.
The ultrasound images from the September 25, 1996 sonogram, at a gestational age of approximately 16.5 weeks, demonstrated two images of an abnormality involving the fetal brain. Specifically, the images demonstrated an abnormal configuration of the choroid plexus and lateral ventricles. In particular, the left and right choroids plexes appeared to fuse in the midline within the lateral ventricles that also appeared to fuse in the midline. These images indicate midline fusion abnormality affecting the fetal brain consistent with the diagnosis of holoprosencephaly. The office notes from the prenatal visit of September 25, 1996 record nothing concerning this abnormal ultrasound finding, indicating that neither the technologist who obtained the images nor the physician who interpreted the images observed the abnormal ultrasound finding.
Since birth, the infant plaintiff has had significant developmental concerns. He cannot speak any words, he is not toilet-trained, and he is not able to communicate his needs. The infant plaintiff is not stable in a sitting position and is not able to sit up independently. This is presently a six-year-old boy with permanent neurological disabilities and who has had no meaningful development.
MEDICAL MALPRACTICE FOR FAILURE TO APPROPRIATELY INTERPRET SONOGRAM
The infant Plaintiff was born on December 15, 1994. At that time infant Plaintiff was noted at birth to be microcephalic with a number of congenital anomalies, including low-set ears, an extra rib and neck folds. After birth a cranial ultrasound was reported as showing a 5mm choroid plexus cyst. Chromosomal analysis was performed and revealed a chromosomal anomaly, specifically deletion of the long arm of chromosome 18.
The defendant obstetrician in this case failed to retain the sonogram images. It was the position of the Plaintiffs that failure to maintain the sonogram images and documentation were deviations from the accepted standards of care. Plaintiffs were able to base the proofs of their case on the existing physical condition of the child at the time of birth as certain of the child’s physical anomalies would have been present at the time of the second trimester sonogram.
Since birth infant Plaintiff is significantly developmentally delayed and mentally retarded. It was the Plaintiffs’ position that a sonogram performed during the mother’s second trimester at approximately 19 weeks gestation should have detected the intracranial cyst and nuchal folds. It was the contention of the Plaintiffs that these abnormalities would have been diagnosed if the sonogram had been adequately done with proper equipment and had complied with the existing standards in 1994 for performance of a second and third trimester obstetrical sonogram. Standards for a second trimester and third trimester sonogram provide that the fetal head should be measured and the intracranial contents should be examined. If the sonogram had diagnosed a choroids plexus or other intracranial cyst, it is likely that a chromosomal analysis via amniocenteses would have been performed. If that had happened, the chromosomal anomaly would have been detected and the poor prognosis with respect to mental function would have been explained to the parents and they would have had the option of aborting the pregnancy.
The child is presently 7 years old, has a feeding tube, is mentally retarded, is wheelchair bound and requires full time care. The child’s life expectancy is limited to approximately another ten years.
Rachelle L. Harz, Esq., of the law firm of Goldsmith, Harz, LLP, represented the Plaintiffs.
FOR DEATH OF 66 YEAR OLD MAN AFTER SURGERY FOR RECTAL CANCER
Decedent, a 66 year old retiree, presented to Defendants in August 1991 for the removal of a low-lying rectal carcinoma and he underwent an Anastomosis of the bowel. The anastomosis ruptured 8 days after surgery, spilling fecal material into decedent’s abdomen and out the surgical wound. Plaintiff claimed that defendants failed to intervene surgically to this emergency. The emergency repair surgery was delayed for 16 hours. Decedent developed peritonitis and sepsis and remained in the hospital for next 8 months until his death in March of 1992.
for Wrongful Life
Infant plaintiff was born with spina bifida, secondary ventriculomegaly and an Arnold - Chiari malformation. His parents, instituted a wrongful life action against their treating obstetrician and the sonographer and sonography company.
The Plaintiffs contended that obstetrician failed to inform them of the increased risk of an open neural tube defect based on the mother's elevated alpha feta protein results. In addition, the doctor did not discuss with them the option of genetic amniocentesis. Furthermore, the Level II ultrasound that was performed in the doctor's office by the sonographer required knowledge of the implication of an elevated alfa feta protein and appropriate sonographic technique that was not reflected in the images in this fetal ultrasound. Due to a number of deficiencies, the study did not meet the criteria for a basic fetal ultrasound established by the American Institute of Ultrasound In Medicine. Despite the deficiencies, however, there were sonographic findings which suggested that the fetus was affected with an open neural tube defect and these were neither reported nor further evaluated. There was no written documentation by the obstetrician regarding his evaluation, interpretation, or final diagnosis of the fetal ultrasound. Plaintiffs' attorneys contended that the parents should have been given the option of genetic amniocenteses or alternatively the doctor could have referred them to a center with the appropriate sonographic equipment, technical skills and support personnel to provide more in depth counseling which was totally absent in this case. As a result, the parents were not given the opportunity of having the fetal anomalies detected and therefore were not provided with sufficient time to consider all of their reproductive options.
FOR RSD/NEUROLOGICAL INJURY TO RIGHT ARM AND SHOULDER
The plaintiff was injured at age 34 when entering a drug store and was struck on her right shoulder and right side of her body by a malfunctioning electronic entrance door. She was pinned at the shoulder against the wall, and subsequently required surgery for a shoulder impingement. She then developed reflex sympathetic dystrophy of the right upper extremity requiring numerous stellate ganglion blocks in her neck to help her cope with the pain. She also sustained injury to her right wrist consistent with a carpal tunnel syndrome and underwent surgery for the right carpal tunnel release. Her injuries and disabilities are permanent. She is not able to work because of the present condition of her right arm and right hand. She has two children for whom she is responsible as a single mother and does not take pain medication in order to be alert to their needs. She will suffer with pain and disability indefinitely.
FOR BRAIN/NEUROLOGICAL INJURIES SUSTAINED BY A SEVENTEEN YEAR OLD AS A RESULT OF AN AUTOMOBILE ACCIDENT
The plaintiff was a passenger involved in a two vehicle accident. She was hospitalized in a coma for a number of weeks and then required transfer to Children's Specialized Hospital. She has received outpatient treatment for rehabilitation at Kessler and other facilities. She presently lives with family and functions independently.
FOR UNDIAGNOSED HEART INFECTION
Decedent died in 1992 due to complications relating to a bacterial infection of the heart, called endocarditis. She was 32 years of age. She died five months after giving birth to her only child. She was misdiagnosed as having a sinusitis. The defendant doctor found and recorded data relating to a heart murmur at the time of her child’s birth but did not follow up on that finding. The decedent also showed symptoms of fatigue, fever, rash and urinary tract infection at the time of the birth of her only child.
A structured settlement was reached on the eve of trial with a guaranteed payment of $4,700,000.
MEDICAL MALPRACTICE FOR ERBS PALSY INJURY
The infant Plaintiff born June 1, 1998, was found to have significant right brachial plexus injury. The Defendant obstetrician at the time of the delivery did not document any standard maneuvers that were employed to release the impacted shoulder in the pelvic structure. A surgical procedure was performed on the infant 9 months after birth and when the surgeon explored the brachial plexus there was found a significant traumatic neuroma of the upper trunk which confirmed Plaintiffs’ theory of the traction injury to the brachial plexus. The infant Plaintiff will be left with a permanent impairment of the right upper extremity function as well as persistent abnormal posturing and a possible limb length discrepancy.
Plaintiffs were represented by Rachelle L. Harz, Esq., of Goldsmith Ctorides & Rodriguez, LLP.
for the pain and suffering of an 83 year old woman
FAILURE TO MONITOR HEMOGLOBIN DURING SURGERY CAUSING ANOXIA AND BRAIN DAMAGE
Plaintiff broke her hip and during hip replacement surgery had a dramatic fall in her hemoglobin which went undetected by her anesthesiologist. As a result, she suffered from a lack of oxygen to her brain which caused her to be in a coma for a number of days. She ultimately came out of the coma however the hypoxic event caused her to sustain brain damage which made it impossible for her to continue living independently as she had been prior to this surgery. She became confined to a nursing home and requires assistance with all aspects of daily living. She becomes easily confused and lacks her prior mental acuity. The plaintiff is aware of the change in her mental and physical condition and suffers from depression.
to a 20 year old woman who was driving her car and was struck head on by another vehicle.
She sustained nerve injury to the left side of her face leaving her with partial facial palsy. She underwent surgery for a muscle transfer. She has an uneven smile, ringing in her right ear, and her right eye will abnormally tear.
for Automobile Injury case
On July 5, 1996, Plaintiff, at nineteen years of age, sustained injury to her left facial nerve due to the clear negligence of the driver of another vehicle. Plaintiff was driving a friend's car when defendant driving a Ford pick-up swerved into the opposite lane of traffic and struck the vehicle she was driving.
Plaintiff underwent a surgical procedure, called left temporalis transfer and suspension of the left eyebrow, which places a muscle from the top portion of her head into her left cheek area in order for her to regain some function on the left aspect of her face. Despite the surgery, her smile remains unbalanced. Plaintiff, thankfully, is fully functional, a senior in college with plans for a Doctorate degree. She also has occasional tearing of the left eye, and loss of sound of high pitches in the left ear.
Settlement was effectuated between the parties on December 2, 1998.
SUPERIOR COURT OF NEW JERSEY LAW DIVISION : MIDDLESEX COUNTY.
For the failure to properly manage a high risk pregnancy
Settlement:$725,000 present value with guaranteed payout of 2 million dollars for the failure to properly manage a high risk pregnancy at a United States Air Force hospital resulting in the premature birth of a 24 week gestation resulting in a child who suffers from Cerebral Palsy and Blindness from Retinopathy of Prematurity. Mother went into premature labor at hospital A on a Friday. Was kept in that institution until Monday when she was air evacuated to hospital B. At Hospital B she was placed on complete bed rest for the first 48 hours and then encouraged to ambulate. After beginning ambulation she went back into premature labor and delivered her daughter at 24 weeks. Standard of care required complete bed rest with trendelenberg position. Hospital and doctors departed from standard of care. Case was settled for $725,000 T-Bill Trust with expected yield of $2,000,000 for the child's lifetime. More info reference GVU in e-mail.
MEDICAL MALPRACTICE FOR FAILING TO RECOGNIZE CARDIAC ABNORMALITIES
The deceased plaintiff, a woman born September 25, 1952, died on October 31, 1999 at age forty-seven due to the negligence of an Emergency Room physician in failing to recognize an abnormal ECG and admit her to a hospital for immediate cardiac evaluation.
The facts of the case are as follows. On September 15, 1999, the deceased plaintiff collapsed and was evaluated by an ER physician in the Emergency Room Department of a Hospital. She had experienced syncope and passed out. She was initially cyanotic with decreased respirations.
The Emergency Room physician elicited her history of hypertension and her use of the medication hyzaar. Blood work revealed her potassium to be 3.0. Her ECG revealed a prolonged QT interval. The Emergency Room physician concluded that the deceased plaintiff was suffering from anxiety. He prescribed a potassium mediation and told her to see a private physician. He also gave her xanax for anxiety. The deceased plaintiff died of sudden cardiac death on October 31, 1999.
It was plaintiff’s contention that the Emergency Room physician deviated from the standard of care in his failure to admit the deceased to a monitored hospital bed and to arrange a cardiac consultation. Her presentation in the Emergency Room had multiple features reflecting high risk cardiac status. The defense indicated that the prolonged QT interval was due to her low potassium (hypokalemia) and that she had been observed for approximately three hours in the Emergency Room without any evidence of cardiac arrhythmia. Plaintiff contended that the standard of care required a minimum of forty-eight hours of observation in a monitored cardiac unit for syncope.
The deceased plaintiff left behind her husband and two children, ages six and eight at the time of her death.
The deceased plaintiff and her estate were represented by Rachelle L. Harz, Esq.
for pain, suffering and wrongful death of a 65 year old woman
FAILURE TO DIAGNOSE CARDIAC TAMPONADE CAUSING CARDIAC ARREST AND BRAIN DAMAGE
Plaintiff underwent an angioplasty procedure and thereafter suffered from a cardiac tamponade which went undetected by her treating cardiologists despite multiple complaints and symptoms. As a result of the undetected and untreated cardiac tamponade, she suffered cardiac arrest and neurological damage, which caused her to remain in a comatose state for approximately three years prior to her ultimate death. The plaintiff lived with her husband, and had six adult children. For three years, she was cared for at home, by her family, who would not disconnect life support. She ultimately succumbed to complications from her condition. The medical malpractice allegations included failure to recognize the cardiac tamponade and appropriately and timely treat the condition. It was Plaintiffs' position that had this been done, the chances of her survival without neurological complications would have been excellent.
As a result, the child is now a five year old with multiple chronic medical and neurological problems all of which are related to the presence of a myelomeningocele and Arnold Chiari Type II malformation. These neurological, developmental and orthopedic problems are all permanent and will not improve in the future.
FOR TUBING ACCIDENT AT A SKIING FACILITY: FRACTURE/DISLOCATION OF BACK AT T11-T12
On March 1, 1998, the Plaintiff then 16 years old, sustained a back injury while tubing at Campgaw Mountain. She was sitting on her tube at the staging area when she was unexpectedly pushed from behind by Lee DeSantis, a named Defendant, who was helping tubers off the lift. The incident occurred after the mountain closed at 5:00 P.M. to the public. The trajectory that resulted from the push took her directly over a man-made jump. Going airborne over the jump, she landed and sustained a fracture/dislocation of T11-T12 with partial paraplegia. She underwent reduction of the fracture and posterior fusion with instrumentation. After her initial hospital course, she was discharged to Kessler Institute For Rehabilitation. She then began to ambulate by use of braces and then a cane. The Plaintiff made a good recovery but her injury did not completely resolve and she was left with some residual dysfunction including some weakness to her left foot dorsiflexion. At present she complains of some weakness on the left leg and some numbness in the left leg. She is able to walk but unable to run.
A difficult aspect of this case was the potential comparative negligence that a Jury could place on the Plaintiff herself. The liability rested on the Defendant ski facility, as the ski park management knew or should have known on the evening of the Plaintiff’s incident that there would be dangerous horseplay, and that tubers could encounter the man-made jump and become injured by going airborne off of it. Furthermore, the ski park management failed to provide supervision to control activities at the top staging area, and failed to prevent tubers from accessing the man-made jump. Plaintiff further alleged that the ski facility was not appropriately set up for the activity of tubing and had not been open for tubing to the public for the entire ski season.
Medical Malpractice for Failing to Recognize Widened Mediastinum and Aortic Dissection
The deceased plaintiff, 48 years old, died on February 21, 1998 due to the negligence of physicians treating him for the symptoms of nausea, vomiting, chest pain, abdominal pain, left leg pain, numbness, and left leg ischemia secondary to an acute Type B (III) aortic dissection.
On February 20, 1998, the deceased plaintiff arrived at the Emergency Department of a hospital complaining of vomiting and chest pain. He had a history of hypertension and presented with an elevated blood pressure. Diagnostic lab work was ordered, in addition to a chest x-ray and EKG. The patient was medicated with Compazine for his nausea and vomiting and Procardia for his elevated blood pressure. He furthermore received Tordal for an undocumented reason at about 9:00 p.m. The deceased plaintiff was discharged with a diagnosis of “uncontrolled hypertension-improved”.
After discharge from the Emergency Department, The deceased plaintiff went home, but soon thereafter called an ambulance because of left leg pain. EMTs arrived at 10:59 p.m. and noted elevated blood pressure. He was then transported back to a hospital where he initially went through the Emergency Room and was assessed with a cool pulseless left leg with decreased sensation. An EKG and chest x-ray were ordered and he was admitted to the surgical service with a diagnosis of leg ischemia. An emergent left femoral embolectomy was performed. There was no documented indication that the chest x-ray or EKG were read prior to the surgery. At approximately 12:00 noon, deceased plaintiff complained of chest pain and lost his vital signs; he was pronounced dead at 12:53 p.m.
It was the contention of the plaintiffs that the emergency room physicians deviated from the standards of care in their failure to perform an adequate history and physical examination; failure to review critical diagnostic testing; and failure to admit the patient to the hospital and arrange emergent cardiac and cardio thoracic consultations. Although there had been a chest x-ray and an EKG taken, there was no documentation in the hospital chart that there was an interpretation of either study. Of note, deceased plaintiff’s EKG was abnormal and his chest x-ray showed abnormality of the aorta which should have raised a suspicion of aortic dissection. Plaintiffs contended that the failure to interpret these studies in this case was a clear deviation from the standard of care. In addition, any patient with his system complex required further testing. Plaintiffs further contended that even in the absence of recognizing the clear signs of aortic dissection, the emergency physicians caring for deceased plaintiff, should have admitted him to the hospital based on his symptoms of chest pains and vomiting in the setting of hypertensive crisis and abnormal EKG. The plaintiffs contend that the patient’s symptoms were largely ignored during is ED stay and he was discharged without adequate physical examination, without documented re-evaluation, without complete evaluation of diagnostic testing, and without a credible diagnostic impression.
The deceased plaintiff left surviving his wife, two grown children and a granddaughter.
MEDICAL MALPRACTICE FOR FAILING TO PERFORM VULVAR BIOPSY WHICH DELAYED DIAGNOSIS OF CANCER FOR TWO YEARS
The Plaintiff, a 43 year old female, sought care from her gynecologist in February, 1997, at which time her gynecologist did not perform a necessary vulvar biopsy. Her gynecologist indicated that the white lesion on the vulvar was eczema and a biopsy was not performed until January, 1999. The result of that biopsy revealed squamous cell carcinoma in-situ. Thereafter wide excision of the lesion was performed which demonstrated an invasive squamous cell cancer. The Plaintiff was treated with a radical hemivulvectomy and lymph node dissection.
Plaintiff argued to a reasonable degree of medical certainty, had the vulvar biopsy been performed in January of 1997, a pre-invasive vulvar lesion would have been discovered and treatment of this could have been accomplished with wide local excision and/or laser vaporization. As a result of the two year delay, the Plaintiff had progression from dysplasia to an invasive carcinoma of the vulva which required radical surgery and lymph node dissection.
Rachelle L. Harz, Esq., of the law firm of Goldsmith, Harz, LLP represented the Plaintiffs.
MEDICAL MALPRACTICE FOR FAILURE TO PROPERLY INTERPRET MAMMOGRAM
The Plaintiff, now deceased, had her mammogram of June, 1997, interpreted by the Defendant radiologist which was read as revealing no mammographic evidence of malignancy. This examination in fact should have been reported as demonstrating a new irregular density which measured approximately 1.5 X 1.2 centimeters. Plaintiff was able to establish to a reasonable degree of medical certainty that the Defendant radiologist deviated from the accepted standard of medical care by failing to detect, describe, fully evaluate, and make appropriate recommendations for follow up for the abnormality seen within the Plaintiff’s left breast on the mammogram Defendant radiologist interpreted on June 25, 1997. This deviation lead to a delay in the diagnosis of breast cancer of approximately one year. Plaintiff’s expert oncologist opined that the tumor would have been a Stage 1 carcinoma of the left breast had it been diagnosed in June of 1997 and that the Plaintiff would not have had metastatic disease to the axilliary lymph nodes at the time of diagnosis in June of 1998. Francisco J. Rodriguez, Esq., of the law firm Goldsmith, Harz, LLP, represented the Plaintiffs.
Medical Malpractice for Failure to Appropriately Interpret Mammography;
Failure to Detect Early Signs of Breast Cancer
Plaintiff, born April 22, 1944, died at age 57 on March 10, 2001, as a result of a delay in the diagnosis of breast cancer.
It was the contention of the plaintiffs that the defendant radiologist incorrectly interpreted the mammogram of the deceased plaintiff taken June 25, 1997 as revealing no mammographic evidence of malignancy. In reality her mammogram of 6/27/97 demonstrated a new irregular density in the central, posterior aspect of her left breast. A spot compression view of the new, irregular density was indicated at that time. It was plaintiff’s position that this could have most certainly revealed a persistent suspicious mass which would have prompted attempts to localize the abnormality in another projection to perform an ultrasound and/or image guided biopsy, or a preoperative needle localization for open surgical biopsy.
On the subsequent mammogram on 6/3/98, the missed mass was markedly increased and had the appearance of a large locally advanced breast cancer. At the time of mastectomy of 7/24/98, the mass was reported to be 6 centimeters in diameter and the deceased plaintiff was eventually diagnosed with stage IIIA invasive ductal carcinoma of the breast. Despite undergoing chemotherapy and radiation therapy, the plaintiff eventually died of breast cancer.
The deviations on the part of the defendant radiologist lead to a delay in the diagnosis of breast cancer of approximately one year. It was plaintiff’s expert opinion that had the tumor been diagnosed in 6/25/97, it would have been a stage I carcinoma of the left breast and the patient would not have had metastatic disease to the axillary lymph nodes. It was plaintiff’s position that the prognosis for patients with stage I carcinoma of the breast is far superior to that of patients with stage II or stage II carcinoma of the breast.
The deceased plaintiff left surviving a 24-year-old daughter.
for the medical malpractice of a radiologist who failed to properly interpret chest x-rays of a 40 year old woman
The chest x-rays were interpreted as normal by the defendant radiologist, instead of correctly diagnosing a pleural effusion and therefore, additional medical testing was not ordered. As a result of the misread of the x-ray, the patient's deep vein thrombosis and pulmonary emboli were not diagnosed earlier and she died from a massive pulmonary embolism.
MEDICAL MALPRACTICE FOR FAILING TO APPROPRIATELY INTERPRET AN MRI
FOUR-YEAR DELAY IN DIAGNOSIS OF ACOUSTIC NEUROMA RESULTING IN RIGHT FACIAL NERVE PALSY
The plaintiff, presently a sixty-six-year-old male, sought care from an ear, nose and throat specialist in March of 1994 due to loss of hearing. The treating physician referred the plaintiff for an MRI to rule out the origin of his hearing loss as a tumor. An MRI of the internal acoustic meatus was ordered and interpreted as normal. The plaintiff’s loss of hearing was considered to be idiopathic in nature. No further treatment was rendered until several years later, when the plaintiff presented with new symptoms, including sensation of numbness in his right upper face. This prompted the plaintiff to be sent for another MRI scan of the brain and internal auditory canals in March of 1998. This MRI study revealed a large mass of approximately 4 centimeters.
Plaintiff argued that, to a reasonable degree of medical certainty, had the acoustic neuroma been appropriately visualized and diagnosed by the 1994 MRI, it would have been less than 1 centimeter, and the likelihood of preserving the plaintiff’s facial nerve function for a tumor of this size was extremely high. Due to the fact that the tumor had grown to greater than 4 centimeters, the likelihood of injury to the facial nerve, despite the attempts to preserve the facial nerve, were extremely high. It was plaintiff’s position that the delay in diagnosis and the necessity of having to treat the tumor at a size of over 4 centimeters related to the damage to the plaintiff’s facial nerve and resulting facial nerve palsy; if the tumor had been operated on when it first should have been identified, the probability of facial nerve preservation was much greater.
As a result of the right facial nerve palsy, the plaintiff suffers with multiple difficulties such as closing his right eye, tearing of the right eye, chewing foods, drinking fluids, facial disfigurement and right-sided facial discomfort.
FOR DELAY IN THE DIAGNOSIS OF LUPUS
44 year old male presented at his internist's office complaining of a tick bite. Blood work was performed including Lymes Disease test and the results revealed rhuemetological findings. The internist contended the he referred the patient to a rhuematologist and the patient denied that such a referral was ever made. As a result of the internist failing to properly interpret the blood work, and make the appropriate referral, the patient was not diagnosed with Lupus at an earlier time and developed kidney disfunction due to the delay.
Medical Malpractice for failing to recognize a pulmonary embolus
Plaintiff died at age 30 due to the negligence of a cardiologist in failing to perform necessary diagnostic tests with a suspicion of pulmonary embolus.
The deceased plaintiff was seen by an internist who noted that the patient had felt ill for a number of months and was also complaining of dyspnea (shortness of breath). The ECG was abnormal and was referred to a cardiologist. The deceased plaintiff was evaluated by the cardiologist and at the time, a history of intermittent fevers as well as one flight dyspnea was elicited. The deceased plaintiff was treated for a presumed urinary tract infection, although the urine culture ultimately failed to demonstrate any significant abnormality. The physician treating the deceased plaintiff commented that his “initial thought pattern raises the question of pulmonary embolus”. Diagnostic studies were not performed due to the patient’s lack of medical insurance.
At the time of this visit with the cardiologist, the deceased plaintiff was accompanied by her mother who had always and consistently paid her medical bills. There was never a discussion with the patient or the patient’s mother regarding the performance of studies to rule out pulmonary embolus and there is no documentation in the chart that any such conversation took place. Had this diagnostic testing been discussed with the patient and her mother, her mother indicated that indeed they would have agreed to go forward with this testing.
Nine days later, the deceased plaintiff was transported to a hospital after suddenly loosing consciousness. The autopsy performed later that same day revealed thrombi within the inferior vena cava as well as massive bi-lateral pulmonary emboli.
It was the position of the plaintiffs that the cardiologist caring for the deceased plaintiff deviated from the accepted standard of medical practice. By his own admission, a pulmonary embolus was considered, but diagnostic studies were not performed due to the patient’s lack of medical insurance. Under such circumstances, the standard of medical care demanded that the physician clearly present his concerns to the patient as well as the potential harm that might be incurred if a ventilation/perfusion scan was not obtained. If the patient then chose not to proceed with the recommended diagnostic studies, such refusal should have been documented in the medical record.
Had the patient undergone a V/Q lung scan, pulmonary emboli would almost certainly have been demonstrated. Prompt treatment with Heparin and ultimately Warfarin would in all likelihood have prevented the massive embolization which resulted in the patient’s death.
FOR FAILURE TO APPROPRIATELY TREAT BASAL CELL CARCINOMA WITH MOHS SURGERY
The Plaintiff in 1994, then 46 years old, first presented to the unnamed Defendant dermatologist with a cystic scalp lesion. The tumor was excised and the Plaintiff was never told that the pathology results were consistent with basal cell carcinoma, morphea type. On November 7, 1995, the Plaintiff returned to the physician’s office with a lump at the site of the previous scalp surgery. This recurrent lesion was then re-excised and the Plaintiff was finally advised as to the pathological findings. The cancer was re-excised for the third time on January 23, 1996. On
May 19, 1998, the Defendant dermatologist once again noticed a nodule at the previous cancerous site. The Defendant, having failed to remove this aggressive skin cancer on three previous attempts, undertook a fourth attempt on June 23, 1998. The Plaintiff finally underwent MOHS skin cancer surgery on August 17, 1998.
MOHS surgery is the treatment of choice for basal cell carcinoma, morphea type. Plaintiff should have been referred for MOHS surgery as early as May 9, 1994. By failing to refer the Plaintiff for MOHS surgery this Plaintiff had to undergo multiple surgical procedures. The Plaintiff had to undergo extensive surgery in 1998 to remove the basal cell carcinoma in her scalp and it resulted in a large post-surgical defect. (depression in the scalp and numbness).
FOR WRONGFUL DEATH OF 66 YEAR OLD RETIRED MAN
A wrongful death action was recently settled on behalf of the estate of a deceased retiree for $225,000 as against a cardiologist and hospital. The case alleged improper cardiac monitoring in a known cardiac patient resulting in a massive heart attack and death.
A 66 year old man with prior history of myocardial infarctions presented to the emergency of defendant hospital with complaints of chest pain, shortness of breath and pain radiating down both arms. The patient was observed in the emergency department overnight. The next morning he was admitted to a regular room rather than the Cardiac Care Unit. Cardiac monitoring was not available in the room he was in. Over the course of the next few days, the patient experienced repeated bouts of chest pain. In addition, he experienced anginal pain during a stress test which was performed at a low level of exercise. The patient was kept in the room and not transferred to the CCU. Several days later the patient went into cardiac arrest, was transferred to the CCU and died.
The decedent was retired and survived by a wife and five adult children.
$200,000 Settlement February 1997
Delay in diagnosis of breast cancer for one year three months.
Defendants: Gynecologist; Radiologist:
37 year old white female presented to her gynecologist's office within one week of finding a lump on her right breast. The gynecologist referred her for a mammogram. The radiologists performed both a mammogram and sonogram and concluded that the lump was not malignant. The radiologist recommended clinical studies should the lump persist.
The plaintiff returned to the gynecologist's office several more times over the next few months still complaining about the presence of the lump. No biopsy was performed.
Twelve months later, the plaintiff on her own initiative returned to the radiologists' offices for a follow up mammogram. The radiologists concluded that the lump was not malignant. Three month's later, during plastic surgery, the lump was removed and biopsied. It was cancerous. The plaintiff underwent a partial mastectomy as well as chemotherapy and radiation.
Patient was diagnosed at stage one at the time of diagnosis and was doing well five (5) post diagnosis.
Case Settled with payment from gynecologist of 2/3's of the settlement and 1/3 from the radiologist.