The following summaries are Physicians Insurance cases that have gone to trial and are public record. In reporting these legal results, it is our goal to inform members about issues that impact healthcare professionals. While we share information we think may be informative, we choose not to disclose the names of plaintiffs or defendants when reporting these results.
FAILURE TO IDENTIFY APPENDICITIS ON CT
SPECIALTY: Radiology
ALLEGATION: The plaintiffs claimed that the radiologist failed to identify appendicitis on a CT scan performed on January 2, 2012, resulting in pain, suffering, a large scar, and the need for an open appendectomy via midline laparotomy once acute appendicitis was subsequently diagnosed on April 12, 2012. While the appendix had not ruptured at the time the appendectomy was performed, the plaintiff claimed the open procedure was necessary due to a festering infection, and that a laparoscopic procedure could have been performed with an earlier diagnosis.
The defendant radiologist convincingly testified that her interpretation of the CT complied with the standard of care, stating her belief that the appendix was obscured on the study and that what turned out to be the appendix, she initially believed to be an inflamed loop of bowel.
Defense expert Dr. Bax testified that the sole basis for performance of the open appendectomy was an abnormal location of the appendix, high up in the abdomen near the liver. Any delay in diagnosis or concern about a festering infection had no causal relation to the surgical approach.
Efforts to settle the case prior to trial were unsuccessful.
PLAINTIFF ATTORNEY: Matthew Renda, Kennewick, WA
PLAINTIFF EXPERTS: Timothy Larson, MD, Radiology, Seattle, WA; Jedediah Kaufman, MD, General Surgery, Edmonds, WA
DEFENSE ATTORNEYS: Steve Lamberson and Jeff Galloway, Spokane, WA
DEFENSE EXPERT: Timothy Bax, MD, General Surgery, Spokane, WA
RESULT: Defense Verdict, Grant County
FAILURE TO DIAGNOSE ESOPHAGEAL PERFORATION
SPECIALTY: Orthopedic Surgery
ALLEGATION: The patient was 37 years old when she sustained a neck injury in a motor-vehicle accident. Following unsuccessful attempts at conservative pain management, she underwent a two-level anterior cervical discectomy and fusion of C5-C7, performed by the defendant orthopedic surgeon on May 8, 2014. The procedure was without event, and she had a normal postoperative course and reported immediate relief from her neck and upper-extremity symptoms.
On September 3, 2014, the patient called the defendant’s office and reported trouble with swallowing, regurgitation of food, and a sore throat at the incision site. The message was relayed to the defendant surgeon, who asked his medical assistant to instruct the patient to use salt-water gargles, avoid irritating foods, chew carefully, and schedule an appointment with him if her symptoms did not resolve in two weeks.
The patient traveled to Arizona for a softball tournament, and while she was there her symptoms worsened. On October 12, 2014, she went to the ER in Arizona with complaints of neck pain, swelling, and general malaise. A CT confirmed an abscess behind her esophagus from C5-C7. The patient underwent surgery to explore and drain the abscess, remove the hardware in her neck, and repair a small tear in her esophagus.
The patient subsequently developed a Zenker’s diverticulum, further delaying her recovery.
By the time of trial, the plaintiff’s claims were narrowed to inappropriately managing the September 3, 2014, phone call.
PLAINTIFF ATTORNEYS: Collen Durkin Peterson and Jessica Holman, Holman Law
PLAINTIFF EXPERTS: Joseph Fetto, MD, Orthopedic Surgery; Brooklyn; NY; Richard Wohns, MD, Orthopedic Surgery, Puyallup, WA; Willard Fee Jr., MD, Otolaryngology, Palo Alto, CA; Safwan Jaradeh, MD, Neurology, Palo Alto, CA; Randall Patten, MD, Radiology, Olympia, WA; Francis Riedo, MD, Infectious Diseases, Kirkland, WA
DEFENSE ATTORNEYS: John Graffe and Michael McDermott, Seattle, WA
DEFENSE EXPERTS: William Smith, MD, Neurosurgery, Las Vegas, NV; Charles Nussbaum, MD, Neurosurgery, Seattle, WA; Dinesh Chhetri, MD, Otolaryngology, Los Angeles, CA; James Anderson, MD, Neuroradiology, Portland, OR; Christopher Graber, MD, Infectious Diseases, Los Angeles, CA; Ali Samii, MD, Neurology, Seattle, WA
RESULT: Defense Verdict, Snohomish County