Failure to Diagnose and Treat a Pulmonary Embolism and Deep Vein Thrombosis, Resulting Death
The case involved the failure of defendants to diagnose and treat a pulmonary embolism and deep vein thrombosis, resulting in decedent's death several weeks later. During trial, WRSH Partner, Jason Rubin contended that the defendant hospital failed to perform a workup of decedent for pulmonary embolism (a blood clot in the lungs usually caused when a blood clot from the legs breaks off and travels to the lung) when she presented to its emergency room complaining of shortness of breath and a non-productive cough. A physical examination revealed that she was tachycardic (rapid heart rate), tachypneic (rapid respiratory rate) and had a diminished oxygen saturation. A chest x-ray was performed which revealed a pulmonary infiltrate. Decedent was diagnosed with pneumonia and was discharged with antibiotics. Approximately two weeks later, decedent underwent a hysterectomy and shortly after the surgery she coded and died. An autopsy revealed that she died of an acute pulmonary embolism,originating from a deep vein thrombosis in her legs. The autopsy findings also indicated that she had subacute and remote pulmonary emboli, which were several weeks old or older.
Jason argued at trial that the hospital should have included pulmonary embolism in the differential diagnosis and performed a test known as a CT pulmonary angiogram because decedent's presenting signs and symptoms were consistent with pulmonary embolism. Testimony from the medical examiner indicated that the subacute and remote pulmonary emboli found at autopsy would have been present in decedent's lungs at the time of her emergency room visit, and testimony from both plaintiff's and defendant's expert indicated that a CT pulmonary angiogram would have diagnosed pulmonary emboli. Jason argued that if pulmonary emboli were properly diagnosed, decedent would have been anticoagulated (i.e. placed on blood thinners), she would not have undergone the hysterectomy, and her death from recurrent pulmonary embolism would have been prevented.
Defendant argued that decedent's presentation was consistent with pneumonia and that this diagnosis was confirmed by the chest x-ray demonstrating a pulmonary infiltrate. It argued that decedent did not have risk factors for pulmonary embolism or deep vein thrombosis and her presentation was not concerning for these conditions because, among other things, she did not have chest pain, she was not coughing up blood and she did not have leg swelling. Defendant also argued that there was negligence on the part of the non-party surgeon for performing an unnecessary hysterectomy without obtaining medical clearance and that the immediate cause of death was the pulmonary embolism decedent developed as a result of this surgery.
The case ultimately settled for $835,000. Prior to trial, Jason settled with one of the defendant doctors for $235,000.00. During trial, a settlement of $600,000.00 was reached with the defendant hospital.