$2.15 Million Settled Prior to Trial - Medical Malpractice: Inadequate Medical Workup Leads to Patient’s Death

Wrongful Death - Medical Malpractice

Just prior to trial, WRSH partner Jason Rubin reached a $2.15 million settlement in a medical malpractice case in Onondaga County, New York, arising out of the death of a 39-year-old single mother of four.

Decedent, who was morbidly obese, presented to her OB/GYN with complaints of urinary frequency and right lower quadrant pain. The doctor diagnosed a urinary tract infection and prescribed an antibiotic, Macrobid.

Six days later, decedent presented to an urgent care clinic complaining that her condition was getting worse despite being on Macrobid. Specifically, she was now experiencing vomiting and nausea, and her pelvic pain was radiating to her back. Decedent was evaluated by a nurse practitioner and the physical examination revealed that she was tachycardic (had an elevated heart rate) and had a fever. A urinalysis and urine culture were performed and the urine culture was essentially benign. The nurse practitioner did not perform a pelvic exam and did not draw blood for analysis. He diagnosed decedent with pyelonephritis (infection of the upper urinary tract), changed her antibiotic to Bactrim, and discharged her.

Three days later, decedent experienced shortness of breath while at home. An ambulance was called and, just as EMS arrived, she became unresponsive. She was transported to a local hospital and she had several episodes of cardiac arrest. She died later that day. An autopsy was performed, which revealed the cause of death to be sepsis due to pelvic inflammatory disease with acute peritonitis and a right ovarian abscess.

We started suit, alleging that the nurse practitioner who saw decedent at the urgent care center was negligent in performing an inadequate workup and as a result failed to diagnose and treat decedent’s pelvic inflammatory disease. Specifically, we alleged that the nurse practitioner should have performed a pelvic exam, bloodwork, and a pelvic CT scan or ultrasound as part of his workup in light of the fact that decedent was tachycardic, feverish, experiencing vomiting, and had worsening pelvic and back pain despite being treated with Macrobid for a urinary tract infection. We alleged that, had a proper examination and testing been performed, decedent’s pelvic inflammatory disease would have been diagnosed and treated, and her death would have been prevented.

The defendant nurse practitioner alleged that decedent refused his recommendation for a pelvic exam and bloodwork, and decedent had an agenda when she presented to the urgent care center to merely obtain a Bactrim. The NP contended that he was told by decedent that she had multiple urinary tract infections in the past which did not respond to Macrobid, but were successfully treated with Bactrim. Jason would have refuted this defense by pointing out that the NP’s notes for the encounter didn’t note a history of prior UTIs, nor the alleged refusal of a pelvic exam and bloodwork. Additionally, Jason would have pointed to the medical records of decedent’s primary care physician, which indicated she had just one prior urinary tract infection several years earlier that was successfully treated with Macrobid, belying the testimony of the nurse practitioner.

Additionally, defendants indicated their intention to call an expert pathologist at trial, who was going to testify that the cause of decedent’s death was from pulmonary microemboli, and not an untreated pelvic infection. Jason would have refuted this defense by calling the pathologist who performed the autopsy as a witness at trial. This pathologist would have testified that his gross and microscopic examination of the pulmonary arteries did not reveal any pulmonary emboli. Furthermore, he would have testified that microemboli generally do not cause death in that these small blood clots lodge in the distal blood vessels of the lung and do not cause significant blockage of blood flow to the lungs.

This was a significant recovery in a venue that is known to have conservative jurors. Additionally, there was no evidence of financial loss to decedent’s children because decedent was permanently disabled due to problems with her knees. The recovery in the case was attributable to the loss of parental guidance and nurture to decedent’s children.

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