2.2 Million Cook County Verdict in Misdiagnosed Fungal Infection; D.G.K. v. Dr. Mehregan

DGK saw her primary care physician, Dr. Raymond Di Pasquo, for recently developed skin lesions. After having seen Dr. Di Pasquo on Nov. 20, 2001, DGK consulted with a dermatologist, Dr. Robert Signore, who biopsied the lesion on her right lateral thorax on Dec. 3, 2001.

The biopsy was sent to Pinkus Dermatopathology Laboratory, where it was interpreted by the defendant physician, Dr. Darius Mehregan.

On Dec. 20, 2001, Dr. Mehregan reported that the specimen was squamous cell carcinoma or a type of skin cancer; a low-grade malignancy believed to have originated from the neck of the hair follicle. This kind of tumor is reported to rarely progress into an invasive squamous cell carcinoma. From there, DGK was referred to a surgeon specializing in chemosurgery for removal of skin tumors.

After the surgeon removed the lesion, he advised DGK to get a full physical examination. She returned to Dr. Di Pasquo, who ordered a chest x-ray showing pneumonia. He prescribed antibiotics.

On Jan. 28, 2002, DGK, 43, complained of migraine-like pain in her forehead and back pain. Her back pain increased over the next week and she went to the emergency room at Palos Community Hospital on Feb. 5, 2002.

At Palos Community Hospital, an MRI was done, which showed destruction of her spine. It was originally believed that her squamous cell carcinoma had metastasized, but cultures of the affected area of the vertebrae showed fungal organisms consistent with blastomycosis. Blastomycosis is a rare infection from a fungus found in wood or soil.

An infectious disease physician was consulted who began antifungal treatment for blastomycosis. A pathologist at Palos Community Hospital requested the biopsy slides from the Pinkus lab to see whether the patient actually had squamous cell carcinoma or if the blastomycosis was missed in December 2001.
Upon review by the pathologist, it was found that the carcinoma diagnosis was wrong and that the correct condition was blastomycosis.

The dermatologist, Dr. Signore, contacted Dr. Mehregan at the Pinkus lab and requested that a special periodic acid-Schiff stain (PAS) be performed. The test is used to detect fungi and tissue. When the results of the PAS stain came in, Dr. Mehregan wrote an addendum to his 2001 report confirming the diagnosis of blastomycosis.

Unfortunately, because of the significant bone loss in DGK’s spine, she required a spinal fusion from T4 to L1 using a rib graft and instrumentation leaving her unable to return to work.

At trial, DGK claimed that Dr. Mehregan, as an agent for the Pinkus lab, was negligent for incorrectly diagnosing the biopsy specimen and choosing not to perform the special PAS stain in December 2001.

Dr. Mehregan contended that while he was wrong in his first and original diagnosis, he still complied with the standard of care. It was also maintained that DGK had experienced back pain as early as October 2001, which was evidenced in that the fungal infection had already begun to erode her spine, eliminating the erroneous pathology diagnosis as the cause of her injuries.

However, after considering all of the evidence, the jury found in favor of DGK in the amount of $3,249,822 made up of the following damages:

• $500,000 for past and future loss of normal life;
• $1,300,000 for past and future pain and suffering;
• $200,000 for disfigurement;
• $519,950 for past medical expenses;
• $729,872 for past and future loss of earnings.

The Chicago attorneys representing DGK were Craig Mannarino and Amanda Brasfield. A demand to settle the case was made at $2 million, whereas the defendants made no offer.

DGK v. Dr. Darius Mehregan, Pinkus Dermatopathology Laboratory, P.C., 09 L 4036 (Cook County).
Kreisman Law Offices has been handling medical negligence cases, birth injury matters and nursing home abuse cases for individuals and families for more than 36 years, in and around Chicago, Cook County and its surrounding areas, including Des Plaines, Prospect Heights, Itasca, Villa Park, Lemont, Fox River Grove, Geneva, Hometown, Lincolnwood, Lisle, Joliet, Orland Park, Crestwood, Harvey, Riverdale and Chicago (South Shore), Ill.