Articles Posted in Emergency Room Errors

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In September 2007, 55-year-old Barbara Ann Drebek-Doyle underwent a CT scan of the sinuses due to her recurrent sinusitis condition. The test was performed at Advocate Condell Gurnee Outpatient Radiology Center. The scan was interpreted by the defendant Dr. David E. Foosaner, a radiologist.  In a lawsuit that was filed by Ms. Drebek-Doyle, she contended that Dr. Foosaner chose not to detect and report a brain mass or tumor that was seen on the CT scan. As a result, the tumor remained undiscovered and untreated for 3.5 years. 

In March 2011, an MRI of the brain showed the brain mass at the top center of Ms. Drebek-Doyle’s head. Surgery was done to remove the benign mass, a meningioma that was in the membrane lining of the brain. Meningioma occur most frequently with women; they cause various types of symptoms.  Some symptoms include chronic headache, nausea, vomiting and balance issues. If the tumor is not removed fairly quickly, there is a risk that it may increase in size and cause much more serious effects, including death.

The plaintiff maintained that if the radiologist defendant had reported the mass in 2007, it could have been removed at that time. Instead, the delay caused Ms. Drebek-Doyle to suffer various problems over the next 3 ½ years, including increased headaches, loss of balance, memory deficits, bowel incontinence and fatigue. 

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It is estimated that 250,000 people die each year in the United States as a result of medical malpractice according to the U.S. Department of Health and Human Services.  Approximately 80,000 Medicare patients suffer preventable adverse events that contribute to their deaths; as many as half of those deaths are due to emergency room errors. 

In 2003, the nonpartisan Congressional Budget Office stated that “181,000 severe injuries (attributable to medical negligence) occurred in U.S. hospitals [,]”.  These numbers show that medical malpractice deaths have worsened during the past ten years. Despite this increase, state governments and legislatures have tried to impede the amount of money recoverable to injured or killed persons and/or their families as the result of medical malpractice. 

For example, in Missouri, where I have been a member of the bar since 1976, nearly 1/3 of medical malpractice cases involve surgery in some way. The next largest percentage of medical errors reported there is 18.7% for misdiagnosis leading to severe injury or death followed by 13.2% involving falls or injuries during transport of patients. 

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Kody Myrick, 17, suddenly slumped over at his job and had difficulty speaking. He was brought to Bakersfield Memorial Hospital’s emergency department. A nurse there made note of a possible stroke. Then an emergency room physician diagnosed profound neurological deficits and ordered a brain CT scan. The scan results showed an abnormality.

Four hours after the onset of symptoms, Kody was seen by a hospitalist to arrange admission to the hospital. The doctor called in admission orders and included a diagnosis of possible stroke. However, Kody was not seen by a doctor for the remainder of that night.

Kody’s neurological condition worsened suddenly the next morning. He was later diagnosed as having an ischemic stroke, which resulted in significant damage to his brain stem. Kody now suffers incomplete tetraplegia and requires 24-hour care.

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On Feb. 13, 2008, Richard Potrawski was taken by ambulance to Little Company of Mary Hospital in Evergreen Park, Ill., after suffering a head injury during a slip and fall on ice.  Mr. Potrawski was brought to the emergency room at 12:30 pm.  He had a large contusion above his right eye and a medical history of congestive heart failure as well as atrial fibrillation for which he was taking Coumadin, a blood thinner.

Mr. Potrawski had the potential for a brain bleed, but the defendant ER physician, Dr. Melissa Uribes ordered a CT scan which was done at 2:30 pm.  A scan revealed a 1-cm left-sided subdural hematoma.

Little Company of Mary Hospital did not have a neurosurgeon on staff, so Dr. Uribes took steps to find a hospital with neurosurgical services that would admit Mr. Potrawski. 

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Continuity of care is paramount in patient healthcare. The goal is always to give the patient the best medical care while at the same time reduce medical errors. For the last 20 years hospitals and physicians have been using electronic health records (EHR).

Although the intent was noble, EHR has caused serious and even catastrophic injury and harm to patients because of poorly written software programs for healthcare providers. Sometimes the medical recording software does not allow for certain medical conditions, treatments and tests. In those cases, the medical providers simply use the drop down or other shortcut to comply with the entry requirements.

It used to be that narrative nursing notes would be important in providing details of patient care. But in most hospital settings, nurses simply use default screens on a computer to make their entries. Physicians often are not able to read the nurses’ remarks or notes. 

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Sometimes we have to wonder: Would we get the best care possible if we were to be transported to a hospital emergency room? Our local hospital has a good reputation, but it is managed by humans, correct? And humans are known to make mistakes.

The quality of care was debated in the case of a young woman who died in a Brooklyn hospital five years ago. She was an aspiring novelist named Sabrina Seelig.Only 22 at the time of her death, Seelig might have received inadequate care. At least, that is what her family believes.

Convinced she was the victim of errors and misjudgment in the emergency room at her local hospital, they filed a medical malpractice suit. The case went to trial this spring, and the trial lasted four weeks. A jury decided that neither the hospital nor an emergency room doctor or nurse had been negligent.

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A consortium of 55 hospitals in the New York region has launched a campaign to aggressively identify sepsis for early treatment. Hospital administrators say the campaign is needed because sepsis, a leading cause of death in hospitals, can at first look like less serious ailments.

The new campaign was recently highlighted in a story published by the New York Times. The Times story focused on Rory Staunton, 12, who suffered what seemed like a minor cut on his arm while diving for a basketball during a gym class. The P.E. director at his school applied Band-aids to the cut, and Rory went about his normal routine. That night, he told his parents about the incident in the gym, did his homework and went to bed.

The next day, he started vomiting, spiked a high fever and reported pain in his leg. His parents brought him to a pediatrician, who referred him to the emergency room at NYU Langone Medical Center, where he was treated for upset stomach and dehydration. Doctors prescribed fluids and Tylenol and sent the boy home.

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Physicians should be aware that patients can use their smart phones or other electronic devices to tape alleged malpractice or negligence and introduce this evidence at trial. The presiding judge will determine whether the videotape may be presented.

Videotape, audiotape, and/or photographs can be introduced at trial if a proper foundation is laid and the subject matter is relevant, according to Robert Kreisman, JD, medical malpractice and personal injury attorney with Kreisman Law Offices in Chicago.
Kreisman was quoted in a recent issue of ED Legal Letter.

“To inform the jury, videotape could be introduced to give time and place. On the other hand, it depends on the quality of the videotape and what it depicts,” says Kreisman.

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A DuPage County medical malpractice verdict was returned in favor of the surviving family members of five day-old Isaac Diaz. Baby Isaac died after physicians delayed in performing surgery that could have prevented his death from a bowel obstruction. The $1.5 million verdict was entered in Estate of Diaz v. Central DuPage Hospital, et al, 06 L 448 (DuPage County).

Just five days after his birth, Isaac Diaz began vomiting yellow bile and had blood streaked through his stool. After the symptoms failed to resolve on their own, his mother took Isaac to Central DuPage Hospital’s emergency room. Within twenty-five minutes of his arrival, Isaac was seen by the Dr. Panfil, an emergency room doctor. Dr. Panfil took the preventive measures of placing Isaac on antibiotics and ordered an IV be placed. Then, in an attempt to figure out the source of Isaac’s vomiting and blood-streaked stool, Dr. Panfil ordered a range of labs, x-rays, and consulted with Dr. Pearce-Falls, the hospital’s pediatrician.

By the time Dr. Pearce-Falls consulted with Dr. Panfil, the x-rays results were already available. Because the x-rays were negative, Dr. Pearce-Falls elected to order an upper GI series, which would show the infant’s stomach region in more detail, possibly highlighting a problem unseen on the x-rays. Because of the severe nature of baby Isaac’s symptoms, the upper GI series was ordered STAT, meaning it was meant to be done urgently.

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There’s an old saying that there are two sides to every story – in civil litigation, the plaintiff’s attorney present one side of the story to the jury while the defendant’s attorney presents the other. In order to ensure that the facts are fair and that neither party presents information to the jury that would unfairly prejudice it towards the other side, the trial judge rules on motions in limine prior to the trial.

Each side prepares its own motions in limine, which set out various evidence and testimony that it feels should be excluded from the trial. Each motion includes not only a recitation of which evidence the party seeks to exclude, but also an argument as to why that specific evidence should be excluded from the civil trial. The judge then makes the final ruling on each motion in limine. If the judge rules to exclude the evidence, then neither side may bring it up during trial. However, if the judge denies a motion in limine, then that evidence is free game.

The Illinois attorneys involved in Guski v. Raja, No. 1-10-0108 (May 10, 2011), went through this motion in limine process prior to the Illinois medical malpractice trial. The judge granted some motions, but denied others, including one of plaintiff’s motions regarding the decedent’s marijuana use. After the jury found in favor of the defendant doctor, the plaintiff sought a retrial based on the the trial court’s erroneous motion in limine rulings and the defense’s unfair closing argument.

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