Trial Results

UNNECESSARY HERNIA SURGERY

SPECIALTY: General Surgery

ALLEGATION: A male patient had been diagnosed with a hernia and underwent surgery in 2014. The surgery itself was uneventful, and the surgeon noted, “No obvious hernia defect” but significant weakness to the inguinal floor, which the surgeon addressed with placement of a mesh patch.

The patient developed significant pain from what turned out to be an entrapped nerve. After several months of conservative treatment, the patient underwent a right-groin exploration with neurolysis of the ilioinguinal and iliohypogastric nerves, as well as mesh removal. This provided some, but not complete, relief of the patient’s debilitating pain. By the time of trial, the patient was again able to work; but he claimed he still had constant pain that affected his ability to work at peak capacity.

Plaintiff argued that the surgery was unnecessary and that a diagnostic ultrasound should have been performed before deciding to go to surgery. 

PLAINTIFF ATTORNEY: David Williams (Bellevue, WA)
PLAINTIFF EXPERT: Daniel Tseng, MD, General Surgery (Portland, OR)
DEFENSE ATTORNEY: Colin Kearns (Seattle, WA)
DEFENSE EXPERT: Kelly Clinch, MD, General Surgery (Kirkland, WA)
RESULT: Defense Verdict, King County


FAILURE TO TIMELY DIAGNOSE PULMONARY EMBOLISM, RESULTING IN DEATH

SPECIALTY: Internal Medicine

ALLEGATION: It was alleged that the provider had negligently prescribed narcotics, benzodiazepines, and methadone for chronic pain and fibromyalgia, after the patient had transferred care from another provider who had initiated these prescriptions. The provider obtained prior records, adjusted the medications, referred the patient to a pain-management specialist, noted that the patient was seeing a psychiatrist, and referred the patient for imaging. The plaintiff alleged that the medications made the patient less ambulatory and this inactivity caused the DVT/PE, resulting in the patient’s death.

PLAINTIFF ATTORNEY: Carl Lopez, Lopez & Fantel (Seattle, WA)
PLAINTIFF EXPERT: Paul Brown, MD, Internal Medicine (New Hope, PA)
DEFENSE ATTORNEYS: Steve Lamberson and Jeff Galloway, Etter McMahon (Spokane, WA)
DEFENSE EXPERTS: Greg Ledgerwood, MD, Family Practice (Brewster, WA), Dermot Fitzgibbon, MD, Pain Management (Seattle, WA), Tim Chestnutt, MD, Pulmonology (Spokane, WA)
RESULT: Defense Verdict, Private Trial


FAILURE TO DIAGNOSE EPIDURAL ABSCESS, RESULTING IN PARALYSIS

SPECIALTY: Emergency Medicine

ALLEGATION: In August 2015, a 46-year-old single female with a history of homelessness and chronic intravenous drug use presented to the Emergency Department with right flank/back pain that she reported had been ongoing for three days and was atraumatic. The patient had previously been seen at, and promptly discharged from, another facility for back pain six days prior.

On this date the patient denied use of drugs, although she later admitted she had used heroin shortly before presenting to the hospital. The emergency physician performed a physical exam, a neurologic exam, and lab work. There were no motor or sensory deficits noted. The lab results were effectively normal, with a somewhat elevated white-blood-cell count. In an effort to identify a cause of the patient’s back pain, a CT scan was ordered. The patient had been given morphine to address her pain. She then told a nurse that she required additional medication in order to complete a CT scan, and additional morphine was ordered. When the nurse returned to administer the additional morphine, the patient appeared to be sleeping. The nurse opted not to give the additional morphine to an already sedate patient and updated the provider. The emergency physician looked in on the patient and also saw her sleeping or resting quietly. When the patient was taken to Radiology, she refused the CT exam, stating that her pain was muscular. She was taken back to the Emergency Department, where the provider talked with her about the fact that he was unable to reach a diagnosis for her pain and it could be a very serious, life-threatening condition. He indicated that he wanted her to get a CT scan. She again refused. She left the Emergency Department, ambulating on her own.

The patient returned to her apartment, where she obtained additional intravenous drugs. The next morning she was found on the ground at a bus stop and a passerby called paramedics. When they arrived, the patient refused their assistance. She got up and sat on a bench on her own power, then apparently returned to her apartment. Later that afternoon, she was taken to a hospital by ambulance with significant motor dysfunction of both lower extremities. A CT scan was obtained but did not reveal any concerning findings. An MRI showed an epidural abscess from T7 to T11, and the patient underwent urgent surgery.

PLAINTIFF ATTORNEY: Carl Lopez, Lopez & Fantel (Seattle, WA)
PLAINTIFF EXPERT: Patrick Tibbles, MD, Emergency Medicine (Las Vegas, NV)
DEFENSE ATTORNEYS: Chris Anderson and Rachel Bench, Fain Anderson VanDerhoef (Seattle, WA)
DEFENSE EXPERT: Fred Abrahamian, MD, Emergency Medicine/Infectious Disease (Los Angeles, CA)
RESULT: Defense Verdict, King County