Plaintiff, 55, suffered from amyloidosis with renal involvement, a rare blood disease for which no cure exists. She underwent chemotherapy and a successful stem cell transplant in April 2012. On June 17, 2012, the patient was re-admitted with fever of unknown origin and other non-specific symptoms. During her readmission, the patient was seen by multiple physicians in various specialties. These physicians extensively worked her up during her month-long stay by placing her on broad spectrum of antibiotics, as well as other medications, to fight off an infection. They further ordered numerous tests, including blood chemistries, hematology studies, x-rays, CTs, blood cultures, and other specialized tests and procedures.
On June 18, 2012, a CT of the sinuses supported a clinical diagnosis of acute sinusitis and medications were adjusted. On June 21, 2012, a tagged white blood cell body scan was performed and showed persistent uptake in the chest indicative of either an inflammatory process or an infectious process in the lungs, and she was treated for possible lung infection. During each day of her admission, the physicians performed a neurological exam on the patient and the exams were negative for definitive signs and symptoms of a CNS infection. Throughout the course of the patient’s stay, antimicrobial therapies were adjusted and additional specialized tests were ordered. On June 25, 2012, a bronchoscopy was performed and demonstrated gram positive cocci and antibiotics were adjusted. The patient’s fever improved along with her white blood cell count. When the patient developed gastrointestinal symptoms around June 26, 2012, it was considered that the abdomen could be the source of her fever but the patient initially refused a flexible sigmoidoscopy. On June 30, 2012, due to abnormal lab findings, specialized tests were ordered to look for thrombotic thrombocytopenic purpura, or TTP, a rare disorder of the blood-coagulation system.
When there was deterioration in the patient’s condition on July 2, 2012, with a new change to mentation, the patient was moved to the MRICU and was administered fresh frozen plasma for possible TTP, along with medication for low blood pressure and was intubated. The patient’s specialized test for TTP returned, the AdamsTS13, and was consistent with a diagnosis of TTP. The patient was therefore also started on plasmapheresis and hemodialysis. With such treatment, her condition improved, including improvement in her sodium level, BUN, creatinine, and platelets. On July 9, 2012, the patient decided to stop all treatment, including plasmapheresis and hemodialysis. Thereafter, she experienced seizures and a brain hemorrhage, and she became comatose, and died on July 16, 2012.
After her death, the patient’s husband filed suit against 15 of his wife’s physicians and he attempted to sue the hospital. Throughout the workup of the case, a dismissal of the hospital-entities and other physicians were obtained, with the exception of five physicians, including three bone marrow transplant physicians and two infectious disease physicians. Plaintiff contended that the decedent’s death was caused by the failure to diagnose and treat a CNS infection and that the patient should have undergone additional testing for a CNS infection. Plaintiff further claimed that there was a failure of communication between her attending physicians and a failure to develop a unified and effective treatment plan.
At trial, plaintiff called his hematology/ oncology expert, who opined that the patient did not have TTP; rather, she had a CNS infection likely from reactivated toxoplasmosis. Plaintiff’s expert focused on the fact that one of the Defendant infectious disease physicians had recommended a toxoplasmosis PCR study that was never ordered by the attending physicians though numerous other tests had been ordered.
Well-credentialed experts in hematology/ oncology, infectious disease, and neuroradiology testified that the defendant physicians complied with the standard of care and that the care that was provided did not cause or contribute to the decedent’s death. In particular, the defendant physicians appropriately worked the patient up for fever and correctly diagnosed the patient with TTP. They testified that it was the patient who ultimately decided to stop life sustaining treatment for TTP that caused her death.
Just before the case went to the jury, the judge granted in part the defense’s renewed motion to strike and dismissed one of the defendants because plaintiff failed to prove that his care of the patient caused her death. During his closing statement, plaintiff’s counsel asked the jury for an award of over $2 million. After deliberating for about an hour, on Sept. 15, 2016, a jury in the Circuit Court of the City of Richmond returned a unanimous verdict in favor of the remaining four defendant physicians.[16-T-174]
Type of action: Wrongful Death/Medical Malpractice
Court: Richmond Circuit Court
Tried before: Jury
Name of judge or mediator: Hon. William R. Marchant
Date resolved: Sept. 15, 2016
Verdict or settlement: Defense Verdict
Attorneys for defendant: Linda B. Georgiadis, Shyrell A. Reed, and Rodney K. Adams, Richmond
Attorneys for plaintiff: Robert Brown, Jr., Newport News