The decedent was a 27-year-old male who had presented to the hospital emergency department on Sept. 21, 2015, with acute onset flank and abdominal pain. CT exam revealed a kidney stone. He was treated and discharged with instructions. The complaints regarding the stone resolved. However, one week later, Sept. 28, 2015, he returned to the same emergency department with complaints of fatigue, insomnia, vomiting and diarrhea for five days. The emergency physician ordered a CT to rule out an abdominal process. The CT was negative, and the GI tract was reported by the defendant to have to have been “normal.” The decedent was discharged to home with instructions to follow up with his family physician.
The decedent followed up with a new family physician on Oct. 2, 2015, and on examination had absent bowel sounds. He was immediately transported to the emergency department where he was admitted.
Abdominal surgery revealed frank gangrene of his transverse and right colon with ischemia and areas of gangrene on his distal ileum, with evidence of shock liver. Postoperatively, the decedent developed a massive gastric bleed, arrested and died.
The plaintiff, who was married to the decedent, alleged that the CT read of her decedent’s abdomen on Sept. 28 had been negligent. Far from being “normal,” the CT showed clear evidence of significant inflammation and dilation. An interpretation which had met the standard of care would have mandated admission and aggressive treatment of his inflammatory bowel which would have saved his life.
The defendant alleged that he was provided insufficient information by the emergency physician in order to focus on the areas of abnormality, and his read was reasonable under the circumstances.
Further, defendant alleged that plaintiff suffered from a sudden, unforeseeable Mallory-Weiss tear, which caused a massive upper-GI bleed, hemorrhagic shock and death.
The plaintiff and her decedent had been married just a few months prior to his death. She was his only beneficiary.[18-T-140]
Type of action: Medical Malpractice
Injuries alleged: Death due to massive GI bleed, hypovolemic shock and disseminated intravascular coagulopathy (DIC)
Special damages: $250,000 in medical expenses
Verdict or settlement: Settlement
Attorney for plaintiff: Malcolm P. McConnell III, Richmond
Plaintiff’s experts: William Frohna, MD, Washington, DC, Emergency Medicine; Brian Behm, MD, UVA, Gastroenterology; Arthur Kornbluth, MD, Mt. Sinai, NY, Gastroenterology and Inflammatory Bowel Disease; Arun Kirshnaraj, MD, UVA , Radiology; Richard Leder, MD, Duke University, Radiology; David Gaieski, MD, Philadelphia, Emergency Medicine
Defendant’s experts: Stuart A. Fruman, M.D., Fairfax, Radiology; Christopher S. Levey, M.D., Eston MD, Radiology; Douglas M. Heuman, M.D., Richmond, Gastroenterology; Jeffrey Young, M.D., UVA, Emergency Medicine