Type of action: Medical malpractice
Injuries alleged: Ruptured appendix resulting in 13-day hospital stay, a second three-day hospital stay and three additional medical procedures
Court: Augusta County Circuit Court
Verdict or settlement: Verdict
Amount: $0 (defense)
Attorneys for defense (and city): Matthew E. Kelley, Roanoke and Samuel T. Bernier, Richmond
Description of case: Plaintiff presented to the emergency room complaining of right-sided abdominal pain beginning earlier that day after eating. She reported nausea, cramping and severe pain over the right side of her abdomen. A physician’s assistant performed a physical exam and noted that plaintiff was “exquisitely tender” in the right upper quadrant with mild right lower quadrant tenderness. Plaintiff’s white blood cell count was high, but a gallbladder ultrasound was normal. The PA ordered an abdominal CT scan with an indication of “[r]ight sided abdominal pain” that was performed approximately six hours after the first onset of pain.
The defendant radiologist reported that the CT showed an unremarkable gallbladder and a “[n]ormal-appearing retrocecal appendix” with “[n]o evidence of any appendicitis.” A surgeon then examined the plaintiff. The surgeon reviewed both the abdominal CT images and the radiologist’s report and agreed with the report.
Three days later, the plaintiff presented to a different ER with worsening right upper quadrant pain and a persistent high white blood cell count. A gallbladder scan was negative, but no CT scan was obtained. The plaintiff was discharged again. Three days after that, the plaintiff presented to her primary care provider with worsening right upper quadrant pain, a persistent high white blood cell count and occasional fevers. Her primary care provider prescribed antibiotics but ordered no imaging.
That evening, six days after the defendant’s CT interpretation, the plaintiff felt a “pop” in her abdomen followed by increased pain. She called EMS and was transported back to the original hospital where she was diagnosed with a ruptured appendix. She underwent surgery to remove the appendix, but infection from the rupture caused a 13-day hospital stay and two additional procedures. The plaintiff’s ruptured appendix also caused a second three-day hospitalization for a third procedure related to infection, and she claimed chronic right chest wall pain, scarring and lost wages.
During trial, the plaintiff’s experts asserted that the CT scan showed findings consistent with appendicitis that the radiologist should have appreciated and reported. The defendant argued that the CT scan at issue showed no signs of appendicitis because it was obtained so early in the disease-process. After a four-day trial, the jury returned a defense verdict.[021-T-123]