Type of action: Medical malpractice
Injuries alleged: Hearing loss and balance impairment
Date resolved: 9/20/2022
Verdict or settlement: Settlement
Attorneys for plaintiff (and city): Carlton Bennett, Virginia Beach; Brewster Rawls, Richmond
Description of case: In early 2019, the patient presented to an ENT physician with a complaint of progressively worsening allergic rhinitis. She had a four-week history of left-sided hearing loss with extreme ear pressure. Multiple allergy medications had failed to provide relief. A subsequent CT showed left otitis media with a retracted eardrum and complete opacification of the left mastoid cells and Eustachian tube, a nasal septal deviation to the left and right inferior turbinate hypertrophy.
The doctor recommended a myringotomy, which involves a small incision in the eardrum to drain fluid or relieve pressure from the middle ear, and placement of a tube (sometimes called a “PE tube”), which prevents the incision from closing on its own to allow further draining or pressure relief. The doctor also prescribed ciprodex ear drops for use following the procedure.
In an office visit about two weeks after the tube placement, the patient complained that the ciprodex drained into her throat. Her hearing was checked and found to be normal.
The ENT physician switched the patient from ciprodex ear drops to gentamycin ear drops. Gentamycin is a known ototoxic medication. The doctor never advised the patient of the risks of using such a medication.
A week later, the patient complained of muffled hearing and balance issues, but the doctor could not see her at that time. Two days later, she presented to a local ER with complaints of left ear pain, tinnitus, double vision, vertigo and nausea. She went to the ER the following day as well.
Two days later, the patient was seen in the office by the ENT physician. She described the events of the last several days and stated that the prior night her left ear yellow drainage became heavier and was accompanied by sharp pain. The patient also reported vomiting and diarrhea the previous day, as well as current sharp ear pain, yellow drainage, a buzzing sound, dizziness, fullness, hearing loss and tinnitus. The diagnosis was vertigo and otorrhea of the left ear. In addition to medications for vertigo and nausea, the physician also prescribed tobramycin ear drops. Tobramycin is also a well-known ototoxic medication. The patient subsequently went through a complicated course of evaluations and treatments. She had a complete and permanent loss of hearing in her left ear as well as significant balance issues.
In the lawsuit, the patient asserted the ENT doctor breached the standard of care by prescribing gentamycin and tobramycin, known ototoxic medications. Her experts pointed out that the regular use of aminoglycides (which include gentamycin and tobramycin) for patients such as this one had ended in the late 1990s when safer alternatives became available. In circumstances such as this one, there was no conceivable reason to use ototoxic medications.
The defense did designate a standard of care witness to support the conduct of the ENT physician. Another expert also asserted that the patient’s problems might be associated with a totally unrelated condition.
About a month before trial, the case was resolved for $600,000 in mediation.
Plaintiff’s counsel provided case information.[022-T-168]