Type of action: Medical malpractice, wrongful death
Injuries alleged: Wrongful death
Verdict or settlement: Settlement
Attorneys for plaintiff (and city): Charles J. Zauzig III and Melissa G. Ray, Woodbridge
Description of case: On June 13, 2016 the 46-year-old patient underwent a hernia repair surgery. The patient was on chronic anticoagulation medications which were discontinued prior to surgery and bridged with lovenox.
Early in the morning on June 18, 2016 the patient presented to the hospital with complaints of increased abdominal pain and swelling of the right groin area. He had resumed taking his pre-op dosage of warfarin at the time of his presentation to the ER. The ER doctor ordered labs, which revealed a low red blood cell count and multiple abnormalities including elevated glucose and abnormal liver panels. On physical examination in the ER, it was documented that his abdomen was distended and rounded with pain and tenderness in the right lower quadrant.
The ER doctor contacted the patient’s surgeon who agreed to admit the patient to the hospital and act as the attending. The ER doctor also ordered a CT of the abdomen and pelvis with and without contrast, which was performed at approximately 6:34 am.
The CT was initially interpreted by a remote teleradiologist who concluded the imaging showed a “large heterogenous density hematoma with active arterial hemorrhage noted in the right retroperitoneum extending from the right mid-abdomen into the deep right hemipelvis.” The teleradiologist’s interpretation of the CT was reported to the ER doctor and a copy of the report was faxed to the hospital to be added to the patient’s medical records.
At 7:45 am the defendant radiologist, located in the hospital, reviewed the same CT, and generated his own report. The defendant radiologist did not reference the prior interpretation in his report. His interpretation of the CT was that there was a “large acute hematoma with active bleeding in the right retroperitoneum and right groin” but he identified the source of the bleeding as the right external iliac vein as opposed to arterial bleeding. The defendant radiologist asked a colleague of his, defendant interventional radiologist to look at the CT scan and the defendant IR agreed the source was likely venous but disagreed as to which vein was the source. The defendant radiologist communicated his interpretation of the CT and that the source of the bleeding was venous to the attending doctor.
Because it was reported by the defendant radiologist that the source of the bleeding was venous and the defendant IR did not recommend any intervention, it was decided that they would watch the patient and see if the bleeding would stop on its own rather than take him to the interventional radiology suite for a procedure to stop the bleeding. Over the next several hours the patient’s condition continued to deteriorate and serial lab work showed that his hemoglobin (13.1 to 10.7) and hematocrit (39.1 to 33.1) were falling since his arrival to the ER nine hours earlier.
About 13 hours after his arrival to the hospital, the patient went into cardiopulmonary arrest as he had been actively bleeding to death. A stat hematocrit/hemoglobin was obtained during the code which showed a hemoglobin less than five. After the code was the first time blood products had been ordered for the patient or surgical intervention considered, but by this time it was too late and the patient died on that night.
Plaintiff’s radiology experts opined that the standard of care required both defendant radiologists to properly interpret the CT scan as showing a life-threatening active arterial bleed, that the standard of care required the defendant IR to recommend an angiogram be performed to determine the source of the bleeding and that the defendants were required to know that an arterial bleed, or even a bleed from the external iliac vein, would not stop on its own and would require a procedure to stop the bleeding. Plaintiff’s experts opined that a procedure to stop the bleeding would have been successful and saved the patient’s life.
At the time of his death, the decedent left behind his wife, two adult children from a prior marriage and two minor children ages 5 and 7. One of the adult children relinquished her claim to any settlement proceeds as she was estranged from her father at the time of his death. The decedent was not employed at the time of his death, so future lost earnings were not claimed as a part of the damages in this case.
The trial in this case was postponed twice due to COVID.
Plaintiff’s counsel Melissa G. Ray provided case information.