The children of a woman who died from a long-untreated blood infection after being seen at a hospital emergency room will share in a $1.1 million settlement of a claim against the hospital and the ER doctor.
The settlement left a novel legal issue unresolved: The woman’s estate had sought to bar a doctor’s undocumented claim that the patient had refused admission. The estate’s attorney maintained the doctor should not be allowed to testify about the patient’s alleged refusal when the doctor failed to make any record of it in the medical charts.
The estate asserted claims under both the federal “patient dumping” law – the Emergency Medical Treatment and Labor Act – and under state medical malpractice standards. A federal judge ruled last year that the state law claims would remain in the case pursuant to the federal court’s supplemental jurisdiction.
Lynchburg attorney James B. Feinman, counsel for the estate, said he accepted the defendants’ offer out of concern about how a jury might regard the value of the case. The deceased patient was an IV drug abuser who previously had given up custody of her two children, the beneficiaries of her estate.
The 27-year-old patient came to the emergency department on Nov. 25, 2014, with severe sepsis, hyponatremia and probable bloodstream infection, according to a summary provided by Feinman.
A blood sample was sent for analysis on a “stat” basis, but the patient was discharged before culture results were obtained.
The doctor discharged her with a diagnosis of sinusitis and a prescription for oral antibiotics.
The lab results were positive for staphylococcus aureus in the patient’s bloodstream, establishing the “emergency medical condition” of staph aureus septicemia. The patient required hospitalization and long-term intravenous antibiotic treatment, Feinman said.
An emergency department nurse received the lab report, but never advised a doctor. The hospital never contacted the patient to tell her she had a bloodstream infection.
The patient returned and saw the same doctor 17 days later. She had not received any treatment for the blood infection in the interim.
While waiting for the doctor to start her on IV antibiotics, the patient had a stroke from a clot released by an erratic heartbeat caused by the infection, Feinman said. She was partially paralyzed and remained hospitalized until her death on March 12.
The ER physician claimed he knew of the patient’s serious condition when she first arrived at the hospital and tried to admit her. She refused, the doctor said.
The medical records showed the patient was discharged, but the doctor testified that he forgot to write down that he offered admission and the patient refused.
Feinman asked the judge to bar the doctor’s testimony about the patient’s purported refusal.
The lawyer pointed to a state regulation that requires doctors to maintain accurate medical records. Because the doctor, by his testimony, violated that rule, he should not be allowed to profit from his wrongdoing, Feinman argued.
“You can’t let him get the benefit of breaking that law,” Feinman told the judge.
“This is a whole new line of argument that had never been tried, never been litigated, never been decided,” he said.
The case settled before the judge could rule on the issue. Mediation was conducted with retired U.S. Magistrate Judge B. Waugh Crigler.
“The estate was of the opinion it could not afford to gamble the offer of $1.1 million given the decedent’s admitted IV drug use,” Feinman wrote in a settlement report. (16-T-077)
The money recovered for the patient’s children, ages 8 and 12, was placed in long-term structured settlement funds.
The identity of the parties is not being disclosed pursuant to the parties’ confidentiality agreement, which allowed a report on the details of the case.
Attorneys for the defendants declined comment.