-Plaintiff alleged she was sent home despite pneumonia suspicions.
Type of action: Medical malpractice
Injuries alleged: Death
Court/Date: Wayne County Circuit Court/ Feb. 21, 2018
Name of mediator: Robert F. Riley
Settlement amount: $900,000
Attorneys for plaintiff: Robert M. Giroux, Caroline M. Whittemore
The case concerns the death of a young woman (26), who expired as a result of extensive bronchopneumonia five days after her discharge from defendant hospital. The young woman’s medical history was significant for systemic lupus erythematosus (SLE), diagnosed three years prior. She was admitted to the hospital on May 27, 2014, with complaints of bilateral lower extremity pain, headache, and shortness of breath. A CT of the thorax was obtained on June 1, 2014, which demonstrated findings suspicious for pneumonia and follow-up was advised. A chest X-ray obtained on June 2 also included the potential for pneumonia. No follow-up radiology studies were obtained, nor was a bronchoscopy performed to definitively identify the pathogen, prior to the patient’s discharge home on June 6, 2014, according to plaintiff’s counsel.
On June 10, the young woman went to the office of her rheumatologist with complaints of fatigue and fevers up to 104. Plaintiff offered testimony that the young woman was so weak that her husband had to transport her into the office by wheelchair. At the time of her exam, she was hypotensive with a blood pressure of 88/54 and tachycardic with a pulse of 121. Instead of directing the patient to go to the emergency department, the treating rheumatologist instructed the young woman to continue her prednisone, prescribed a blood pressure cuff, and instructed her to follow up in one month, plaintiff’s counsel stated.
The following morning, she became unresponsive and was pronounced dead at her home. The medical examiner determined the cause of death to be due to extensive bronchopneumonia. Plaintiff alleged acts of negligence against defendant hospital in that the treating physicians failed to place the patient on an appropriate course of antibiotics after receiving the results of the CT of the thorax; failed to perform a bronchoscopy or lung biopsy to establish a definitive diagnosis of the patient’s lung infection; refrain from assuming the patient’s abnormalities were due to Lupus and rule out a lung infection; and refrain from discharging the patient without first obtaining a chest X-ray and/ or CT of the chest, so as to confirm resolution of airspace disease. Plaintiff further alleged that the patient’s treating rheumatologist was negligent in failing to perform a comprehensive and thorough physical exam on June 10, 2014, and appreciate the findings of such; and failing to instruct the young woman to go directly to the emergency department (ED) and/or call EMS to transport the patient to the ED for work-up on June 10, 2014, given that she was hypotensive, tachycardic, extremely fatigued, and relayed having a recent fever of 104.
Defendants claimed that the young woman did not have bronchopneumonia and that a pulmonary infection was not the cause of her death; her death was instead caused by a severe flare-up of her SLE. Defendant contended that she did not have pneumonia as evidenced by a normal initial chest X-ray; three sets of negative blood cultures; the patient had normal oxygen saturations on room air from June 2nd to the date of discharge; and a negative biopsy of the lung tissue taken at the time of autopsy. Plaintiff rebutted this defense with the testimony of two experts in Critical Care/ Pulmonary Medicine, along with supportive testimony by the medical examiner who was the only individual to see and examine the gross lung pathology in combination with the microscopic slides, according to plaintiff’s counsel.
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