A Bucks County, Pennsylvania jury has awarded $5 million to a 78-year-old woman whose attorneys argued that a gastroenterologist’s repeated misdiagnosis of her condition contributed to a cascade of complications that ultimately required the amputation of her left hand, right thumb, and left great toe.[1] The verdict, returned on May 14, 2026, followed a nine-day trial before Bucks County Common Pleas Judge Jordan Yeager.[1] For attorneys handling diagnostic error claims, the case offers a notable example in the cumulative weight of repeated misdiagnoses, the interplay between diagnostic and treatment negligence, and the calculation of substantial future medical expenses in cases involving permanent functional loss.
The case also serves as a reminder that severe outcomes can flow from gastrointestinal complaints that, on the surface, present as relatively common conditions.
Background of the Case
According to court filings and a press release from plaintiff’s counsel, Jean Zekas, a Montgomery County resident, first presented to the Sellersville practice of gastroenterologist Dr. Ronald Markos in 2014 with complaints of rectal bleeding.[1] Following a colonoscopy, Dr. Markos diagnosed her with ulcerative colitis, a chronic inflammatory bowel disease.[1] The plaintiff’s theory, accepted by the jury, was that her symptoms were in fact attributable to diverticulosis, a condition involving small pouches in the colon that can become inflamed or infected.[1][2]
The plaintiff’s case alleged that the initial diagnosis was not an isolated error. The jury found that Dr. Markos repeated the same misdiagnosis on four subsequent colonoscopies performed over the following years.[1] This pattern formed a central pillar of the plaintiff’s theory of liability, allowing counsel to frame the case not as a single diagnostic mistake but as a sustained failure to reassess and refine the working diagnosis as the patient continued to present for follow-up care. The complaint, filed in September 2022, named Dr. Markos along with Regional Gastroenterology Associates of Lancaster and USDH Clinical Research as defendants.[2]
In 2020, Ms. Zekas began experiencing a worsening of her symptoms. Dr. Markos prescribed steroids, a treatment consistent with management of ulcerative colitis flares but which the plaintiff argued was inappropriate given the actual underlying condition.[1] Over the course of approximately one month, Ms. Zekas reportedly contacted the physician’s office on multiple occasions, reporting abdominal pain, rectal bleeding, and vomiting.[1] According to the complaint, Dr. Markos instructed her to continue the steroid regimen and did not refer her to an emergency department for evaluation or imaging studies such as a CT scan.[1]
Two days after her final reported call to the physician’s office, Ms. Zekas collapsed while on vacation in South Carolina. She was transported to a local emergency room, where physicians performed emergency surgery and removed the majority of her colon, a procedure that left her with a permanent ileostomy bag.[1] According to the plaintiff’s case, complications from the untreated condition progressed to severe systemic illness and circulatory compromise, ultimately resulting in ischemic injuries that required amputations. Her condition continued to deteriorate, and in December 2020 surgeons amputated her left hand, right thumb, and left great toe.[1]
The Verdict and Damages Allocation
The jury’s $5 million award was structured as follows: $2.5 million in non-economic damages, $2.5 million in future medical expenses, and $95,000 in past medical expenses.[1][2] Plaintiff’s counsel David Inscho and Helen Lawless of Kline & Specter, P.C. represented Ms. Zekas at trial.[1]
In a statement following the verdict, the attorneys said they were pleased that the defendant was held accountable, describing their client as a resilient woman who had worked to maintain a positive attitude in the face of her amputations.[1] As of May 18, 2026, it was not publicly known whether Dr. Markos intends to appeal.[1]
From a damages strategy perspective, the allocation reflects a measured approach. The substantial future medical expense component is consistent with the lifetime needs of a patient living with multiple amputations and a permanent ileostomy, including prosthetics and their replacement, home modifications, ostomy supplies, occupational therapy, and ongoing medical monitoring. The matching non-economic figure addresses pain, suffering, disfigurement, and loss of life’s pleasures, categories that, in a case involving the loss of a dominant or non-dominant hand alone, often command significant valuations.
Legal and Strategic Considerations for Practitioners
The case illustrates several issues that medical malpractice attorneys regularly confront when evaluating diagnostic error claims. The first is the question of how to handle repeated diagnostic encounters with the same provider. Pennsylvania, like most jurisdictions, applies a two-year statute of limitations to medical malpractice actions, subject to the discovery rule.[3] Where a misdiagnosis is repeated across multiple encounters, issues related to continuing treatment and the discovery rule can become focal points in determining when the limitations clock began to run. Counsel in this case was able to present the full arc of the patient-physician relationship to the jury, which likely strengthened the narrative of an ongoing failure to reassess.
Second, the case underscores the value of building a record around patient communications during the acute decompensation phase. According to the complaint, Ms. Zekas placed multiple calls to the physician’s office over the month preceding her collapse, reporting symptoms that the plaintiff’s experts characterized as red flags warranting emergency evaluation.[1] Documentation of these contacts, whether through call logs, electronic health record entries, or patient testimony, can be pivotal in establishing breach of the standard of care during the critical pre-emergency window.
Third, the case is a reminder of how diagnostic error and treatment error can compound. The alleged misdiagnosis of ulcerative colitis led not only to the absence of correct treatment but, in the plaintiff’s framing, to the affirmative administration of steroids that may have masked or worsened the underlying diverticular disease.[1] For plaintiff’s counsel, the dual layering of errors can be useful in defeating defenses that focus narrowly on whether a different diagnosis would have changed the ultimate outcome.
Fourth, the case touches on the standard expected of a specialist responding to deteriorating symptoms by telephone. Cases involving telephonic patient encounters frequently turn on whether the provider should have escalated care, including by directing the patient to an emergency department or arranging urgent imaging. The plaintiff’s theory here was that the absence of a referral for an emergency evaluation or CT scan, in the face of escalating symptoms over a sustained period, fell below the standard of care for a gastroenterologist managing a patient with the reported presentation.[1]
On the defense side, common counterarguments in cases of this nature include challenges to causation, particularly the question of whether earlier or alternative diagnosis and treatment would have prevented the ultimate outcome. Defense counsel may also focus on the inherent diagnostic overlap between ulcerative colitis and complicated diverticular disease on endoscopic examination, the limitations of colonoscopy in distinguishing certain inflammatory patterns, and the role of comorbidities or other intervening factors in the development of the conditions that led to the amputations. Whether any of these arguments were pressed at trial is not reflected in the publicly available reporting, and the defense’s response to the verdict has not been announced.[1]
Broader Context
Diagnostic errors remain one of the most studied and most frequently litigated categories of medical malpractice. Gastrointestinal conditions, in particular, are a known area of diagnostic challenge because of overlapping presentations between inflammatory bowel disease, diverticular disease, ischemic colitis, infectious colitis, and malignancy. Verdicts in this category vary widely depending on the severity of the resulting harm, the strength of the causation evidence, and the jurisdiction.
Pennsylvania does not impose a cap on economic or non-economic compensatory damages in medical malpractice actions against private practitioners, which is one of several reasons the state has historically been a venue where significant verdicts of this nature can be returned.[4] The state’s punitive damages, when awarded, are capped at twice the amount of compensatory damages, with limited exceptions.[4] Kline & Specter, the firm that tried the Zekas case, has reported a series of substantial misdiagnosis verdicts in Pennsylvania courts over the past decade, including a $10.1 million verdict in a delayed-diagnosis pediatric bacterial meningitis case and a $7.4 million verdict in a Delaware County stroke case.[5]
Conclusion
The Zekas verdict stands as a recent example of a successful diagnostic error claim in which the plaintiff’s narrative spanned years of clinical encounters rather than focusing on a single missed opportunity. For attorneys evaluating similar matters, the case offers a template for how a sustained pattern of repeated misdiagnoses, paired with documentation of a failure to escalate care during a period of acute deterioration, can support both a finding of liability and a substantial damages award. As of this writing, it remains to be seen whether the defense will pursue post-trial motions or an appeal, either of which could affect the ultimate disposition of the verdict.[1]
Sources
[1] Ciavaglia, J. “After woman loses hand to medical mistake, Bucks County jury awards $5M.” Bucks County Courier Times, May 18, 2026.
[2] “$5M medical malpractice verdict reached in Bucks County.” Pennsylvania Record / Legal Newsline, May 2026.
[3] 40 Pa. Cons. Stat. § 1303.513 (statute of limitations and repose for medical professional liability actions); see also Ray, D., “Pennsylvania Medical Malpractice Laws and Filing Deadlines,” Nolo, updated 2026.
[4] 40 Pa. Cons. Stat. § 1303.505(d) (cap on punitive damages in medical professional liability actions); Ray, D., “Pennsylvania Medical Malpractice Laws and Filing Deadlines,” Nolo, updated 2026.
[5] Kline & Specter, P.C., “Philadelphia Missed or Delayed Diagnosis Lawyer,” published case results summary, klinespecter.com.
