A court in Ohio issued a verdict in favor of a plaintiff whose wife requires 24-hour care as a result of brain damage suffered because of a misdiagnosed brain infection. The defendants include two neurologists who treated the patient in 2013, when she first began showing signs of illness, as well as the neurologists’ employer, a private practice neurology clinic. It is the largest settlement in the county’s history, slightly larger than the amount awarded to a man injured in an accidental shooting in 1979.
On October 3, 2013, the patient, a retired pathologist who was 76 years old at the time, visited the emergency room. Her chief complaint was a chronic cough. The patient had been a heavy smoker for her entire adult life; she had smoked an average of two packs of cigarettes per day since she was in her 20s. Examinations conducted during the emergency room visit and during follow-up showed a mass in her lungs. The doctor who detected this mass on an X-ray wrote a note saying that lung cancer was suspected, given the patient’s symptoms and history of smoking.
The patient returned to the hospital on October 28 of the same year. This time her complaints were weakness in her legs and mental confusion. As these are possible signs of infection, doctors conducted tests to rule out an infectious cause of the patient’s symptoms. They also did an MRI of her brain, which showed abnormal lesions, which could have been either cancerous tumors or an abscess.
Since the patient’s temperature and white blood cell count were normal, the physicians determined that the lesions appearing on the MRI were cancer that had spread from the patient’s lungs. They reasoned that, if the lesions had been an abscess of infectious origin, the patient would have had a fever and her white blood cell count would have been elevated. They had taken blood samples from the patient, and these had also tested negative for bacteria and viruses.
The patient was given steroids as treatment for what her doctors had determined was a brain tumor. Since steroids reduce patients’ resistance to infections, the brain abscess worsened, and the patient’s condition deteriorated. Instead of being able to go home from the hospital, she was eventually discharged to a nursing home. She lost the use of her legs as well as of one of her arms, and she has relied on the use of a wheelchair since she fell ill. She suffers from cognitive impairment and has limited control over her bodily functions.
The patient’s husband sued the hospital and the two neurologists who treated his wife. He alleged that the doctors’ failure to treat his wife with antibiotics, while giving her steroids that would lower her resistance to infection, constituted negligence. Attorneys for the plaintiff argued that the standard of care dictates giving antibiotics prophylactically when treating a patient with steroids if that patient is determined to be vulnerable to infection, as an elderly patient with cancer would be. Expert witnesses summoned by the plaintiff’s attorneys demonstrated to the court how the steroids enabled the abscess to grow and to spread to parts of her brain that control her ability to walk and to perform other tasks of daily life.
Attorneys for the defendant argued that making the quick decision to begin steroids once the MRI showed a mass in the brain is standard treatment. The purpose of the steroids is to prevent brain swelling, which is painful and carries the risk of permanent impairment; thus, steroids are an essential part of treatment for brain cancer, even though they do not actually kill cancerous cells. They argued that the defendants took reasonable measures to check for signs of infection. The patient did not have a fever or an elevated white blood cell count, and her blood tests were negative for the infectious agents for which she was tested.
The expert witnesses for the plaintiff argued that the tests performed by the doctors only ruled out a systemic infection, not a brain abscess. They said that, in being too sure that what they saw on the MRI was cancer and treating it accordingly without also taking measures to manage a brain abscess, they left the patient vulnerable to permanent damage from the abscess. The court ruled in favor of the plaintiff. It awarded damages to the plaintiff for past and future medical expenses. It assigned 60% of the responsibility to one neurologist and 40% to the other.
Today, the patient remains in a nursing home, where she depends on a wheelchair and on constant care by nursing home staff. She suffers from memory loss, and her ability to speak is limited. Her husband visits her every day.
In medical malpractice lawsuits like this one, both sides had a strong case, and they both relied on the testimony of expert witnesses. It was the testimony of the medical expert witnesses for the plaintiff that was able to persuade the court, enabling the patient’s family to recover damages.
Sources
http://www.sanduskyregister.com/story/201808280033
https://www.13abc.com/content/news/Family-awarded-millions-after-medical-malpractice-trial-492540421.html
