Pulmonary Embolism

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CASE: Pulmonary Embolism

FACTS: The decedent was a highly active 76-year-old female who visited the defendant, a family practitioner, complaining of symptoms in her right leg, including swelling, pain, redness, and warmth. The defendant performed a physical exam but failed to recommend or order the imaging necessary to rule out a deep vein thrombosis (a “DVT”). The defendant diagnosed the decedent with cellulitis and prescribed an antibiotic. She (defendant) noted in the chart that she saw no concerning features for a DVT.

Two days later, the decedent called the defendants’ office early in the morning with complaints of shortness of breath and intermittent dizziness. The defendant recommended reducing the dosage of the previously prescribed antibiotic. Despite the dosage reduction, the decedent’s symptoms continued. She called back several hours later with continued complaints of shortness of breath. She was then scheduled to be seen 4.5 hours later that evening.

She was seen by a different family practitioner at the evening appointment, also a defendant. She (defendant) took a history of the decedent’s symptoms and performed a physical exam. She documented acute shortness of breath, light-headedness, heart palpitations, along with erythema, swelling, and tenderness in the leg. She attributed these symptoms to an allergic reaction to the antibiotic, and recommended switching to a new one. She apparently never considered the possibility that her patient was suffering from a DVT.

Immediately after leaving that appointment, the decedent collapsed in the parking lot of the defendants’ office and became unresponsive. She died approximately 24 hours later as a result of a pulmonary embolism, which caused cardiopulmonary arrest and acute respiratory failure.

DEFENSE: The defendants disputed the amount of damages claimed.

INJURIES: Premature death.

SPECIAL DAMAGES: Medical bills: $198,078.71; Funeral expenses: $5,873

SETTLEMENT: The parties agreed to settle for a confidential amount.

PLAINTIFF’S COUNSEL: Randolph J. Reis, Esq. and Kimberly Kirkland, Esq.

NAMES/COUNTY: Anonymous v. Anonymous

CASE: Pulmonary Embolism

FACTS: The decedent was a 47 year-old patient of the defendant family practitioner, who was on oral contraceptives at the time of her death. Following pelvic surgery, the decedent began complaining of left foot pain with radiation to her mid calf. Two ultrasounds ordered to evaluate possible DVT, were both negative. Three weeks post surgery the decedent began experiencing similar symptoms in her left arm. The defendant examined her, recorded that there were no indications of acute injury or overuse, and ordered another ultrasound. That imaging was positive, showing thrombus in her cephalic vein. The defendant concluded that the ultrasound was indicative of superficial phlebitis and that there was no need for anticoagulation. He prescribed warm compresses and Motrin.

Five weeks post-surgery, due to continued symptoms in her left arm and leg, the defendant ordered lab-work and prescribed prednisone. The lab-work results showed a Factor V Leiden mutation, which is a risk factor for DVT. Despite that abnormality, the recent surgery, the confirmed presence of a left arm thrombus, being on oral contraceptives (all of which are risk factors for DVT), and the continued signs and symptoms suggestive of DVT, the defendant’s impression was “pain of unclear etiology.” Moreover, in response to the decedent’s reports of worsening symptoms, the defendant asked her to stop emailing him.

Thereafter, the decedent was examined by the defendant because of the new complaint of her being short of breath. His impression was “no diagnosis found,” and his plan was to monitor “for now.” Two days later the decedent collapsed at home and was taken to the hospital by ambulance. On route she went into respiratory arrest and became pulseless. She was diagnosed with a pulmonary embolism due to untreated DVT. She suffered anoxic brain injury, cardiac arrest and died.

DEFENSE: General denial.

INJURIES: Premature death.

SPECIAL DAMAGES: Medical bills: $101,032.50; Funeral expenses: $8,226.99.

SETTLEMENT: The parties agreed to settle for a confidential amount.

PLAINTIFF’S COUNSEL: Randolph J. Reis, Esquire (Reis Law, PLLC)

NAMES/COUNTY: Anonymous v. Anonymous