Articles Posted in Emergency Room Errors

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Koni Johnson filed suit against two emergency physicians and their employer, Cook County, alleging the doctors were negligent in their treatment of her spinal cord injury. She had gone to John H. Stroger Jr. Hospital, a/k/a Cook County Hospital a day after she slipped and fell injuring her back.

Johnson alleged that the county violated the Emergency Medical Treatment and Active Labor Act (42 U.S.C. Section 1395dd) by choosing not to provide appropriate screening and to stabilize her medical condition before discharging her.

Cook County, which owns and operates Stroger Hospital, requested summary judgment based on Sections 6-105 and 6-106 of the Local Governmental and Governmental Employees Tort Immunity Act. The defendants argued they had provided appropriate treatment for the condition the emergency room doctors diagnosed, which was muscle spasm and back and buttocks bruises.

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On April 29, 2004, 36-year-old Tamara Greico sprained her ankle during a bowling match. She was diagnosed in the emergency room of a hospital with a severe ankle sprain. She had wrapped it and was given crutches and told to keep her ankle elevated before being referred to an Alton, Ill., clinic.

The physician’s assistant and medical assistant at the clinic testified at the jury trial that they saw Tamara the next day and made a similar diagnosis while also giving her a walking boot, medication and instruction for exercising the ankle. Tamara returned to the clinic on May 5, 2004 complaining of more pain and numbness in her toes. A physician and one of the defendants, Dr. Bruce Vest, testified that he examined her and considered the possibility that she had a deep vein thrombosis, a blood clot, but ruled it out and did not order anticoagulant therapy.

Two days later, Tamara’s employer found her lying on the ground near her car in the office parking lot, lapsing in and out of consciousness. She was taken to the hospital where she complained of breathing problems before going into cardiac arrest.

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HW was 44 years old and had a history of heroin abuse. He developed severe back pain and then went to a local hospital’s emergency room telling the nursing staff that he was also suffering from heroin addiction and that he had experienced fever and nausea.

HW underwent testing, including an EKG, x-rays and blood work and was discharged from the hospital with a diagnosis of exacerbated back pain and narcotic withdrawal.

When the final results of HW’s blood culture were finalized it showed that he was suffering from a systemic blood infection. However, the hospital claimed that it was not able to reach HW by phone to advise him of these very dangerous results. Instead, the hospital sent a certified letter to the address that HW had given at the time of his admission. A copy of that letter was found in his medical records file. Predictably, before HW received the letter, he suffered paralysis from his chest down because of the systemic blood infection.

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The state of South Dakota has imposed a medical malpractice cap that leaves many who are injured or killed without a remedy. It was reported recently that a young woman who brought herself to a hospital in Sioux Falls, S.D., because she was carrying a dead fetus for removal from her uterus found things going from bad to worse.

The hospital did a procedure to remove the fetus, but things in the recovery room left the woman in shock. The doctor who examined her did not notice that the first doctor who removed the fetus had perforated her uterus during the procedure. She was literally bleeding to death.

A nurse eventually noticed that something was wrong and rushed the woman back to the operating room where the doctors performed emergency surgery to remove her uterus. She survived the ordeal, but lost the ability to have children.

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On Jan. 8, 2008, Nicole Yerkovich, who was 35 at the time, was taken by ambulance to the emergency department at LaGrange Memorial Hospital because of severe abdominal pain and nausea. The ER doctor at the hospital ordered a contrast CT scan of her abdomen and pelvis to see if she was suffering from an appendicitis attack. The CT scan was initially read by a teleradiologist who reported she could not visualize the appendix and therefore could not rule out appendicitis. The teleradiologist recommended the hospital’s doctors obtain the delayed images to get better visualizations of the appendix and noted a moderate amount of free fluid in the pelvis, which could have been due to a ruptured cyst.

The following morning, the in-house radiologist, Dr. Vladislav Gorengaut, reviewed the same CT scan and reported there were no definite findings to suggest appendicitis. He noted there were ascites, which may be caused by peritonitis, and there could be a gynecological issue such as a ruptured hemorrhagic ovarian cyst. Ascites refer to the accumulation of fluid in the peritoneal cavity in the abdominal area.

Based upon the first report of Dr. Gorengaut, the emergency department doctor canceled the delayed CT scan and instead admitted Yerkovich to gynecology and ordered a pelvic ultrasound. Dr. Gorengaut read the ultrasound and reported there was echogenic fluid most likely representing blood from a ruptured ovarian cyst.

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At issue in this South Carolina Supreme Court case was whether the medical malpractice statute of repose applied to indemnify the claim of Columbia/CSA-HS Greater Columbia Healthcare System — also known as Providence Hospital. The trial court in the Court of Appeals in South Carolina held that it does and thus barred the indemnity action brought by Providence Hospital. Because the statute of repose barred the indemnify action brought by the Providence Hospital, the Supreme Court of South Carolina affirmed the lower court’s and the appellate court’s decision.

In 1997, Dr. Michael Hayes and Dr. Michael Taillon were working as emergency room physicians at Providence Hospital as independent contractors. Arthur Sharpe came to Providence Hospital in the emergency room on the same date. He was complaining of chest pain. Drs. Hayes and Taillon evaluated Sharpe and diagnosed him as suffering from gastric reflux. Sharpe was then discharged from the hospital; in fact, he had actually suffered a heart attack. That heart attack was determined a few days later when he went to seek other medical care.

Because of the misdiagnosis, on May 25, 1999, Sharpe and his wife filed a medical malpractice and loss of consortium suit against Providence Hospital and Dr. Hayes. The Sharpes did not name Dr. Taillon as a defendant. Providence Hospital settled with the Sharpes on June 10, 2004.

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Kevin Tolson was 49 years old when he was injured as the collapsible barrier he was walking over suddenly shot upward, entangling him. He was taken to the nearby hospital emergency room where he experienced symptoms, which included a cold left foot that he was unable to move, numbness and tingling in the foot as well as severe pain. X-rays were completed and a physician assistant diagnosed knee strain and released Tolson from the hospital with instructions to see an orthopedic surgeon.

When Tolson’s symptoms persisted, he consulted a local doctor who detected low pulse in his leg and instructed him to return to the hospital. An MRI revealed that all of the ligaments in Tolson’s left knee were damaged. Despite surgery, Tolson’s leg had to be amputated above the knee. He had been a security guard working two jobs at about $20 an hour, but is now able to hold only one position due to his medical condition.

Tolson sued the physician assistant and emergency room physician at the hospital and also named the hospital as a party defendant. It was alleged in the lawsuit that these medical providers chose not to diagnose a popliteal artery injury. Tolson claimed that based on his symptoms and the x-rays that were taken at the emergency room a dislocation and possible vascular injury could not be ruled out.

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On March 10, 2007, Ramona Sue Yates was a patient in the emergency room at Memorial Hospital in Carbondale, Ill. She complained of severe back and abdominal pain. The defendant, emergency room physician, Dr. Daniel Doolittle, who was employed by the defendant Legatus Emergency Services, chose not to correctly diagnose or even suspect that Yates was suffering from a bowel obstruction and internal hernia.

Two years earlier, Yates, 47, had undergone gastric bypass surgery. Bowel obstruction is a known complication for patients following the weight-loss surgery.

Dr. Doolittle reportedly misdiagnosed Yates as having back spasms and had her admitted to the hospital for observation. Unfortunately, Yates died from the bowel obstruction the next day, March 11, 2007. She is survived by her husband and an adult son. She was employed as a nurse at a mental health facility.

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Butch Borden, 51, underwent lower back surgery by neurosurgeon Dr. Tom Staner. While Borden was recuperating, he developed weakness and sensory deficits in his legs. Dr. Staner instructed Borden to go to Brookwood Medical Center, where testing there revealed a small hematoma in the lower back. A hematoma is where a pool of blood gathers in an area of the body for different reasons. Borden was then admitted to the hospital.

While overnight in that hospital, Borden developed urinary incontinence and lost the use of both legs. This development was not communicated to any of Borden’s treating physicians, including Dr. Staner.

The next morning, however, Dr. Staner examined Borden and ordered an urgent CT scan and myelogram, which showed a large hematoma, another pool of collecting blood, compressing Borden’s cauda equina. The cauda equina, which is Latin for horse’s tail, is a bundle of spinal nerves and spinal nerve roots that run through the second to fifth lumbar nerves in the back. The compression of the cauda equina is a serious neurological condition and can cause loss of function. The cauda equina syndrome is caused by the compression of nerves at the end of the spinal cord.

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A Tuesday, July 15, 2014 a story in the Science section of the New York Times covered the circumstances in which doctors are faced with a dilemma in practice. They are reluctant to say to a patient or his or her family that they were sorry for a poor outcome in medical care. It has long been discussed whether doctors should approach patients and family members of patients to express regret or say the word “sorry” because of a bad outcome.

Many risk managers would stand in the way of doctors saying they were sorry for fear that those words might translate into an admission of wrongdoing, guilt and/or negligence.

The New York Times story, written by a physician, Abigail Zuger M.D., relates the medical issue to that of a plumber who worked in her home; a chain of events led to gushing water. Although the plumber wasn’t directly at fault for the problem, he happened to be at the wrong place at the wrong time when he turned a bolt, screw or valve that was old and ready to break at anytime. The issue there was whether the plumber could have said “I’m sorry” without taking responsibility. The writer of this story wrote that saying, “I’m sorry” is not an expression of anything other than empathy and not an admission of fault.

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