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.
Thereafter, her gynecologist ordered lab work, a blood draw, which showed a normal overall white blood count with left shift and a drop in platelets. Yerkovich also had tachycardia, which is a faster than normal heart rate when resting. She was given the choice between a conservative treatment plan involving bedrest and pain control or a diagnostic laparoscopy. Yerkovich chose the conservative plan, but her abdominal pain continued.
On Jan. 11, 2008, her gynecologist prepared a discharge summary despite her significant pain and increasing tachycardia, but her partner canceled the plan after Yerkovich’s parents objected and instead scheduled a laparoscopy.
As Yerkovich was being prepped for surgery, she suffered a sudden cardiovascular collapse. During 20 minutes of CPR, surgeons opened her abdomen to find a liter of foul-smelling pus, found no source for the intra-abdominal infection and reviewed her appendix, which looked normal as did her right ovary.
After the surgery, Yerkovich was diagnosed with having irreversible brain damage stemming from the cardiovascular collapse and died just a week later. Since the unruptured appendix had no pathological evidence of intrinsic appendicitis, the autopsy pathologist concluded bacteria had migrated through the wall of the appendix, which started the infection. The family alleged that Dr. Gorengaut, the radiologist, chose not to report all of the significant findings, and they claimed if he had reported appendicitis that could not be ruled out, she would have been admitted to general surgery and operated on before her infection progressed to septic shock, which led to her untimely death.
The defendants contended that Dr. Gorengaut properly interpreted the images and results, the CT report complied with the standard of care, it was the treating gynecologist’s responsibility to recognize the early indicators of infection and respond with treatment, the gynecologist acts or omissions were the sole proximate cause of death and that the appendix was not the source of the infection.
The jury deliberated for 12 ½ hours over two days. It was deadlocked 11-1 in favor of the plaintiff. The case later settled.
The attorneys representing the family of Nicole Yerkovich were Craig Nannarino and Amanda Brasfield. Before trial, a demand of $2 million was made, which were the policy limits of the defendant Dr. Gorengaut and his practice. At trial, the jury was asked to return a verdict of $5,500,000. There was no offer by the defendants to try to settle the case.
In addition to the all the medical providers for Yerkovich, experts in the fields of radiology, critical care and general surgery also testified on her behalf. The defendants engaged a radiologist, an infectious disease physician and a colorectal surgeon who were their medical experts.
Estate of Nicole Yerkovich v. Dr. Vladislav Gorengaut, Suburban Radiologists S.C.,
No. 09 L 7221 (Cook County, Ill.).
Kreisman Law Offices has been handling physician negligence cases, surgical negligence cases, medical malpractice cases and birth injury cases for individuals and families who have been harmed, injured or died as a result of the carelessness or negligence of a medical provider for more than 38 years in and around Chicago, Cook County and its surrounding areas, including Lemont, Lynwood, Alsip, Skokie, St. Charles, Aurora, Elgin, Lockport, Oak Park, Palatine, Park Ridge, River Forest, Round Lake Beach, Summit, Chicago (Roscoe Village, Printer’s Row, Pill Hill, North Park, Norwood Park, McKinley Park, The Loop, Little Italy, North Town, Old Town, Irving Park, Gold Coast, Englewood, Chinatown, Back of the Yards, Austin, Archer Heights, Lincoln Square), Hinsdale, Glencoe, Glenview and Northfield, Illinois.
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