Michael Mals, 57, underwent a hip replacement at Lutheran General Hospital on Aug. 14, 2008. He was given Coumadin, a blood thinner, to prevent deep vein thrombosis (DVT). Three days later he was transferred to a nursing home for rehab where his INR (international normalized ratio) became supratherateutic and Coumadin was discontinued. In other words, his blood became too thin for his well-being.
Mals was readmitted to Lutheran General Hospital on Aug. 28, 2008 with an elevated INR level, suspected internal bleeding and an elevated white blood count. He was diagnosed with a bleed within the left iliacus muscle and bilateral DVTs. He was restarted on Coumadin, and he returned to the nursing home on Sept. 2.
On Sept. 11, 2008, Mals was readmitted to Lutheran General with elevated INR and anemia, placed on Lovenox anticoagulant therapy and sent back to the rehab facility.
Mals was readmitted to Lutheran General on Sept. 20, 2008 with anemia. He was given a color duplex venous ultrasound, which showed progression of the lesion in the proximal left leg deep veins. He received two blood transfusions, and the Lovenox therapy was disconinued.
One of the defendants, Dr. Okrent, read an abdominal pelvic CT scan with contrast, which showed an enlargement of the left iliopsoas muscle, focus of high density interior to the left hip and a mid-thigh hematoma. Dr. Okrent also called the on-call internist, Dr. Higgins, regarding the bleeding.
A hematologist recommended a hold on all of the blood thinners with daily hemoglobin monitoring, after which Mals’s blood counts did stabilize. He was transferred to another nursing home on Sept. 27.
Last, on Oct. 24, Mals experienced severe pain walking up the stairs to his bedroom at his home. He was taken to Northwest Community Hospital where a vascular surgeon diagnosed a pseudoaneurysm, which is a false aneurysm, but is a bleeding leak through a wall in a blood vessel.
When the vascular surgeon, Dr. Woloson, reviewed Mals’s CT scans and films from Lutheran General, it was concluded that the films did show a pseudoaneurysm. Dr. Woloson testified that Dr. Okrent said words to the effect that, “Who is the idiot who read this film?” And when he saw his own name at the end of the report, he stated “Oh s***!”
Dr. Woloson performed surgery to repair the pseudoaneurysm on Oct. 27, 2008. However, Mals sustained permanent femoral neuropathy in his left leg with pain, weakness, quadriceps wasting, diminished sensation and difficulty walking.
Mals contended that Dr. Okrent was negligent in choosing not to identify and report the pseudoaneurysm. His defense team also said that Dr. Higgins should have consulted a vascular surgeon due to the enlarged hematoma and bleeding and the untreated pseudoaneurysm, compressed femoral nerve that resulted in neuropathy.
The defense for Dr. Okrent argued that the CT was not diagnostic of a pseudoaneurysm since there was no connection between the artery and the hematoma, and only in retrospect could the acute bleed have been diagnosed as a pseudoaneurysm.
The defense for Dr. Higgins asserted that the CT findings were not unexpected based on the patient’s anticoagulation status and a vascular consultation was not necessary. The defense also stated that a treatment plan was established by the hematologist and the pseudoaneurysm was not present on Sept. 21.
The attorney for Mals made no demand to settle the case before trial, but asked the jury to return a verdict between $900,000 and $1,024,000. There was no offer to settle by the physician defendants. However, Advocate Lutheran General Hospital and Affinity Healthcare settled prior to trial for $60,000.
The attorneys for Mals were Henry Phillip Gruss and Gena Gruss Romagnoli.
Michael Mals v. Dr. David Okrent, Dr. Richard Higgins, No. 10 L 9714 (Cook County, Illinois).
Kreisman Law Offices has been handling medical negligence 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 Romeoville, Joliet, Mount Prospect, Elgin, Waukegan, Worth, Willow Springs, Tinley Park, Streamwood, Lincolnshire, Dolton, Evanston, Forest Park, Orland Hills and Oak Lawn, Ill.
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