Plaintiff v. Defendant Emergency Medicine Physician

Synopsis:

DBMS successfully defended an emergency medicine physician in a case involving an alleged failure to diagnose an aneurysmal subarachnoid hemorrhage.

The plaintiff had neck pain radiating to her back and chest, and had a headache prior to arrival at the emergency department. Defendant emergency medicine physician performed a physical examination and did not identify any neurological deficits. The plaintiff was able to walk and talk, and denied a headache. Suspecting muscle spasms or degenerative arthritis, defendant ordered a CT scan of the neck to address the plaintiff’s complaints of neck pain. The CT scan returned negative. Defendant diagnosed plaintiff with muscle spasms and treated her with pain medication, muscle relaxant, and anti-nausea medication. Plaintiff remained under observation while she slept comfortably until 6:48 a.m. when she was discharged.

Shortly thereafter, plaintiff re-presented to the emergency department. She again complained of neck pain, and was evaluated another emergency medicine physician. A CT scan of the head was ordered, which resulted at 10:44 a.m. and revealed a subarachnoid hemorrhage. Neurosurgery service was called, where plaintiff first reported “the worst headache of her life.” Plaintiff was transferred at 2:51 p.m. to another area hospital for surgical intervention. At approximately 6:30 p.m., the plaintiff underwent neurosurgery to coil the aneurysm and decrease the likelihood of a recurrent bleed. At discharge, she returned to her neurological baseline and had not suffered a re-bleed.

Plaintiff claimed that the defendant negligently failed to timely diagnose her aneurysmal subarachnoid hemorrhage which would have been identified sooner had defendant ordered imaging of plaintiff’s head during the first emergency department admission. Plaintiff argued that if defendant ordered the imaging, surgical intervention would have occurred sooner, and she would not have suffered claimed memory loss.

The defense contended that the plaintiff never reported head pain while admitted to the emergency department. The only documented reports of head pain were to the paramedics who transferred the plaintiff, and the triage nurse’s note which indicated head pain PTA, or “prior to arrival.” Plaintiff never told the defendant of any head pain, and the defendant’s thorough physical examination did not reveal any neurological deficits. Nor did any subsequent treating physician document neurological changes. In addition, the plaintiff’s causation expert opined that blood was present on the CT of the neck ordered by the defendant, which should have been identified by the interpreting radiologist. The sole proximate cause of plaintiff’s injuries was either the unpreventable initial bleed in the brain, or the radiologist’s conduct in not alerting the defendant to the presence of blood in the neck CT.

In closing arguments, plaintiff’s counsel asked the jury to award plaintiff $3,000,000 in damages. After approximately two hours of thoughtful deliberation, the jury returned its verdict in favor of the defendant.