Articles Posted in Emergency Room Care

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A Philadelphia jury found that the death of a 51 year old man at St. Joseph’s Hospital was preventable and awarded $2.185 Million to his wife of 17 years. Zachary Jones was taken to St. Joseph’s by ambulance after complaining of chest, back and leg pains. An Emergency Room doctor, Dr. Powell, evaluated Mr. Jones within 30 minutes of his arrival at the E.R. and ordered a variety of tests to include blood work, x-rays and an echocardiogram (DEFINE). Unfortunately, the tests Dr. Powell ordered weren’t done for almost 2 hours and by then, Dr. Powell had left the hospital to attend a meeting in Horsham. When Dr. Powell left the E.R., he turned over care of Mr. Jones to Dr. Skobeloff, who had arrived for his first day on the job. Mr. Jones attorney told the jury that Dr. Powell was scheduled to be orienting Dr. Skobeloff all day, but instead left Dr. Skobeloff on his own while Dr. Powell went to the meeting.

If Mr. Jones care had been handled appropriately, his test results would have been read by the E.R. doctor caring for him as soon as they were done and then the tests would have been sent to the radiology department for an “official” read by a radiologist at some later point. Instead, Mr. Jones’ test results were not reviewed by either Dr. Powell (who had left the hospital) or Dr. Skobeloff (who was new to the E.R) and were simply sent on to radiology where the were not reviewed until the morning, by which time Mr. Jones had died. The tests showed that Mr. Jones had a dissecting aortic aneurysm (blood filling in between the layers of the heart wall and the sack that surrounds the heart) that prevented the heart from pumping properly. If the tests had been reviewed, Mr. Jones would have been transferred to another hospital for an operation that may have been able to fix his problem.

Mrs. Jones, who herself was recovering at a different hospital when Mr. Jones was taken to St. Joseph’s, sued St. Josephs and both Dr. Powell and Dr. Skobeloff for the negligent care of her husband. The hospital and doctors argued to the jury that Mr. Jones had a complicated medical history, including high blood pressure and “chronic” failures to properly take his blood pressure medication. They also argued that even if they had learned that Mr. Jones suffered from a dissecting aortic aneurysm, they wouldn’t have had enough time to transfer him to another hospital for surgery. The jury apparently rejected these arguments and concluded that Mr. and Mrs. Jones deserved the opportunity for another hospital to try to save Mr. Jones’ life. The jury found Dr. Powell 48% responsible, Dr. Skobeloff 36% responsible and St. Joseph’s 16% responsible.

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In a case strikingly (and frighteningly) similar to one I am currently handling, a patient’s family filed suit in California for the family of a child who was pronounced dead by a hospital and then later found to actually be alive. In both my current case and the California case, the patient suffered brain damage from the delay in necessary treatment and was forced to sue the hospital and doctors to obtain compensation for the injuries and medical care caused by the obvious negligence of the medical providers.

In the California case, which settled in April, 2008, then 20 month old Mackayla Jespersen was rushed to the emergency room after being found floating facedown in her family’s pool in November, 2003. Paramedics initially provided treatment to Mackayla at her home and then transported her to the emergency room of the Anaheim Memorial Medical Center where doctors pronounced her dead 39 minutes after arrival. Following the determination that Mackayla was dead, the doctors removed a breathing tube and left her unattended for over an hour despite the fact that Mackayla’s parents and grandmother advised doctors and nurses that they saw her breathing.

Just over an hour after Mackayla was left for dead, a police officer who was photographing the body observed her chest moving and called for help. Mackayla’s family argued in their lawsuit against the hospital and treating doctors that Mackalya should have been warmed upon arrival at the emergency room so that her vital signs could be properly monitored. The family further argued that if Mackayla had not been left unattended for over an hour, she would have recovered from the drowning event or suffered significantly less brain damage. The hospital and treating doctors argued that it was not the absence of treatment for the hour she was wrongfully declared dead, but rather the 15 minutes under water, that caused her brain injury.

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A 33 year old man in California with complaints of chest pain and left arm pain died from a heart attack (myocardial infarction) after three hours of waiting in an Emergency Room. Although medical care standards required that anyone with chest pain complaints be screened within 10 minutes, the patient never received the standard screening test of an electrocardiogram (EKG or ECG). The patient was walking out of the Emergency Room when he collased on the pavement just outside the hospital. He died from his heart attack.

Unfortunately, this situation is far too common. I have personally handled several cases where individuals died (or suffered brain injuries) in waiting areas or while sitting in an emergency room triage area without getting proper and timely care for their emergency symptoms, such as chest pain (or pressure), arm or jaw pain, sweating, lightheadedness, pallor, and/or increased or irregular heart rate. Such improper care can be grounds for not only a medical malpractice lawsuit, but also for a claim under the federal law of EMTALA (Emergency Medical treatment and Actice Labor Act). Under federal EMTALA law, a hospital and doctor must follow the standard screening practices of the hospital to attempt to identify an emergency medical condition for all patients presenting to the hospital. When such a proper and timely screening does not occur, EMTALA law may be violated. Patients can base claims for their injuries on this statute in addition to the more common state law medical malpractice grounds. Hospitals and doctors can be subjected to governmental investigations and fines in addition to damages owed families for injuries caused by not properly screening or stabilizing patients.

In the California case, the hospital had been previously cited for by the Department of Health several times concernign other deaths at the hospital. Such patterns of deaths at hospitals are frequently not identified until discovered through litigation. Many medical malpractice cases can have other related claims, such as EMTALA claims, that should be brought as part of the litigation. Not only can such additional theories of liability strengthen the case, but they can sometimes create a better venue (location for the trial), permit additional types of discovery during the case and put additional pressure on defendants. Also, there can be an added benefit to future patients at the hospital if it is investigated by the federal government, fined or a corrective action program is put into place.