Failure to investigate falls is Negligence
Here is a paper submitted on behalf of a client whose pending stroke was missed by an emergency room doctor.
BASIS FOR PLAINTIFFS’ CLAIM
On or about December 14, 2002 Barbara M presented to Lake Charles Memorial Hospital emergency room and Dr. K with symptoms indicating the onset of a stroke. The stroke was misdiagnosed as Bell’s Palsy. Proper diagnosis of the stroke was therefore delayed until Mrs. M could be seen at the Nacogdoches Medical Center where she was diagnosed with a right posterior circulation brain stem stroke.
Mrs. M was advised by her physician in Nacogdoches, Dr. Steven P. Busby, that had the stroke been timely diagnosed in Lake Charles and the proper medications administered, the permanent damages caused by the stroke could have been avoided.
PATIENT BACKGROUND
At the time of the stroke’s onset, Mrs. M was a 51-year-old white female whose past medical history was significant for Type II diabetes mellitus, hypertension, chronic back pain and fibromyalgia. Her surgical history included three cesarean sections, a hysterectomy and a cholecystectomy.
She is married. She smoked one half to one pack of cigarettes per day. She consumed no regular alcohol.
Her symptoms began roughly two days before her hospital ER visit while on a family vacation in Florida. It began with a mild right frontal headache which could not be relieved with analgesics. She next began experiencing numbness over her right cheek which increased to involve her face, left arm and facial drooping on the right. With these symptoms, Mrs. M and her husband stopped at the Lake Charles Memorial Hospital on the way back home to Texas from Florida.
TREATMENT AT LAKE CHARLES MEMORIAL HOSPITAL
Attached herewith as Exhibit “1” is a copy of the medical records for Mrs. M’s treatment at Lake Charles Memorial Hospital December 14, 2002. The panel will note she had an admit complaint of “poss cva”. The nursing assessment reads as follows:
“0130 51 y/o W [female] AARC x 3. Reports new onset weakness numbness in R face and L arm. H/A [with] onset at 1000 yesterday morning. R eye drooping and R mouth droop noted. [No] expressive ______ and pt swallows [with] difficulty. [No] hemiperesis neurovascular check intact throughout. [No] ______ s/s BBS-clear.”
The records indicate that Dr. K’s clinical impression was “R/O Bell Palsy”. He ordered a head CT scan without contrast which revealed “No evidence of central nervous abnormality.” The scan was read by Dr. Joseph Prejean. Following the CT scan results, Mrs. M was released with discharge instructions to follow up with her primary care doctor on Monday and to report to the ER if needed.
FOLLOW-UP AT NACOGDOCHES MEDICAL CENTER
After returning home to Texas and with continued symptoms, Mrs. M presented to the Nacogdoches Medical Center. A copy of their medical records are attached herewith as Exhibit “2”. A history and physical was performed by Dr. Mark A. Cline. He noted a chief complaint of facial weakness and headache. His neurological exam described noticeable weakness to the right face with some drooping of the right eyelid consistent with Horner’s syndrome. He noted mild decreased sensation in the left arm and lower leg. Mrs. M’s gait was tested by Dr. Busby and was described as slightly ataxic. Her left toe was up going. She had weakness in her cranial nerves, facial weakness and slight weakness in her palate. Dr. Cline’s assessment and plan diagnosed a “probable right posterior circulation brain stem stroke.”
An MRI of the brain showed evidence of an infarct on the right lateral pontomedullary area consistent with Wallenburg syndrome.
Mrs. M was admitted to the hospital and showed improvement after a few days. She was discharged December 18, 2002. She was given orders for out-patient PT, OT and ST.
DAMAGES
In the case of Mrs. M, there are two theories of damages which apply. The first form of damage is the actual or objective worsening of her condition by the failed diagnosis. As was stated above, Mr. & Mrs. M were advised by Dr. Busby that had her condition been timely diagnosed and treated, the majority of the permanent injury she sustained from the stroke could have been avoided.
The second type of damages are more subjective. Louisiana law recognizes that a patient who has been the victim of malpractice may recover for the “lost chance of a better outcome”. These damages require this panel to think in terms of probabilities rather than certainties. As an example, it is more probable than not that had the stroke been timely diagnosed and treated, Mrs. M would not have suffered as severely from the stroke symptoms. This panel does not have to attempt to quantify what those damages are. This is the role of a jury. This panel need only recognize that this damage does in fact exist, and in doing so, must render a decision in favor of the plaintiff.
CONCLUSION
The evidence in this case overwhelmingly suggests that Mrs. M was misdiagnosed at the Lake Charles Memorial Hospital emergency room by Dr. K. Dr. K failed to recognize the symptoms of a stroke, failed to seek a consult, failed to order an MRI, and failed to administer the proper medications to prevent a worsening of the stroke.
As a result of the aforedescribed malpractice, Mrs. M lost the chance of a better outcome and suffered permanent injury which more probable than not could have been avoided with earlier diagnosis and treatment.
RESPECTFULLY SUBMITTED,
GUILLIOT & ST. PÉ, LLC
________________________________
KENNETH D. ST. PÉ
La. Bar Roll No. 22638
428 Jefferson Street
P.O. Box 2877
Lafayette, Louisiana 70502
(337) 232-8177
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