Two interesting medical malpractice verdicts!

1) Failure to diagnose Preeclampsia: $5 Million in settlements!

Angela Cecchi was pregnant with her first child and went to Northwestern Memorial Physicians Group for her prenatal checkup in 2003. She was a known case of Chronic hypertension and taking medication since very long. 

Patient showed signs of preeclampsia in her last trimester and was ordered 24-hour urine test and USG to diagnose preeclampsia. But, although the tests were ordered but never completed. She was discharged the next day after a doctor told her that she does not have any signs of preeclampsia and cancelled the tests.

She came on a follow-up visit after a week and still did not receive the tests. Two days after her last visit she underwent an emergency cesarean section for fetal distress after a nonreactive CTG.

Her son Nicholas showed developmental delays and was diagnosed with cerebral palsy, spastic quadriplegia, and dystonia. He will be unable to walk, work, live independently or enjoy a normal life.

Angela Cecchi filed a lawsuit against the Northwestern Memorial Physicians Group and Scott D. Moses — the physician who provided medical care to Cecchi — were negligent in their failure to obtain the 24-hour urine test and ultrasound before she was discharged from the hospital in 2003.

She contested the case on the basis that had the doctors been able to diagnose preeclampsia earlier, resulting in immediate cesarean section preventing damage to Nicholas’s brain. She also added that physicians also did not order non-stress test and USG during the following week of her follow-up visit.

The case was settled during a trial.  

A $5,000,000 Illinois settlement was reached through mediation with the hospital physicians’ group and 2 Obstetricians.

Full verdicts can be read at Chicago Daily Law Bulletin article titled “Birth injury nets $5M in settlement.”

References:

http://www.bwmklaw.com/news/5-million-birth-injury-settlement-reached-by-bwmks-kevin-burke-elizabeth-kaveny-over-canceled-test/

http://www.bwmklaw.com/uploads/BWMK-5M-Birth-Injury-Settlement.pdf

2) Failure to perform timely cesarean: $ 3 Million in Jury Verdict for brain damage.

Alice Sodjago was scheduled for induction of labor (IOL) for post maturity at Piedmont Henry Hospital in May 2007. After the induction as planned, not much progress was seen. As the CTG was reactive and USG showed that fetus was doing well, she was discharged and was instructed to return after 4 days or after increase in her contractions.

She returned the following day with 2 cm dilatation and very strong contractions. CTG in labor ward showed fetal distress. The labor room nurse called the midwife and told her to call the obstetrician immediately for an emergency cesarean section. Due to gap in communication the obstetrician was not called for 30 minutes and even after he came he waited for 19 minutes to start the cesarean 

section.

 Baby Joanna Sodjago was born in great distress, resuscitated with difficulty and was left with cortical blindness, ADD (attention deficit disorder), impaired cognitive development and motor skills all of which will make her life a great challenge.  

The case was highly contested during trial.

The Jury ultimately, after hours of deliberation, came back with an award for the Plaintiffs in the amount of $ 3 Million Dollars.

The message sent by the jury was that if the doctor would have been called in time by the nurse and midwife, the series of acts and events that ultimately led to baby Joanna’s severe brain damage would not have happened.

References:

http://www.popehoward.com/wp-content/uploads/2014/09/PopeandHowardFultonCountyDailyReportReprint9-10-2014.pdf

http://www.georgiainjurylawyerblawg.com/2014/09/15/fulton-county-georgia-jury-awards-plaintiffs-3-million-medical-malpractice-case-involving-birth-resulted-permanent-brain-injury/

http://www.chicagobirthinjurylawyersblog.com/

Medical error ranks third as leading cause of deaths in United States.

A recent paper published in the BMJ ranks Medical error as the third leading cause of death after heart disease and cancer.

CDC compiles the annual list of the most common cause of deaths in USA, based on death certificates filled out by physicians, funeral directors, medical examiners, and coroners. 

The health care provider fills the certificates using an International Classification of Disease (ICD) code to the cause of death, and unfortunately no ICD-10 code exists at present for human and system factors.

According to an article published in Journal of patient safety, premature deaths associated with preventable harm to patients was estimated at more than 400,000 per year costing the nation a colossal $1 trillion each year.

There's also the 10,000 serious complications cases resulting from medical errors that occur each day, beside the 1000 death each day.

"Medicine today invests heavily in information technology, yet the promised improvement in patient safety and productivity frankly have not been realized," said Peter Pronovost, MD, senior vice president for Patient Safety and Quality and director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins.

According to authors although human error is inevitable, but steps can certainly be taken to reduce its frequency and severity. They suggest making error made and lesson learnt more visible instead of conducting closed door mortality meetings, so that healthcare staff is more aware of such complications.But all these requires a robust data which is difficult in the absence of standardized  collection and reporting at the national level.

The death certificate can be changed to include an extra column requiring to address whether a preventable complication have contributed to the cause of death.

Increasing trained healthcare staff to rescue patients and limiting human error by always following set protocols in handling an emergency situation.

Beside USA, medical errors are also leading cause of deaths in Canada and UK. About 117 other countries in the world also code the cause of death using ICD codes, using it as an indicator of health status. ICD-10 also has limited codes to capture the cause of mortality.

The authors suggest that when a medical error occurs, the physiological cause of death along with the error leading to it should be captured.

At the same time the statistics relating to medical error death should be shared nationally and internationally as other research is shared, creating a common platform to heightened awareness.  

References:

http://www.healthcareitnews.com/news/deaths-by-medical-mistakes-hit-records

http://journals.lww.com/journalpatientsafety/Abstract/2013/09000/A_New,_Evidence_based_Estimate_of_Patient_Harms.2.aspx

http://www.bmj.com/content/353/bmj.i2139