Failure to Diagnose and Treat Pulmonary Abscess: $1.75M Settlement
2016 Medical Malpractice Trial Report
Wrongful Death: Patient identified with pleural effusion in the lung is delayed treatment and dies awaiting care
The decedent presented to the ER of a local hospital on 3/30/11 complaining of back pain, cough, and fatigue. A chest x-ray revealed a small pleural effusion in the right lung. She was instructed to follow up with her PCP. She was seen by the Nurse Practitioner the following day. Another x-ray confirmed the presence of the pleural effusion and the fact that an infectious etiology could not be ruled out. Rather than send the decedent to the hospital for drainage, culture and antibiotics, she was instructed to see a pulmonologist on an outpatient basis. This was scheduled for 4 days later, however, the decedent was unable to attend that appointment and another appointment was scheduled for six days later on April 12, 2011. In between the visit with the NP and the pulmonologist the decedent was seen again in the ER with worsening blood sugars and continued complaints of back pain and non-productive cough.
The decedent then presented to the pulmonologist for a consult for her right pleural effusion. The pulmonologist noted her pleural effusion had initially been found 2 weeks earlier. He wrote that her sob with 1 flights of stairs has been present for 2 weeks, her cough is productive of white, yellow and has been present for 2 weeks, and she has a history of a prior pleural effusion which she had tapped in 2003 After his examination, his impression was of a medium pleural effusion, etiology unclear and that he was unable to delineate the effusion “perhaps due to her weight.” He ordered labs and a CT scan for the next day (4/13/11). There was no plan to drain the effusion that day or send her to the hospital.
During discovery the pulmonologist testified that he wanted to drain the effusion in the office but he was unable to do it, so he planned to send her to the hospital to have it done under radiographic guidance. That however was not noted in his record. What is noted is a call from the patient 2 days later inquiring of the CT scan results. At that time an appointment is made for thoracentesis 5 days later on 4/19/11.
Unfortunately, at 8am on 4/17/11, the decedent was rushed to the hospital in severe respiratory distress with labored breathing. A chest x-ray revealed a substantial increase in her right pleural effusion. She was transferred to a tertiary care center however en route she coded and died at 58 years old. Autopsy findings confirmed bilateral pneumonia, pulmonary abscess in the right middle lobe and empyema of the right pleura.
The case went to mediation in the weeks before trial and settled for $1,750,000.
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