Lab Error in Stem Cell Transplant Blamed for Death of 5-year-old Twin

2013 Trial Lawyers Report

Medical malpractice lawsuit results in $7.5 million settlement and significant changes in hospital policies

The plaintiff’s five-year-old decedent was diagnosed with hemophagocytic lymphohistiocytosis (HLH), a rare life-threatening blood disorder, which is universally fatal if not promptly diagnosed and treated. The treatment is allogeneic bone marrow stem cell transplantation. The child underwent this transplant with stem cells provided by her fraternal twin sister. Testing was conducted to identify whether engraftment had occurred. The child had clinical signs of engraftment by the time the test results were made available. In addition, the chimerism testing showed that the transplant had been successful. The chimerism report, however, contained inaccurate donor information and incorrect chimerism results. As a result of the inaccurate and incorrect findings, the child underwent a second and unnecessary stem cell transplant. After substantial pain and suffering associated with the second stem cell transplant and accompanying immunosuppressive regimen, the child experienced progressive hypoxia and signs of pulmonary hypertensive crisis with right heart failure, and the child died.

The plaintiff claimed that the chimerism samples were reported with the incorrect donor. The tests were run at a second hospital and the lab error was not recognized or addressed at that hospital. The first hospital failed to provide the second hospital with the identity of the donor. For their part, the second hospital took no action to confirm the donor’s identity, instead performing the analysis with a random and unrelated donor. When the reports were provided to the team at the first hospital, the providers failed to identify that the incorrect, unrelated donor was referenced in each report.

The plaintiff claimed that the lab error and the failure to recognize the error resulted in the child having to undergo a second, unnecessary transplant procedure. The plaintiff claimed that because the first stem cell transplant was successful, the child’s prognosis was excellent with a very strong outlook for a normal life and a normal life expectancy. The defense contested that assertion and denied that the child was cured of the disease.

The case settled following mediation for $7,500,000. The defendants also agreed to name a room in the child’s memory, to designate a Grand Rounds in her honor, and to provide documentation that steps have been taken to prevent any similar occurrence from happening to any other patients.

Attorneys for the plaintiff: Andrew C. Meyer and William J. Thompson, Lubin & Meyer, P.C.

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