ER Medical Malpractice: $3 Million Settlement

2012 Medical Malpractice Trial Report

ER physician did not rule out abdominal trauma, leading to undiagnosed bowel perforation, sepsis and prolonged hospitalization

This medical malpractice action was brought by the plaintiff, who is a 65 year-old man in December of 2005 when he was a restrained driver in a single car automobile accident. He presented to the Emergency Room with fractures of his clavicle and a “seat belt sign. ” He had mild left lower quadrant tenderness on palpation and decreased bowel sounds. He was medicated for his severe shoulder pain. A FAST ultrasound evaluation of his abdomen was negative. After observation and upon re-examination, the defendant emergency room physicians felt that the abdominal tenderness had localized over the bony prominence of his hip. His vital signs were stable and the defendants discharged him with instructions to follow up for his orthopedic injuries and return to the emergency department if his condition worsened. No abdominal CT scan or surgical consultation had been ordered or performed to rule out an intraabdominal injury.

Two days later, the plaintiff had his orthopedic follow up with the third defendant, a nurse practitioner. The plaintiff indicated that he had some bruising on his abdomen from his seatbelt, that he felt tired, that he had lack of an appetite, and that he had not moved his bowels since the injury. The defendant dealt with his orthopedic injuries and, with respect to the abdominal issues, instructed him to take prune juice or milk of magnesia, to keep hydrated and mobile, and if he was unable to move his bowels to try an enema. She further instructed him to follow-up with his primary care physician if he remained unable to move his bowels. She did not send him for immediate evaluation of his abdominal complaints even though she was not qualified to assess such issues.

Three days later, the plaintiff presented again to the emergency room. By this point in time, the plaintiff had a distended, acute, abdomen that required surgery. He was taken to the operating room where it was found that he had copious amounts of fecal spillage into his abdominal cavity. The source of the contamination was found to be a nearly transected sigmoid colon. The plaintiff had a prolonged and complicated hospital and rehabilitation course (almost a year) involving multiple surgeries. Over the years, the plaintiff has improved significantly, but continues to have ongoing lung and kidney issues.

The defendants argued that the colon injury that was found in surgery simply could not have existed at the time of their care and treatment of the plaintiff or else he would have been far more ill. Therefore, they concluded that a CT scan would not have shown an injury, but instead that it must have developed after he left their care. The plaintiff countered that the initial presentation of blunt abdominal trauma can be relatively benign, but that the “seat belt sign” and abdominal tenderness were indicative of abdominal trauma that needed to be ruled out, but was not.

Lubin & Meyer represented the plaintiff in this emergency room malpractice lawsuit.

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