Lawsuit for Undiagnosed Abdominal Aortic Aneurysm Settles for $3 Million

2012 Medical Malpractice Trial Report

Plaintiff claims his AAA was mistaken for kidney stones by urgent care physician leading to paraplegia. Settlement reached during jury deliberations.

This medical malpractice action was brought by the plaintiff, a 75-year-old man, who had presented in 2006 to his local Urgent Care Center with an elevated blood pressure and some flank and groin pain. The patient was found to have trace blood in his urine (hematuria). The defendant, an urgent care physician, assessed the patient to have the classic signs of a kidney stone. He also took note of the fact that the plaintiff appeared to be comfortable, was in no apparent distress, with no sign of low blood pressure and a generally benign abdominal examination (no pulsatile mass, no abdominal tenderness, no rebound, no guarding and no constovertebral angle tenderness). The defendant doctor arranged a renal ultrasound for the next day to assess for a stone and did see the patient the next day after the testing, where he again noted the patient to be comfortable and not complaining of significant pain. The renal ultrasound was negative and a CT scan was recommended. The defendant doctor gave the patient instructions to have a CT scan set up by the Primary Care Physician and to go to the Emergency Room if the symptoms worsened. Early the next morning, the plaintiff’s wife found him in bed in severe distress. An ambulance was called and he was taken to the hospital. A ruptured Abdominal Aortic Aneurysm (AAA) was found and surgery was peformed, where substantial blood loss was found to have occurred. A subsequent surgery found that a portion of the plaintiff’s bowel had died and a colostomy was performed. Postoperatively, the plaintiff required substantial ongoing care and skilled nursing rehabilitation (approximately 6 months). Due to blood loss, the plaintiff had suffered an ischemic injury and was not able to ambulate.

At trial, the defense argued that, although there may have been a AAA present when the plaintiff saw the defendant in the Urgent Care Clinic, it could not have ruptured at that point because (a) the plaintiff’s condition was absolutely inconsistent with a ruptured AAA, which would be expected to cause acute illness, deep visceral back or abdominal pain that does not come and go, hypotension, loss of pallor and, most significantly, that it would not cause blood in the urine, as kidney stones commonly do; and (b) the renal ultrasound would have absolutely shown the bleeding if it had ruptured. The plaintiff argued that a AAA can leak (short of massive rupture as happened later) and therefore can cause symptoms like those experienced by him and that there was a known problem in medicine of physicians mistaking AAA for kidney stones, which the defendant allowed himself to fall into.

Lubin & Meyer represented the plaintiff in this lawsuit.

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