Misdiagnosis of CT Scan: $1 Million Settlement
2012 Medical Malpractice Trial Report
Misdiagnosis of CT scan results in death of 65-year-old woman
In this medical malpractice trial action, the decedent was hospitalized because of longstanding abdominal pain that she could no longer tolerate. On 2/22/03, a CT scan was ordered. There was a system in place that, after hours, films were read by the “night watch” service at a tertiary care hospital. Based on the Residency Schedule for the radiology department, the defendant, a radiology resident, worked the “night watch” service on 2/22/03. There is no documentation regarding the defendant’s initial interpretation, or “Wet Read” of the scan, but according to a note written at 1:00 a.m. by the surgical resident, the CT scan had been reviewed by radiology at the tertiary care hospital and there was no “collection, bowel [was within normal limits] grossly [and there was no evidence of] vasc. occlusion proximally.” Based on that report, the surgical team noted that there was “no evidence [of an] acute surgical issue.”
Accordingly, no surgical intervention was undertaken.
At 12:40 pm the next day, the medical records indicate that the CT scan from the previous night was reviewed by the attending radiologist. The very same CT scan was found to reveal probable free air in the peritoneum, with a question of portal venous air, making surgery imperative. An emergency exploratory laparotomy demonstrated severe small bowel infarction with no hope of revascularization. Because of these findings, the family decided against any heroic measures. As such, the decedent expired on February 24, 2003 as the result of acute mesenteric ischemia of the small bowel.
The defense tried to challenge the doctor patient relationship because no document states that it was the defendant resident who interpreted the CT scan during the overnight. However, the plaintiff relied upon the schedule produced in discovery by the same attorney representing the defendant. On causation, the defense argued that the bowel necrosis was so extensive that she would not have lived even if she were brought to surgery at the time of the CT scan. However, the defendant himself testified that, in looking at the CT scan in preparation for his deposition, he did not believe it showed significant necrosis at that point. Putting that testimony together with the massive degree of necrosis and gangrene at the time of eventual surgery, plaintiff was prepared to show a significant change in the intervening hours.
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