Cost of a mystery ailment: $5.5M, a family’s pain

Published by The Boston Globe, February 26, 2001

Charlton – She went to her HMO with a simple sore throat. Five days later, Patricia Letourneau, a 24-year-old newlywed, suffered massive brain damage that left her unable to move or speak.

This month, Fallon Clinic Inc., six of its doctors, one of its nurse practitioners, and a doctor at St. Vincent’s Hospital agreed to pay her family $5.5 million in what is believed to be one of the largest pretrial malpractice settlements in state history, according to Massachusetts Bar Association officials.

Letourneau’s family believes her throat infection, improperly treated, spread to her brain.

But no one knows for sure: None of the medical professionals she saw ever took a throat culture to determine what she had.

A lawyer for Worcester-based Fallon, which in 1997 was rated the nation’s best health maintenance organization by U.S. News and World Report, says the doctors and nurses did nothing wrong. He says Letourneau had a disease that defied diagnosis.

“Nobody knows what was going on,” said David Gould, who represents Fallon and one of the doctors, Howard Bassel. “Nobody knows that even if she had been admitted to the hospital on minute one, whether the end result would have been different. That’s the ultimate bottom line. There may have been an infection that was immune to cure. ”

But Letourneau’s still stunned husband, Robert, and parents, Edwin and Marjorie Barnes, believe she would be well today had Fallon professionals – even just one – recognized obvious signs that her condition was getting worse.

“She fell through the cracks, to put it politely,” said her father, 56, a Shaw’s supermarket manager. “There were so many doctors involved, they just kept passing her around. No one had the guts to make the call: Put her in the hospital. ”

“It is a classic case of HMO mismanagement,” said the family’s lawyer, Andrew Meyer of Lubin & Meyer. “No one doctor took responsibility for the patient. Each one passed the problem on to the next physician, with no one actually making a correct diagnosis. ”

“The ultimate result was the catastrophic collapse of Patty Letourneau, which the Fallon Clinic was ill-equipped to handle. ”

Letourneau, a graphic artist and Sunday school teacher, complained of a sore throat on May 8, 1996, and followed the advice of her mother to see a doctor.

Letourneau visited Fallon nurse practitioner Karen Fleming, who, according to records, surmised she had strep throat and, without performing a throat culture, sent her home with antibiotics.

No culture was performed, said Gould, a lawyer for Fallon, because “there was nothing there, nothing to culture. ”

Over the next four days, as her condition worsened, Letourneau returned to the Worcester clinic and was treated by a succession of doctors – Stuart Bentkover, Stuart Pollack, Jonathon Sillman, Joseph Procaccini, Sarah Stevens, and Bassel – who tried more and different medications, including such antibiotics as erythromycin, Bicillin, and clindamycin, some intravenously, and sent her home.

Lawyers for the family say she possibly had something simple that was never diagnosed, and never properly treated.

That Saturday and Sunday, even though her heart was beating more than 160 times per minute – nearly twice the normal rate – Bassel sent her home. “She reported to him she was feeling better,” Gould said.

It was not until Letourneau passed out in front of Fallon doctors that Sunday night that they sent her by ambulance to St. Vincent’s Hospital in Worcester.

There, even though her lungs were so congested she could barely breathe, and her pulse was racing, Dr. Susan Ruane didn’t hook her up to a respirator until 2:30 a.m., some three hours later, according to hospital records.

“We were all on our knees praying,” said her husband.

At 9 a.m., her heart stopped.

“The infection had traveled into her bloodstream and was affecting all of her organs,” said Suzanne McDonough, a nurse-turned-lawyer who represents the family. “Her body was worn and beaten, and just shut down. ”

For three days, her family didn’t know whether she would live. Weeks passed before they learned she would never be the same.

Though doctors finally cured the infection, Letourneau was in a vegetative state.

“We keep waiting for her to wake up,” said her mother. “But she didn’t get beyond the state she is now. ”

After nearly two years in two rehabilitation centers and a nursing home, Letourneau returned to her parents’ home in April 1998.

Her mother quit her job at a crafts store, and the family, with help from such charities as the Lions’ Club, retrofitted the house, converting a first-floor den into a bedroom for Patty.

Letourneau is now dependent on relatives and round-the-clock health aides for everything. She has to be hoisted from bed to wheelchair and back again with a mechanical lift, and turned every two hours to avoid bedsores.

With the settlement, her parents will install a whirlpool and an exercise room. And they will keep pressing Fallon, which is still insuring her, for physical therapy and other services.

“We still hold out hope for a miracle,” said her mother, 50. “We have never given up hope. ”

Letourneau’s husband, a 35-year-old machine shop worker, has moved in with his mother in Worcester, and visits Patty once a week.

“But nothing is the same anymore. We wanted to have a family – the whole works,” he said. “I keep thinking about what could have been. I wish we could go back. ”

Most of the medical professionals named in the settlement still work for Fallon. Bassel was fired in 1999, but not because of job performance, and is working for the Rhode Island prison system, Gould said. Stevens and Sillman work elsewhere in Massachusetts, according to court papers.

“I wanted the doctors to see what they did to our daughter,” said Letourneau’s mother. “I wanted to push her right in front of them. ”

She says that she believes that won’t happen now, with no trial.

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