Thursday, May 19, 2005

Another stroke malpractice case

Medical malpractice suit takes shape
In the first day of testimony at a medical malpractice trial at the Madison County Courthouse, attorney Robert Wilson alleged that after George Wolfe was admitted to the emergency room at Anderson Hospital on June 13, 2002, Dr. Kevin Bell failed to realize that Wolfe had suffered a stroke.
...
Wilson noted that Wolfe complained of symptoms that should have indicated a stroke, including drowsiness, confusion, losing track of time, and memory loss.


He was discharged from the hospital after about five hours and was advised to begin taking 325 mg of chewable aspirin as part of anti-platelet therapy.


He was re-admitted June 15 after Wilson said the stroke worsened.
...
On June 17, Wolfe was transferred to St. Mary's Health Center in St. Louis where he was placed in a drug-induced coma.


In opening statements, attorney Tim Richards argued that Bell was not given enough information to make a diagnosis and that Wolfe's options were extremely limited. "The appropriate treatment is the miracle treatment of aspirin," he said. "No doubt Mr. Wolfe had a devastating injury that medical science could not have prevented. Even had he been admitted, medical science could not have prevented this."


On Monday, Sarah Scott [the ER doc] and Southwestern Illinois Health Facility, Inc., doing business as Anderson Hospital, settled their case with Wolfe for an undisclosed amount.
Based on this report, did Dr. Bell do anything wrong? Would admitting the patient to the hospital on June 13 have made any difference?

Medical malpractice requires four elements, all of which must be met in order to satisfy the definition:
  1. Duty to treat. From the standpoint of an ER doc, this is usually fairly obvious. In this case, the doc represented the patient's regular primary care clinic. OK, met.
  2. Tort. The patient has to have incurred an injury. This patient is now in a wheelchair and requires assistance with ADL's. OK, met.
  3. Deviation from standard of care. In this instance, is it clear that the SOC was not met? What is the SOC for an established stroke in the ED? Should this patient have been admitted? What would you have done differently? And yes, I acknowledge that all we have to go on is a short newspaper article, but use your imagination. It is obvious that this patient was not a thrombolytic candidate.
  4. The deviation from SOC has to have caused the tort. Again, not clear here. Did the absence of some sort of treatment result in the injury? If so, would that treatment have been considered SOC?