Our client presented two times to the defendant hospital emergency department after recently ongoing cervical epidural steroid injections for management of pain related to his known cervical disc disease. Our client's visits were prompted by the sudden inability to urinate. The physicians assumed our client's inability to urinate was the result of a new pain medication which he had been taking. The physicians did not perform a physical examination, nor did they obtain a history of neurological problems. Instead, our client was catheterized and discharged home. At these visits, the physicians failed to diagnose our client's condition as an epidural abscess and failed to properly monitor, recognize, respond to and manage our client's care following his epidural steroid injections. The following day, our client underwent previously scheduled surgery for removal of a herniated disc. Upon awakening from anesthesia, our client was unable to move his legs. Further evaluation revealed the extensive epidural abscess as the cause of his paraplegia. He required two additional surgeries to drain the abscess, but he did not regain the use of his legs.
The case settled before suit was filed for a confidential amount.
Counsel: Kevin F. Dugan, Esquire Mark A. Abramson, Esquire
Our client had a history of asthma which was treated with steroids. He presented to a local hospital with complaints of mid-lower back pain. He was diagnosed with muscle strain and discharged. Later he saw a physician in his office with complaints of back pain. The doctor prescribed Talwin for pain. His impression was back pain, possibly secondary to vertebral compression fracture, secondary to cortico-steroids. X-rays revealed a compression fracture at T8. The client subsequently telephoned the physician's office with complaints of worsened back pain. The doctor renewed the prescription for Talwin. The client then sought treatment at a hospital emergency department with complaints of mid-back pain lasting for three weeks. X-rays showed a severe compression fracture of the thoracic spine. He was discharged home with a diagnosis of respiratory infection. Several days later, he presented to another hospital with complaints of mid-low back pain and difficulty walking. He also complained of an inability to urinate. He was transferred to the first hospital for neurological evaluation. He was subsequently admitted with numbness from the waist down. He underwent emergent decompression and reconstruction with rib grafts. Later, he underwent a second operative procedure for spinal reconstruction with instrumentation and bone grafting. Streptococcic was cultured from the T7 vertebral body and this was treated with Penicillin and Gentamycin. The diagnosis was osteomyelitis with a paravertebral abscess. He was transferred to a local hospital for rehabilitation with instructions to taper off Prednisone.
The case settled before suit was filed for a confidential amount.
Counsel: Kevin F. Dugan, Esquire Mark A. Abramson, Esquire
Our client was experiencing symptoms of loss of vision in her right eye, severe headaches, dizziness, loss of consciousness and light headedness. Her family physicians ordered carotid flow studies which revealed a large irregular plaque formation at the origin of the right internal carotid artery producing severe stenosis. The plaintiff was immediately referred to the hospital for admission and follow up care. Instead, the plaintiff was only seen in the emergency room and was sent home the same day. Client was instructed to take aspirin, wear TED stockings and to sit if dizziness occurred. Less than 2 months later, client suffered a severe and debilitating stroke in the right hemisphere. A subsequent angiogram revealed 90% stenosis of the right internal carotid artery. The client now suffers from left facial weakness, paralysis of the left arm and leg, decreased vision of the right eye, and permanent brain damage.
The case settled before suit was filed for a confidential amount.
Counsel: Kevin F. Dugan, Esquire
Our client's decedent lived and worked in Wisconsin as an on-site supervisor for a furnace company. He was in New Hampshire on a special project for the company when he began having trouble breathing and eating and was coughing frequently. He sought out medical advice at a walk-in medical facility with presenting signs and symptoms of pneumonia. Radiological studies were obtained, which showed a live infiltration on the left lung. The physician referred the plaintiff to a local hospital, stating that admission was warranted. The emergency room physician, after examination and acquiring a complete blood count, which was elevated, prescribed medication and discharged the patient with a diagnosis of pneumonia. The physician referred the decedent to a medical group for follow up. He scheduled a follow up appointment with the medical group for six days later, however, in the interim he began having increased chest pain and admitted himself to the hospital where he died soon thereafter.
The case settled before suit was filed for a confidential amount.
Counsel: Kenneth C. Brown, Esquire
Our client went to his family physician with complaints of flu-like symptoms; i.e., nausea, vomiting and fever. Prior to that visit, the physician was familiar with the decedent's medical history which included a traumatic emergency splenectomy in 1973, but the physician failed to recognize that such patients are particularly susceptible to infection. The client went twice to the ER at a local hospital with complaints of fever, cough, nausea, vomiting, diarrhea, an unexplained neurological event (fainting spell), and an elevated temperature. The ER physicians noted that the plaintiff underwent a splenectomy during adolescence. He was repeatedly discharged from this hospital with a diagnosis of enteric viremia when in fact he was suffering from Hemophilus Influenza Group B. Ultimately, the client suffered disseminated intravascular coagulation with vascular complications requiring below the knee amputation of both lower extremities, the loss of the point, index and little finger of his left hand, and amputation of the four fingers on his right hand at the first digit.
The case settled before suit was filed for a confidential amount.
Counsel: Kenneth C. Brown, Esquire
Our client presented to the emergency department with two deep lacerations on his knee from a chainsaw accident. The attending doctor attempted to clean the wounds, stitched them up, and sent him home. The next day he returned to the hospital complaining of numbness in his lower leg and severe pain in the knee. A different doctor saw him this time, but he was sent home again with instructions to avoid prolonged weight bearing and to return in four days for a follow up examination.
Later that evening, our client became extremely disoriented and showed signs of delirium. His wife and a neighbor brought him back to hospital where he was admitted with a working diagnosis of right knee cellulitis (deep inflammation of the tissues just under the skin caused by infection with germs) with sepsis (poisoning of the body by products or bacteria) and delirium. His condition dramatically worsened and he was transferred to Dartmouth Hitchcock Medical Center the following day where he was diagnosed with synergistic gangrene (death and deterioration of a part of the body caused by an interference with the blood supply) and sepsis. He underwent several operative procedures at Dartmouth, including exploratory surgery of his knee and debridement; exploratory surgery of the thigh to rule out fasciitis; and split thickness skin graft to the open knee wound. He remained an inpatient until he was finally discharged home nearly four weeks after the accident.
The case settled before suit was filed for a confidential amount.
Counsel: Kenneth C. Brown, Esquire
On November 4, 1997, our client, who was 63 years old, presented to the Emergency Department at the local hospital at 8:52 a.m. complaining of chest pains and nausea. Shortly after being given nitroglycerine, the plaintiff vomited and passed out while sitting up in a hospital bed. He fell backwards and struck his head against the bed or the railing. The nurse noted in the records that it took three to five minutes before our client became fully alert and oriented. Our client's head injury was not reported to the Emergency Department physician. On the orders of the Emergency Department physician, and within minutes after the plaintiff struck his head, the nurse administered thrombolytic therapy designed to treat the heart attack, via a protocol which included Retavase, heparin, and aspirin. The thrombolytic protocol is well-known to be contraindicated for patients with head injuries. Despite this, our client remained on the thrombolytic therapy and was transferred to the SCU. A nurse in the SCU noted our client's head injury and notified the defendant doctor. Still, our client was kept on the thrombolytic therapy. The next comprehensive assessment noted our client to have a frontal headache and he was sweating profusely. Minutes after the assessment, our client developed extreme difficulty breathing and significant vital sign changes. A CT scan was ordered immediately. Before our client could be taken for the CT scan he suffered another episode of extreme difficulty breathing. He was emergently intubated and ventilated at which time the thrombolytic therapy was finally discontinued. The CT scan revealed a large right-sided subdural hematoma. Our client was airlifted emergently to a tertiary care facility where he underwent a right craniotomy with evacuation of his acute subdural hematoma.
The defendant doctor had a duty to obtain a CT scan upon learning of our client's head injury on November 4th. Had a CT scan been taken after noon on November 4th it would have diagnosed the plaintiff's intracranial bleed. The thrombolytic protocol would then have been discontinued and the anticoagulants would have been reversed. This would have stopped the bleeding prior to causing permanent brain damage and/or would have insured the plaintiff's transfer to a tertiary hospital to monitor the intracranial bleed and to timely surgically evacuate it if necessary.
The case settled before suit was filed for a confidential amount.
Counsel: Kenneth C. Brown, Esquire Kevin F. Dugan, Esquire
Address:
Abramson, Brown & Dugan
1819 Elm Street
Manchester
New Hampshire 03104-2910
Phone: (866) 938-3321
Fax: (603) 666-4227