This episode discusses cases where there are medical disasters and a medical malpractice attorney is needed to evaluate medical records and identify who was responsible for negligent care.
Transcript[00:00:06] Good morning, and welcome to Ask Andy, this is a daily podcast about personal injury practice in Philadelphia, Pennsylvania. I’m Andrew Neuwirth. You can reach me at 215-259-3687 or on the web at Neuwirthlaw.com. I wanted to talk to you today about medical malpractice war stories, so I guess I practice medical malpractice law for about a little less than two years in New York City, at a firm that defended malpractice cases. And then I eventually moved to Boston and practiced about another six or seven years there, defending medical malpractice cases in Boston. And now I handle medical malpractice cases from the other side as a plaintiff’s attorney here in Pennsylvania. So but over the course of time, you know, I got some war stories for you about, you know, what a medical malpractice case looks like and what they don’t look like. So when I was a young lawyer about four or five years out of law school, I was getting ready, maybe six years out of law school. I was getting ready to leave New York City to join my fiancee out of state, and I was working as a defense lawyer and there was a case that was in my office that had kind of hit the front page of the New York Post, our local, you know, tabloid for obvious reasons. A young boy was in a car accident, was rendered unconscious in a really bad car accident, and he was taken to a local hospital and brought into an MRI scanner after some other testing and basically to evaluate his, you know, brain injuries and an MRI scanner is basically a huge magnet. [00:02:07] Someone at the hospital screwed up and left his oxygen tank in the room. When the MRI scanner was turned on, the boy was in MRI scanner and the oxygen tank was sucked into the MRI tank, into the MRI scanner and killed the kid. Kid never regained consciousness after the car accident, and that was the case, so it was an awful story. It was on the cover of the paper. You know, it was a case that was going to get settled fairly rapidly. You know, one of the lawyer issues in the case, really, the only lawyer issue to defend the case was that the kid was never conscious after the car accident, so he couldn’t have suffered, you know, pain and suffering that he was aware of. And that was really the only thing that, you know, one could address as a potential defense. The only question in that case was really, you know, who was responsible? Was it a nurse? Was it the hospital? Was it a hospital employee? And how much insurance was there to cover the case? Because, you know, obviously someone had screwed up and broken with policies and procedures. [00:03:17] You know, there’s a lot of signs around saying, you know, if you have a metal plates in your body, you can’t have an MRI. If you have a pacemaker, you can’t have an MRI or something like that. So whatever the rules are, were plainly not followed in that situation. So that was one. You know, there are others over the years which are, you know, equally horrific. There was a I worked on a case at one point where there was a mix up in. Pathology slide reviews, so basically, let’s say you have a possible prostate cancer tumor. A doctor takes the sample, they make a slide out of it, you know, on a piece of glass like maybe you saw in biology class in high school and they look at it to see if there’s cancer cells. But in this day and age, there’s a lot of slide review needed and there are labs set up to review a lot of slides. So there were a lot of different patients slides on a bench being read by a pathologist and slides from Patient A got mixed up with slides from Patient B because they were all just sitting next to each other on the table. Slides that had cancer were mixed up with slides from a patient who didn’t have cancer. The slides were read as cancerous. The patient was told you have prostate cancer and you need to have your prostate out. [00:04:57] And his prostate was removed and once it was removed, they do another round of pathology to make sure you know that they got it right and they find there’s no cancer there. So what happened? A patient who never needed surgery, who didn’t have cancer, one was told he had cancer and two had his prostate removed for no reason at all, except for a mix up in the lab. Meanwhile, the other patient who has cancer, who needs his prostate removed, is going along fine and comfortable in the belief that everything’s fine. He doesn’t have cancer, and meanwhile, his cancer is growing, and that’s a mess. That’s a bad medical malpractice case, but it’s a bit of a caper. It’s a bit of a, you know, detective story to figure this all out. Eventually, it gets figured out and eventually the case is settled because there’s really no defense once you figure out the facts in that case. An interesting situation, not a pleasant one. Most of the medical malpractice cases that are really, you know, the devastating ones are ones where it’s not necessarily the doctor doing something wrong, but it’s a lack of communication, at least in my experience. It’s a lack of communication handing off a patient from one doctor to another or from one facility to another or something like that. So, you know, what does that look like? Well, you know, I had a weird case involving cauda equina [00:06:24] syndrome. Cauda equina is actually kind of a little piece of your spinal cord. I believe that is dangles sort of below your coccyx like down kind of real deep into your into your pelvic area. And it’s kind of the end of your spinal cord. And there’s something called cauda equina syndrome, which is where that sort of tail end of your spinal cord is injured, usually by trauma, usually by a blow or a crush impact. And you can rapidly lose feeling in your legs and be paralyzed if that cauda equina injury isn’t figured out. So, you know, there was a case I was working on at one point where and this is all public, where a patient was injured in a weird accident and that they were, you know, their spine was hit during some recreational activity and they were otherwise healthy, you know, 40 year old woman and they went to the hospital because they were in a tremendous amount of back pain, which is one of the signs of cauda equina, but one of the signs of a lot of things. And the hospital said, all right, here are some back pain medication and let her go. And she came back the next day, she said, I’m still in tremendous back pain. I’m having kind of tingling in my toes now your, you know, nerves in your lower back, control your legs and they control sensation, you know, can you feel numbness or or pain? And they also feel motor meaning? Can they move your legs, move your toes, et cetera? So this was, you know, a patient who had been exercising over the weekend. [00:08:14] She was in this, you know, traumatic injury situation, but not a car accident. She was just exercising and had a fall and a blow to the back. And so now she’d already been to the hospital once and they said, No, it’s just back pain. You’ll get over it. Most back pain resolves. She comes back. She’s still in tremendous pain, but now she’s got some, you know, concerning signs in retrospect and the doctors are seeing all right numbness and tingling still most likely just back problems. But then she rapidly, you know, decompensated so rapidly goes downhill and several of the doctors recommend a neurology consult. Neurology doesn’t see her for 24 hours, and by then, she’s got sort of what’s called dense hemiplegia, meaning she has, you know, real paralysis setting in, and by the time the recommendation is to go see neurosurgery, which is the correct recommendation, she’s paralyzed. And, you know, she goes in for a neurosurgical decompression of that area and they do the surgery, but it’s useless and she’s paralyzed from the waist down. And you know, as you can imagine, there are probably 10 to 20 providers who missed it now. Are all of them responsible? Yes and no. [00:09:38] You know, does your ER doc have to know about cauda equina syndrome? Absolutely. Does your primary care doc or the person seeing you on the floors of the hospital during the evaluation? Are they responsible for diagnosing cauda equnina? Probably not, but they are responsible to understand that there’s been a change in symptoms and that they need to call for a specialist if it’s outside their area. Is the nurse responsible? Probably not. Are the nurses recording complaints or concerns of the patient or the patient’s family to the doctors? Yeah, so the nursing notes become very important in terms of how the patient’s presentation was changing. Now these are all, you know, evidence that can be found in the medical record. And sometimes people know to, you know, go see a lawyer, and sometimes family members just have concerns about what happened. So that’s the sort of thing those are, you know, very strong medical malpractice cases, but they do take some evaluation and reading of medical records. So that’s usually where most of these cases start is the ordering and review of your medical records. So that’s enough of war stories from medical malpractice cases from my career. There’s probably 9000 other ones, but those are the ones that jump out at me while I’m, you know, talking to you guys anyway. I hope all as well. Again, this is ask Andy. I hold people accountable.