Confidential – Failure to Diagnose

THE VIRGINIA STATE BAR RULES OF PROFESSIONAL CONDUCT REQUIRE ALL ATTORNEYS TO MAKE THE FOLLOWING STATEMENT AND DISCLAIMER TO THEIR CASE RESULTS.

SETTLEMENTS AND VERDICTS IN ALL CASES DEPEND ON VARIOUS FACTORS AND CIRCUMSTANCES WHICH ARE UNIQUE TO EACH CASE. THEREFORE, PAST RESULTS IN CASES ARE NOT A GUARANTEE OR PREDICTION OF SIMILAR RESULTS IN FUTURE CASES WHICH THE ALLEN LAW FIRM AND ITS LAWYERS MAY UNDERTAKE.

Location: Confidential
Injuries: Catastrophic Injuries
Settlement: $700,000

This medical malpractice case involved an emergency room doctor and physician assistant’s failure to diagnose a ruptured popliteal artery aneurysm leading to a below-the-knee amputation.

Plaintiff, a 36-year old African American male, presented to the emergency department with excruciating left calf pain without specific injury. Plaintiff reported a history of a stroke occurring several years prior and a recent history of a DVT (deep venous thrombosis) of the right leg which was being treated with oral anticoagulant.

During the physical examination the attending emergency room physician noted a “rock hard” left calf muscle. Plaintiff was discharged home following lab work showing abnormally low hemoglobin, hematocrit, and red blood cells, all of which are potential indicators of an internal bleed. No diagnostic studies of any kind were ordered to investigate the cause of plaintiff’s leg symptoms.

Approximately 6 hours following discharge, plaintiff returned to the same emergency department complaining that his severe left leg pain had returned and was now limiting his ability to walk independently. Plaintiff had an elevated blood pressure and an abnormally rapid heart rate throughout his visit, both of which represented changes from his prior vitals. Plaintiff was evaluated and treated by a physician’s assistant under the supervision of an attending emergency room doctor. The PA documented suspicion of compartment syndrome secondary to a suspected spontaneous bleed but then ruled out the syndrome and plaintiff was discharged. It is unclear whether the attending emergency room physician ever examined plaintiff.

3 days later plaintiff was taken by rescue squad to another emergency room with pain, swelling and coolness of the left leg. A CT scan revealed a ruptured aneurysm. Plaintiff was taken to emergency surgery where he underwent repair of the aneurysm with bypass grafting. Plaintiff had a difficult postoperative course and eventually required a below-the-knee amputation.

Plaintiff’s experts opined that the standard of care required that plaintiff receive a lower extremity CT-scan or duplex study during his initial emergency room visits to investigate the cause of the persistent lower extremity symptoms. Plaintiff’s experts also opined that had the appropriate studies been performed, plaintiff’s aneurysm would have been discovered, repaired in a timely fashion and the limb salvaged. The defendant claimed the patient’s condition did not warrant any diagnostic studies during either emergency visit, and that compartment syndrome was appropriately ruled out as a potential diagnosis on the basis of the physical examination findings. The case was resolved at mediation for $700,000.