Case details

Defense: Earlier testing would not have showed fatal embolus

SUMMARY

$0

Amount

Verdict-Defendant

Result type

Not present

Ruling
KEYWORDS
arterial, death, embolism, vascular
FACTS
On July 19, 2010, at approximately 11:08 a.m., plaintiff’s decedent Susan Baratti, 52, presented to the emergency room at Presbyterian Intercommunity Hospital in Whittier. Baratti was examined by an emergency medicine specialist, Michael Martin, M.D., and noted to have complaints of an acute onset of shortness of breath and shoulder pain radiating to her chest. As a result, she was triaged and an EKG was immediately performed. Baratti, who was characterized as morbidly obese, had previously been diagnosed with deep venous thrombosis with possible pulmonary embolus on May 14, 2010. She was subsequently admitted to Presbyterian Intercommunity Hospital and treated from May 14, 2010, through May 16, 2010. She then treated at the Coumadin Clinic at Presbyterian Intercommunity Hospital from May 19, 2010, through July 15, 2010. After returning to Presbyterian Intercommunity Hospital on July 19, 2010, Baratti underwent an EKG and lab workup, which indicated that she had a blood oxygenation level of 65 percent, that she had normal cardiac enzymes and that her international normalization ratio (INR) was at a therapeutic level. However, a note was made of swelling and edema bilaterally to her lower legs. At 12:13 p.m., a resident physician ordered a CT angiogram, an echocardiogram and a bilateral lower extremity Doppler to rule out possible deep vein thrombosis/pulmonary embolism. However, Baratti passed away 40 minutes later, prior to the tests being performed. At autopsy, it was determined that Baratti died of a complete occlusion, or blockage, of her right main pulmonary artery due to a massive pulmonary embolus. The decedent’s son, Steven Baratti, sued Martin and Presbyterian Intercommunity Hospital, alleging that the defendants failed to properly diagnose a pulmonary embolism and failed to properly treat his mother in the E.R. The decedent’s son further alleged that these failures constituted medical malpractice, making the defendants liable for his mother’s wrongful death. Prior to trial, Presbyterian Intercommunity Hospital was dismissed on a motion for summary judgment based on standard of care and causation. Thus, the matter proceeded to trial against Martin only. Plaintiff’s counsel contended that Martin failed to timely order a CT angiogram or other related studies, and that if he had done so, the pulmonary embolism would have been timely diagnosed. The plaintiff’s medical experts testified that the decedent’s presenting complaints, in addition to her recent hospital admission and treatment for deep vein thrombosis and/or a pulmonary embolism, should have prompted Martin to order the CT angiogram and related studies no later than 11:13 a.m. on the subject date. The experts opined that if the studies were ordered at that time, they would have shown deep vein thrombosis and/or a pulmonary embolism, and treatments, including administering Heparin and tissue plasminogen activator (tPA), to break down blood clots could have been administered, which would have saved the decedent’s life. Plaintiff’s counsel contended that Martin failed to enter anything in the decedent’s chart, except for a postmortem history and physical report, and that a resident entered the orders for the CT angiogram and other tests. Thus, counsel argued that the absence of any charting entered by Martin and the fact that a resident entered the orders for tests indicated that Martin had not been attentive or actively engaged in treating the decedent during her presentation. Martin claimed that his management and treatment of the decedent complied with the applicable standard of care. He also claimed that the treatment administered to the decedent in the E.R. was done as a team approach under his direction. Defense counsel contended that given that the decedent’s INR was at a therapeutic level at the time of her presentation, heparin was not indicated and would not have prevented the breaking off and migration of the fatal embolus. Counsel also contended that tPA was contraindicated in this case, specifically prior to a definitive diagnosis of a pulmonary embolism being made by a CT angiogram. Defense counsel noted that on cross-examination, both of the plaintiff’s experts conceded that the embolus that killed the decedent did not migrate to her right pulmonary artery until just prior to the code being called. Thus, counsel argued that even if the CT angiogram and echocardiogram had been done sooner, they would not have showed the fatal embolus., Susan Baratti suffered a massive pulmonary embolism, resulting in her death on July 19, 2010. She was 52. The decedent left behind an adult son. Thus, the decedent’s son sought recovery of wrongful death damages. According to defense counsel, plaintiff’s counsel asked the jury to award $500,000 in general damages.
COURT
Superior Court of Los Angeles County, Norwalk, CA

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