Case details

Doctors claimed no chance to intervene in patient’s sudden bleed

SUMMARY

$0

Amount

Verdict-Defendant

Result type

Not present

Ruling
KEYWORDS
arterial, death, internal bleeding, loss of society, vascular
FACTS
On April 1, 2011, plaintiffs’ decedent Marilyn Ford, 61, an employee of the Department of Public Social Services for the county of Riverside, underwent a lung biopsy at Riverside Community Hospital, in Riverside. Ford was previously transported to the emergency department of Riverside Community Hospital with complaints of back and chest pain on March 29, 2011. A CT angiogram of the chest was subsequently ordered to rule out a dissecting aneurysm. Ford was then taken to the catheterization laboratory by Dr. Joseph Quan, an interventional cardiologist, on March 30, 2011. While undergoing an angioplasty and placement of a stent in the right coronary artery, it was discovered that Ford was suffering from multi-vessel coronary artery disease with narrowing up to 80 percent in the other arteries. The procedure was without complication, and Ford was placed on Effient, an anti-platelet medication, to prevent thrombosis on the stent. Quan then requested a consult from Dr. Andrew Duke, a pulmonologist, due to an incidental finding of a mass on Ford’s right lung, which was identified on the CT angiogram during the procedure. After Duke authored a consultation note on March 31, 2011, Quan advised Ford that, given the size of the lung mass at 3.0-centimeters and Ford’s history of smoking, the mass could be malignant. As a result, Quan recommended a biopsy to determine whether the mass was cancer and if so, to determine the state of cancer and what treatment would be indicated. Duke was aware the Effient would increase the risk of bleeding, but also believed the risk outweighed the benefits of an urgent work-up of the lung mass. Thus, he requested that Dr. Frank Sabatelli, an interventional radiologist, perform the lung biopsy, which Sabatelli ultimately performed on April 1, 2011. (Sabatelli was also aware that Ford was on Effient.) Thereafter, Ford was transferred to the care of Duke for post-procedure monitoring and was later discharged home at midnight after seven hours of post-procedure monitoring. At around 7 a.m. the following morning, on April 2, 2011, Ford was transported back to the emergency department due to shortness of breath. She quickly became non-responsive and after resuscitation efforts, she died. An autopsy ultimately determined that the cause of death was a massive bleed from the tumor with blood compressing the right lung. Ford’s adult daughters, plaintiffs Brandy Roberts and Bridgette Jones, sued Riverside Community Hospital, Duke, Sabatelli, and Quan. The decedent’s spouse, Dale Gray, and their surviving son, Derek Jones, chose to not participate in the action. As a result, they were dismissed from the case and remained listed as nominal defendants. Riverside Community Hospital was also dismissed from the case prior to trial. Thus, the matter continued against Duke, Sabatelli and Quan only. Plaintiffs’ counsel contended that the biopsy should have been deferred until the Effient was discontinued, given an increased risk of bleed associated with the medication and surgical procedures. Counsel also contended that Ford should not have been discharged after the surgery since a post-procedure chest film reflected bleeding into the pleural space in the right chest, and since Ford had excessive chest pain and was coughing up blood. Counsel argued that had Ford not been discharged, the bleeding would have been recognized and physicians could have timely intervened to save Ford’s life. Defense counsel asserted that multiple coronary lesions were identified during the procedure that likely were unstable and could rupture at any time with resulting thrombus formation if Ford was not on an anti-platelet medication like Effient. Thus, counsel contended that Ford would have been on Effient for the remainder of her life. Defense counsel also asserted that findings on the chest film were consistent with expected hemorrhage following a lung biopsy and that the complaints of pain and coughing up blood were expected complications. Counsel further asserted that there was no suggestion of unusual bleeding. Thus, defense counsel contended that Ford’s discharge was not premature and that the bleed was sudden and catastrophic, such that there was no chance for timely intervention. Counsel further contended that shortly before Ford became non-responsive, chest sounds were clear and blood tests reflected a near-normal blood volume. In addition, defense counsel contended that the exact reason for the sudden and catastrophic bleed was uncertain., Ford suffered a massive bleed from the tumor, causing blood to compress the right lung. She quickly became non-responsive and died on the morning of April 2, 2011. She was survived by her adult daughters, plaintiffs Brandy Roberts and Bridgette Jones. Plaintiffs’ counsel asked the jury to award Roberts and Jones $3.4 million in non-economic damages and $50,000 in economic damages for an inheritance loan that Jones had previously made to Ford.
COURT
Superior Court of Riverside County, Riverside, CA

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