Case details
Lack of full facts changed reading of CT scan: radiologist
SUMMARY
$0
Amount
Verdict-Defendant
Result type
Not present
Ruling
KEYWORDS
internal iliac artery, psoas muscle abscess, vascular injury
FACTS
On July 23, 2010, plaintiff Christopher Scott, 22, a student and grocery store checker, presented to Sharp Memorial Hospital’s emergency room with abdominal pain. He was diagnosed with acute appendicitis. Dr. Jose Zamora, II, a board-certified general surgeon, subsequently performed a laparoscopic appendectomy on Scott that same day. During the surgery, Zamora noted a hematoma that he thought he controlled. However, following the procedure, Scott continued to have fever and an elevated white blood cell count. As a result, on July 27, 2010, Zamora ordered a CT scan of Scott’s abdomen and pelvis to rule out an abscess. Dr. Neeraj Panchal, a board-certified radiologist, then interpreted the CT scan as showing considerable inflammation, but no drainable abscess. Based on this finding, Scott was discharged from Sharp Memorial Hospital on July 31, 2010. Scott followed up with Zamora at his medical office on Aug. 9, 2010, at which time Scott was complaining of pain in his right thigh and hamstring. Scott then underwent CT imaging on Aug. 13, 2010, and he was found to have a pseudoaneurysm of his right internal iliac artery, as well as a psoas muscle abscess. As a result, Scott underwent an endovascular coiling procedure and had a stent was placed in the artery three days later. However, Scott was left with a right-sided foot drop. Scott initially sued Zamora and Sharp Memorial Hospital. Panchal and another doctor, Dr. Barry Browne, were later substituted in for “Doe” defendants. Scott alleged that the defendants failed to timely diagnose the pseudoaneurysm and that this failure constituted medical malpractice. Sharp Memorial Hospital was dismissed for a waiver of costs, and Browne was also dismissed from the case. In addition, Zamora settled with Scott on the first day of trial. Thus, the matter continued against Panchal only. Prior to Zamora settling, plaintiff’s counsel contended that Zamora was negligent in performing the laparoscopic appendectomy, causing an injury to Scott’s right internal iliac artery. Counsel also contended that Zamora was negligent for failing to advise Panchal that Scott had dropping hematocrits following the laparoscopic appendectomy, or that he was concerned about a vascular injury at surgery and a possible bleeding problem. Plaintiff’s counsel further contended that Zamora failed to take appropriate action on Aug. 9, 2010, in that Zamora failed to properly evaluate, image and refer Scott to an appropriate specialist for his right leg complaints that day. Plaintiff’s counsel argued that Zamora relied on Panchal to review the CT scan on July 27, 2010, and report the large pseudoaneurysm, or mass of blood, in time so that Zamora could take immediate action to avoid a foot drop. Counsel contended that Panchal admittedly missed the mass that showed up on many different CT screens. Counsel also contended that Panchal missed the mass when comparing the identical portions of the abdomen in a previous CT scan that was performed on July 23, 2010, which did not show the mass, with the CT scan that was performed on July 27, 2010, which did show the mass. Plaintiff’s counsel noted that Panchal explained, “You see what you look for and you look for what you know.” The plaintiff’s expert radiologist opined that Panchal fell below the standard of care. Panchal claimed that he complied with the standard of care in his reading and interpretation of the subject CT scan, even though he did not appreciate a small pseudoaneurysm on the right internal iliac artery. He also claimed that Zamora should have reported to him that there was a vascular injury at surgery and that Scott’s hematocrits had been dropping. Panchal alleged that had he been given that information, it would have changed his search pattern and would have greatly increased the chances of him seeing the pseudoaneurysm, since he would have been looking for a bleeding complication., Scott was diagnosed with a pseudoaneurysm of the right internal iliac artery and a psoas muscle abscess. As a result, he underwent an endovascular coiling procedure on Aug. 14, 2010, and had a stent placed in the artery on Aug. 17, 2010. However, Scott was left with a right-sided foot drop. He also suffered deep vein thrombosis and a pulmonary embolism, and had to have an inferior vena cava (IVC) filter placed. Scott claimed that his right foot is now “paralyzed.” He alleged that as a result, he lost wages as a grocery checker for several years. However, he admitted that he has returned to school and is now employed as a certified dental assistant, but that he still has some continuing physical limitations due to the permanent foot drop. Thus, Scott sought recovery of over $50,000 in past lost earnings, $192,000 in past medical costs, between $972,000 to $1.22 million in future medical costs, and $250,000 in general damages for his pain and suffering.
COURT
Superior Court of San Diego County, San Diego, CA
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INJURIES:
- anxiety
- brain
- brain damage
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- cognition
- depression
- epidural
- extradural hematoma
- face
- facial bone
- fracture
- head
- headaches
- hearing
- impairment
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- loss of
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- skull
- speech
- subdural hematoma
- tinnitus
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