Case details

Urologist claimed antibiotics masked patient’s rare condition

SUMMARY

$0

Amount

Verdict-Defendant

Result type

Not present

Ruling
KEYWORDS
fever, pain, urinary tract issues
FACTS
On July 15, 2011, plaintiff Robert Zargarian, an internet automotive parts salesperson in his 40s, presented to Dr. Armen Kassabian, a urologist, for urinary tract issues, as well as an alleged fever and an inability to urinate. Kassabian previously presented to an urgent care center, where he was prescribed antibiotics for urinary tract issues five days earlier. After presenting to Kassabian, Zargarian was placed on Flomax to improve his urinary stream. Two days later, on Sunday, July 17, 2011, Zargarian called Kassabian to report that he was in considerable pain. Kassabian subsequently prescribed pain medication over the phone and allegedly told Zargarian to come in the following day if he was still in pain. A few days later, Zargarian presented to an urgent care center and was referred to Olive View-UCLA Medical Center, in Sylmar. While in the emergency room, he was diagnosed with Fournier gangrene, a necrotizing lesion of the scrotum and genitalia that is a rapidly progressing and potentially life-threatening disease. As a result, Zargarian underwent surgery that left him with a groin deformity. However, he was able to survive the disease. Zargarian sued Kassabian, alleging that the doctor failed to timely diagnose the condition. Zargarian also alleged that Kassabian was negligent in his treatment and in prescribing the antibiotics and that Kassabian’s negligence constituted medical malpractice. The plaintiff’s urology expert opined that Kassabian did not take a sufficient history of Zargarian and that prescribing the pain medication was inadequate. The expert also opined that Kassabian should have told Zargarian to present to the E.R. or Kassabian’s office to see what was causing Zargarian’s pain. The plaintiff’s urology expert further opined that Kassabian’s medical records were inadequate as to what complaints Zargarian made when he visited Kassabian and that Zargarian had symptomatology that was not included in the medical chart. Defense counsel contended that Zargarian’s disease is a rare condition that is mostly seen in immune-suppressed individuals, in patients unbeknownst to them, or in patients with uncontrolled diabetes, who are more prone to infections. The defense’s urology expert opined that there was no violation in the standard of care, assuming that Kassabian’s chart was accurate as to what was recorded during Zargarian’s appointment. The expert also opined that Kassabian fully complied with the standard of care and that the diagnosis at the time was appropriate under the circumstances. Specifically, the defense’s urology expert opined that the antibiotics that were prescribed to Zargarian at the urgent care center must have masked the disease by suppressing it, as there were no blatant signs of the disease at Zargarian’s appointment with Kassabian., Zargarian underwent a debridement of his groin, and a removal of the scrotal sack and tissue in the groin. He was ultimately able to survive Fournier gangrene. However, he claimed that he is left with a deformity of the groin since his testicles had to be implanted up in the body, as the scrotal sack and other groin tissue were removed. Zargarian’s wife, plaintiff Lili Grigorian, alleged that due to the disease and treatment, she now finds her husband’s body offensive and repugnant. She claimed that as a result, she could never be intimate with him and would not sleep in the same bed with him anymore. Thus, she sought recovery of damages for her loss of consortium. The defense’s urology expert opined that Zargarian had no permanent issues. The expert noted that Zargarian and his wife had two children prior to the events, and testified that Zargarian was still potent and could engage in sexual activity with his wife.
COURT
Superior Court of Los Angeles County, Burbank, CA

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