Clay Robinson and Jonathan Weber successfully defended a gastroenterologist in a wrongful death lawsuit arising from the alleged failure to diagnose esophageal perforation. Plaintiff alleged that perforation of the esophagus was clinically evident, was not diagnosed and resulted in sepsis and death.
The patient was a 57 year old man. He presented to the emergency department with chest pain following an episode of vomiting and choking on food. Initial workup in the ER appeared to rule out a cardiac cause. EKG was normal as were cardiac enzymes. CT angiogram was negative for pulmonary embolus. He was admitted to the hospital for GI evaluation and management. Due to a prior history of esophageal stricture, he underwent EGD with balloon dilation of a strictured esophagus. Following dilation, the patient’s condition worsened. The next day, a gastrografin swallow revealed an esophageal perforation with contamination of the mediastinum. Re-review of the initial imaging studies performed during his presentation to the ER revealed the presence of free air, which had not previously been appreciated. The free air was likely the result of esophageal perforation at the time of his initial presentation. It was felt that he most likely had perforated his esophagus due to Boerhaave’s Syndrome. Surgery followed to repair the perforation. The patient developed sepsis which worsened and he ultimately died three weeks later of multisystem organ failure.
Plaintiff sought $3,514,060 in damages at trial. The case was tried in Kenton Circuit Court in August 2021. After a two-week trial, the jury returned a 10-2 verdict in favor of the defendant gastroenterologist and a 9-3 verdict in favor of the gastroenterology practice.
Clay Robinson and Courtney Soltis successfully defended an APRN in a lawsuit alleging substandard care at a rehabilitation nursing home related to the prolonged Foley catheterization in a patient with an Artificial Urinary Sphincter (AUS) device. The patient experienced urethral erosion and required multiple surgeries to heal.
The patient, a 78 year old male, was admitted to the hospital and underwent a right tibiotalocalcaneal (TTC) ankle fusion, performed by a podiatrist. Prior to surgery, a catheter was placed. Despite the presence of the AUS device, the catheter remained in place for six days following the surgery. The patient was then transferred to a rehabilitative nursing home facility for physical therapy to allow the surgically reconstructed ankle to heal. Discharge orders for his care, included instructions for the Foley catheter to remain in place until the patient was weightbearing. While at the nursing home facility, he was seen by an APRN who issued orders for his medical care. The Foley catheter remained in place during his four week stay at the nursing home facility. At the time of his discharge, the patient was non-weight bearing and his Foley catheter remained in place. Following his discharge, his urologist discovered that the patient had developed erosion of his urethra. The presence of the Foley catheter combined with the patient’s AUS had led to erosion of his urethra. He required additional surgery to remove his AUS device. He subsequently underwent additional surgery to install a new AUS device.
Plaintiff filed suit against the APRN, alleging that it was the APRN’s duty to independently assess whether an actual need for the Foley catheter existed at the time of his nursing home admission. Given the risk of urethral erosion created by prolonged catheterization in a patient with an AUS, plaintiff argued that the APRN should have evaluated the patient and either removed the catheter or sought a urologic consultation regarding the catheter. The parties agreed that the Foley catheter was contraindicated given the patient’s AUS and further that the catheter had in fact led to the urethral erosion. The defense maintained that the erosion had already occurred during his six day stay at the hospital and prior to transfer to the nursing home. Plaintiff countered that the damage to the urethra likely had occurred during his month long stay at the nursing home facility. Plaintiff sought $880,000 in damages for medical expenses and pain and suffering. The case was tried in November 2021 in Fayette Circuit Court. The jury returned a 10-2 verdict in favor of the defendant APRN on the issue of causation.
Nick Edwards successfully defended a hospitalist in a wrongful death lawsuit arising from the alleged failure to timely diagnose and treat sacral decubitus ulcers. Plaintiff alleged that due to negligence the patient developed pressure ulcers which became infected leading to the overall deterioration of the patient’s health, and ultimately his death.
The patient was a 50-year-old man. He presented to the hospitalist in the emergency department with complaints of headache, chills, weakness, worsening left knee pain, cough, respiratory infection, and seizure activity. The hospitalist performed a physical exam and admitted the patient to the hospital for further care, including multiple therapies and consults.
During the hospitalization, the patient developed skin integrity issues, which were treated by hospital staff. The patient was discharged after a two-week hospital admission. The patient’s skin integrity issues subsequently recurred and became infected. the patient continued to struggle with complicated health issues at several different medical facilities and he ultimately died due to cardiopulmonary failure.
The Estate filed suit and retained a hospitalist expert to support their standard of care and causation allegations. Following the deposition of plaintiff’s experts, the defense moved the Fayette Circuit Court to exclude the expert’s standard of care and causation opinions pursuant to KRE 702 and Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579, 113 S. Ct. 2786, 125 L. Ed. 2d 469 (1993). After hearing arguments, the court found that the expert’s opinions were not based upon sufficient data and facts, and the opinions were excluded.
The defense then successfully moved the Fayette Circuit Court for Summary Judgment. The trial court found that with the exclusion of the Plaintiff’s expert’s opinions they were no longer able to establish a prima facie case of medical negligence against the hospitalist.
An appeal by the Plaintiff followed. On December 17, 2021, the Kentucky Court of Appeals affirmed the lower court’s orders excluding the opinions of Plaintiff’s expert and granting summary judgment for the defense.