Malpractice

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Dental -Anesthetic Injection -Needle Trauma –Motor and Sensory Nerve- Loss of Speech

A dentist damaged the cranial nerves during an anesthetic injection when he thrust the needle into the gum near the tempomandibular (jaw joint), causing the patient to feel an immediate, intense pain, electrical shock in the tongue, and to involuntarily lung forward from the chair into an upright position. The dentist with the syringe then pushed the patient back in the chair and plunged in the entire carpule of anesthetic fluid into the lower mandibular area.

All the medical experts agreed, the injury sustained as a result of this injection was the worst reported case of nerve damage caused by needle trauma, leaving the patient with permanent oral pain, a loss of speech, touch, taste, sensation, and general motor function of the tongue, as well as damage to the cranial nerves that included the trigeminal (sensory) and hypoglossal (motor) nerves.

This complex seven-year litigation involved two trials and an appeal. Over forty witnesses participated in the case, including multiple experts in anatomy, anesthesiology, neurology, oral medicine, oral surgery, speech pathology, economics, vocational disabilities, and American Sign Language.

The defense based its strategy entirely on the credibility of the defendant dentist who testified he remembered nothing about the injection and did not write any description in the patient=s chart. The defendant argued that the injection did not occur as described by the patient, because he and his employees would have remembered such an extraordinary event. However, none of the dentist=s employees could recall being present or if they were in a position to observe the injection. The dentist also attempted to present testimony of his past habit and custom of doing injections.

At the first trial, the trial judge excluded the three employees testimony, because defendant established no evidentiary foundation that these separate witnesses remembered being present and in a position to observe this event. However, following post-trial Motion for Judgment Not Withstanding the Verdict, the first trial judge found his own initial ruling to be in error and ordered an entirely new trial that took place a year later before a second judge and jury.

The District of Columbia Court of Appeal, in a reported opinion, Hummer vs. Levin, et. Al., 673 A.2d 631 (DC 1996), ruled that the first trial judge was initially correct in excluding this negative evidence that lacked foundation and subsequently erred in granting a new trial.The first trial ended with a $4 million verdict and the second trial ended with a $3.2 million verdict, which was immediately paid. Patient then appealed the judgment for $3.2 million and two years later, the Court of Appeal reversed the trial court’s order for a new trial and reinstated the original jury verdict of $4 million. The defendant then paid an additional $1.2 million in judgment and interest for total payments of $4,400,000.00 in judgment and interest

 

This case was also reported in the following publications:

    Washington Times, May 1, 1992, Dental Suit Yields $4 Million

    Montgomery Express, May 5, 1993, Chevy Chase Dentist to Pay $3.2 Million Suit

    Daily Washington Law Reporter, April 19, 1996, Negative Evidence

    Metro Verdicts Monthly, Volume 4, Number 7, page 243, Dental Malpractice Injection Nerve Damage

    Metro Verdicts Monthly Volume 5, Number 8, page 289, Dental Malpractice Injection Loss of Speech

Pre-Mature Labor- Wrongful Death – Negligent Obstetric and Neonatal Care

Wrongful death case against hospitals and doctors of two D.C. Roman Catholic hospitals (Georgetown and Providence ) involving the non-consensual abortion of a 22-week fetus. Neonatal negligence was committed by the doctors and hospitals who failed to classify and plan for an high risk pregnancy in a Level 3 facility for the eventuality of pre-mature labor and other complications which the mother had experienced with previous pregnancies.

Mother medical care for her pregnancy was delivered by a second year family practice medical school resident despite the fact qualified obstetricians, neonatal physicians and proper diagnostic equipments where readily available that could have effectually monitored, examined, tested and treated the mother and baby.

Hospital obstetrician in charge, without the mother’s consent, purposely ruptured the membrane to hasten birth. He then dropped the baby into a metal pan causing a severe intra-cerebral hemorrhaging and depriving the baby of oxygen and neonatal care for an hour. The baby died six hours later at Children’s Hospital. Doctors testified for Plaintiff regarding breach of the standard of care in failing to:

· Perform adequate vaginal examination

· Monitor fetal heart rate

· Perform sonogram examination

· Prescribe bed rest

· Administer cortisone to mature lungs by stimulating production of surfactant, and

· Administer tocholytic agents to prevent further dilation and effacement of the cervix

to maintain the fetus in utero, and extend gestation to a time closer to full term.

Fraudulent Surgery - Rotator Cuff Tear - Convicted Felon Surgeon

Orthopedic surgeon committed fraudulent rotator cuff surgery on a 72-year old patient complaining of shoulder pain for only three weeks and she was offered only surgery and no conservative treatment option, such as cortisone injection. Before surgery, the MRI written report of the radiologist stated the film showed no rotator cuff tear. The surgeon testified he never reviewed the MRI film of the shoulder he ordered. Physician was aware patient had health insurance that would pay for a surgery. During the surgery, the surgeon took no tissue sample to send to pathology for study.

During a second surgery by a different orthopedic surgeon to shave the bone spur that was the actual cause of the shoulder pain, the second surgeon visualized and inspected what the first operative report identified as the surgical site of the rotator cuff tear and repair and described the area as “pristine”. The second surgeon testified that the coracoacronial ligament that was to have been repaired in the rotator cuff repair surgery was still intact and without any evidence that a repair had ever taken place.

The civil trial against the surgeon occurred after he was convicted on federal

perjury and tax evasion charges. During the civil trial, the court permitted the jury to hear cross-examination of the doctor explaining to the jury why he could not attend the rest of the trial because he was being sent the next day to federal prison to serve his prison for these criminal charges. The civil case was settled by medical malpractice insurance company while the jury was still deliberating on their verdict.

 

Hospital Negligence – Trauma Care & Surgery - Gunshot Wound - Wrongful Death

Wrongful death suit and settlement against District of Columbia Government on behalf of estate (widow and two children) of a deceased gas station manager who was shot by an armed robber D.C. General Hospital for their negligence during and after thoracic-abdominal surgery for his gunshot wound. During a exploratory laparotomy the surgeon determined by palpation that there was a stellate (star like) laceration over the dome of the liver (2 in. long by 3 in. wide by 1.25 in. deep). The surgeon decided to place a drain and close the lap and monitor the bleeding and decided not to gain access and visualize the wound to determine the full nature, extent, character, and track of the wound or the method of tamponade. The liver wound continued to bleed. The medical records established that for ten hours following surgery the liver was losing a high volume of blood and a high volume of blood products were being infused to replace this loss. (5,450 ml of pack cells, fresh frozen plasma, whole blood and platelets). Repeated post-surgical laboratory results (PH, PO2, PCO2, PT, PTT, Platelets, HGB, HCT, WBC, RBC, NA Clorides, Carbon Dioxide, Potassium, Sodium, Bun, Glucose Calcium Creatinine, Fibrin, Split and Fibrogen) showed a steady decline in the patient’s physiological condition as a result of the tremendous blood loss and its replacement with inferior blood products. The hospital did attempt to repair the bleeding liver laceration for the next 10 hours. When a second surgery to repair the laceration was finally attempted, the patient was in much graver physiological condition from the tremendous blood loss and did not survive the second surgery.

 

Medical Malpractice – Hospital Nurse & Therapist – Drop Post-Surgical Patient.

Patient suit and settlement against hospital. On the morning following surgery for a total knee replacement, patient was dropped by a nurse and occupational therapist when they attempted to make the patient standup and walk. This attempted ambulation of the patient occurred after she had been infused with the analgesics and anesthetics, Fentyl and Bupivacaine. The patient informed the hospital staff that her leg was “dead” and she could not feel anything in it. Patient even banged her leg several times to show the therapist that she could not feel it due to the effects of the epidural and could not safely stand on her own. The therapist responded “we do it all the time.” When therapist and assistant attempted to make the patient stand she was immediately dropped, her surgical incision was completely opened and the surgical site damaged.

A reconstruction of the medial collateral ligament and a third surgery by a plastic surgeon for a muscle flap with skin graft was required causing her disfigurement, pain and permanent loss of range of motion and weight bearing capacity.

The case was settled based largely on the deposition testimony of an nurse expert, certified in orthopedic and emergency nursing. The expert had extensive experience working with adult orthopedic surgical patients in a hospital setting and standards of nursing and of what conduct conforms or fails to conform to those standards. The nurse expert testified that reasonably prudent nurses, occupational and physical therapists, in similar circumstances make an adequate assessment of a patient’s fall risk considering factors such as age, size, weight, mental status, history, medications, impaired mobility, physical weakness, deformity, impaired mobility, poor coordination, balance, sensation status of extremity, and the patient’s perception of their current condition. The nurse expert testified the nurse and/or therapist should have been taken these factors into account. Even if it was necessary to ambulate the patient, the staff should have adequately planned the ambulation, and utilized a safe method and equipment (strapping patient to hospital staff) that could have prevented the fall.

 

Dental Drill Injury - Neurovascular Bundle – Implant Surgery

Negligent pre-and post-operative care of two separate patients in two separate patient lawsuits against the same periodontist who failed to obtain sufficient preoperative radiography (CT scan ) to measure position and anatomical relationship of neurovascular bundle to proposed implant thereby causing inferior alveolar nerve damage during drilling procedure prior to placement of an implant.

 

Attorney - Legal Malpractice - Non-Suit Statute - Failure to Timely Re-file

Claim against attorney for failure to timely re-file personal injury lawsuit of elderly motorist injured during a police chase of another motorist who ran a red light attempting to elude police and violently crashed at high speed. Attorney originally filed suit, then during the litigation obtained an order non-suit in the case under Virginia Code § 8.01-380 which allows a plaintiff to dismiss their claim once as a matter of right with the right to re-file the claim in the same court within 6 months. The attorney failed to re-file the case in six months. The injury case could not be filed and withstand a motion to dismiss. The attorney was immediately amenable to settlement and his professional liability insurance company paid a fair and reasonable settlement of the legal malpractice claim.

 

Attorney – Legal Malpractice – Failure to Timely File Lawsuit- Statute of Limitations

Claim against personal injury law firm for failure to timely file a complaint for negligence on behalf of an injured motorist under Virginia Code § 8.01-243 (limitation for filing a personal action for injury) settled for the likely value of the underlying personal injury claim, if it had been timely filed and reached a verdict or settlement.

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