Middlesex Court Case - November 2015

The Facts

The plaintiff was a 56 year-old married male with 3 adult children and no significant prior medical history. The insured was the plaintiff’s primary care physician. On March 25, 2010, the plaintiff presented to the insured with complaints of severe back pain, nausea and a decrease in appetite. He indicated the pain originated from exercising with heavy weights on March 21st. An x-ray was ordered, interpreted as negative and pain medication was prescribed. On March 31st, the plaintiff returned to the insured with complaints of increased pain and constipation. The insured ordered a lumbar MRI, which was completed on March 31st. The MRI was interpreted by the co-defendant radiologist to demonstrate significant soft-tissue degenerative conditions but also suggested “signal abnormality within the epidural space.” The MRI report noted that the abnormality was “nonspecific and a pathologic process cannot be excluded” at multiple levels. The report further stated that “if clinically indicated, this vertebral body could be further evaluated with a postcontrast study.”

The insured read the MRI report on April 2nd and the same day left a message for the plaintiff with a referral to a spine specialist. On April 6th, the plaintiff consulted with the co-defendant pain management specialist and a physician assistant of Spine and Pain Centers of NJ & NY. This physician was not the physician the insured referred the plaintiff to. There he presented with additional complaints of difficulties walking and signing papers, was examined and diagnosed with an acute endplate compression fracture and disc herniation at L1. Pain medications were prescribed and a thoracic lumbar brace was ordered. The next day, April 7th, the plaintiff fell in the shower, was unable to get up and was taken to Monmouth Medical Center via ambulance. There he was diagnosed with cervical, thoracic and lumbar epidural abscesses with cord and cauda equina compression and quadriparesis. He was emergently taken to surgery for C5 to T6 and L4 to S1 laminectomies with evacuation of epidural abscesses. The operation lasted over 8 hours.

He remained at Monmouth Medical Center for three weeks with a final diagnosis of, among other things, quadriplegia, which was permanent. Subsequently he was admitted to multiple rehabilitation and sub-acute care facilities for several months until ultimately discharged home under care of his family. Prior to the loss, the plaintiff was employed as a civilian supervisor for the Army’s satellite communications program, earning approximately $140k/year, and was a referee for youth soccer.

The plaintiff was alleging over 6 million dollars in economic damages in addition to a claim for pain and suffering, loss of enjoyment of life and disability.

Allegation of Deviation against the Insured

It was alleged that the insured failed to communicate with the radiologist when he was unsure of what the MRI report meant. It was further alleged that he failed to communicate personally and effectively with his patient once he received the MRI results, and failed to reach out to the specialist himself for additional medical input and assistance.

Trial Outcome

All defendants but the insured settled with the plaintiff prior to trial. The strategy at trial, in addition to showing that the insured was not negligent, was to show that the settling defendants were responsible for the plaintiff’s injury and disability. After seven days of testimony and argument, the jury returned a unanimous no cause verdict, finding that the insured did not deviate from the standard of care.