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.