L.H. v. Anonymous Medical Center
Dr. Fagel achieved a settlement of $8.66 million on behalf of a 2-year-old. The child now suffers from short-bowel syndrome, and will require total Parenteral Nutrition for the rest of her life. These injuries resulted from the failure of the defendant ER physician to correctly read the child's x-ray, which delayed surgery for the minor plaintiff's.
On March 10, 2006, the minor plaintiff was taken to her pediatrician's office with complaints of vomiting. The child had a history of bowel obstruction and hospitalization visits but no record of surgery. The physicians gave the mother Reglan and Pedialyte and informed the mother to take her child to the ER if there was no immediate improvement that day. The mother took her child to the hospital where it was noted that the child was suffering from dehydration with acute vomiting. No lab work was recommended, but an abdominal ER was obtained, which the ER doctor examined and read as normal. Once again, the mother was given Pedialyte and told to go home.
The next day, the radiologist at the hospital examined the x-rays and noted dilated loops of bowel. The radiologist contacted the mother informing her to contact her pediatrician regarding a follow-up. However, the message was recorded on the mother's answering machine and a letter was not sent until the 29th. On March 12th, the mother and minor plaintiff returned to the hospital and further x-rays were taken which showed a distended abdomen and a small bowel obstruction. The ER physician called the child's pediatrician for a surgical consult noting a 52.5 cm abdominal measurement. Sometime after that the defendant surgeon saw the child and diagnosed a small bowel obstruction. The defendant did not review the x-rays nor did he consult the ER records. Surgery began at 9:07 am as the child's heart rate was continually falling. The surgeon noted that the small bowel was ischemic and removed all but 3 inches of the small bowel.
The defense alleged that the ER physicians care was within the standard and that the radiologists reading of the x-ray the next morning demonstrates that a system was in place to allow discrepancies and ensure quality care. Additionally, the defense alleged that during the minor plaintiff's early admission to the medical center, the child was not in need of surgical care. The defense alleged that the bowel was necrotic for several days before the surgery and an earlier operation would not have changed the inevitable outcome.
Dr. Fagel was able to refute the various claims made by the defendants and demonstrated that the care center was negligent in failing to properly read the x-rays. Additionally, the hospital staff failed to adequately recognize the child's deteriorating condition and the nurses should have notified the surgeon regarding significant vital sign changes. The defendant should have diagnosed a bowel obstruction sooner and surgery should have been administered immediately. Had surgery been performed just 3-4 hours earlier, the bowel would have been less necrotic and a sufficient amount would have been saved, which would allow for normal function.