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ARTICLE ID 48794

$________ - MEDICAL MALPRACTICE - FAILURE TO TREAT PRESSURE WOUND - SEPSIS - WRONGFUL DEATH OF 51-YEAR-OLD PENTECOSTAL BISHOP

Broward County

This medical malpractice action was brought against nine physicians, their respective practice groups, the plaintiff’s HMO and the rehabilitation hospital where the decedent was treated. The plaintiff claimed the defendants were negligent in failing to properly treat a pressure wound on the decedent’s neck. The plaintiff alleged that the pressure wound caused the development of overwhelming sepsis which led to the decedent’s death. One of the defendant doctors was dismissed and the rehabilitation hospital, the HMO and three doctors settled the plaintiff’s claims prior to trial for undisclosed sums. The remaining five defendant physicians argued that their treatment met the required standard of care and that the decedent’s death was not causally related to the neck wound.

The decedent was a 51-year-old Pentecostal bishop. He was admitted to the hospital after suffering a heart attack in February ________. The decedent also suffered respiratory failure and was placed on a respirator. After a 10-day hospitalization, the decedent was transferred to the defendant rehabilitation hospital to be weaned from the respirator.

During the early part of the decedent’s stay at the rehabilitation hospital, the first defendant, a pulmonologist, documented that the decedent had developed a wound on the back of his neck caused by the pressure of tracheotomy straps. The defendant pulmonologist consulted the second defendant, who was a wound care specialist, as well as the final three defendants, who were all infectious disease specialists.

The plaintiff alleged that none of the defendants took appropriate action to treat the neck wound, allowing it to become infected. The plaintiff sought punitive damages against the defendant wound care specialist, asserting that he willfully ignored the decedent’s care and did not see the decedent for a period of five weeks.

By the time the decedent was transferred from the rehabilitation facility in April, ________, the plaintiff contended that the neck wound had become seriously infected. The plaintiff’s medical experts opined that the infected wound was not properly cared for and led to the overwhelming sepsis.

On May 31, ________, the decedent suffered a severe drop in blood platelets from ________ to ________ and began profuse bleeding from every orifice. The plaintiff contended that the bleeding, which some doctors attributed to intravascular coagulopathy, resulted from either sepsis or the antibiotics administered to the decedent. In either event, the plaintiff claimed that the bleeding was brought about by the defendant’s earlier negligence in not properly treating the neck wound.

The plaintiff’s expert testified that antibiotics were insufficient to treat the plaintiff’s open neck wound. He opined that debridement was required to remove dead tissue, which was a breeding ground for infection. The plaintiff’s expert testified that IV antibiotics travel through the blood system but do not reach a necrotic wound.

The plaintiff contended that, at certain times, the tracheotomy strap was noted to be embedded in the decedent’s neck wound. At the end of the hospitalization, the plaintiff claimed that the open wound was nearly through the decedent’s neck. The plaintiff offered photographs depicting the wound.

Due to potential blood clots in the bladder stemming from the profuse bleeding, a cystoscopy (examination of the bladder with a cystoscope) was performed on June 3, ________. On June 7, ________, a suspected bladder perforation was noted. The decedent died on June 8, ________, of multiple organ failure caused by overwhelming sepsis.

The decedent was survived by his wife and two minor daughters ages six and 19 at the time of his death. The plaintiff made no claim for economic damages, since he was not working at the time of his hospitalization.

Each of the defendants maintained that he acted within the standard of care. The defendant pulmonologist contended that he made the appropriate referrals to evaluate and treat the decedent’s pressure sore.

The defendants argued that the decedent was seen daily by the pulmonologist and an infectious disease specialist who put a treatment plan into effect. The treatment plan was to be executed by the nursing staff and a wound care nurse at the rehabilitation facility, according to defense arguments.

The defense maintained that records showed the decedent’s neck wound was attended daily by the rehabilitation hospital nursing staff and weekly by a wound care nurse at the facility. The defendant wound care specialist asserted that, during the time that he did not actually see the decedent, he was receiving regular reports on his condition from the rehabilitation facility’s nursing staff.

The defendants contended that the decedent’s neck wound was stable and, when it became problematic, an incision and drainage was performed. The defendant wound care specialist testified that he intended to perform a deep debridement of the wound, but the decedent was transferred to another facility before he had the opportunity to do so.

The defendants took the position that the decedent did not suffer from DIC, but another bleeding disorder, thrombocytopenia, probably caused by a reaction to certain drugs. The defense asserted that the decedent’s overwhelming sepsis and death stemmed from the bladder perforation most likely caused by the cystoscopy, not as a result of the neck wound.

The defendants also stressed that the decedent was obese (________ pounds) and had many other complicating health factors including heart attack, respiratory difficulty, congestive heart failure, hypertension, diabetes and gastrointestinal difficulties.

The jury found the defendant pulmonologist 30% negligent; the defendant wound care specialist 40% negligent and assigned 15% negligence to each of two defendant infectious disease specialists. The jury found that punitive damages against the defendant wound care specialist were not warranted. The third infectious disease specialist (who ultimately noted the neck wound as the possible source of the decedent’s infection) was found not negligent. The plaintiff was awarded $________ in damages. The award included $________ to the decedent’s wife; $________ to his oldest daughter and $________ to his youngest daughter. All defendants have filed an appeal. The plaintiff has filed for attorney fees and costs.

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