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$________ CONFIDENTIAL Medical malpractice - General practitioner negligence - Defendant physician negligently permitted the decedent to discontinue Coumadin despite upper extremity clotting disorder - Failure of physician to appropriately assess and treat lower extremity DVT - Wrongful death of decedent in his 40s from pulmonary saddle embolis.

Riverside County, California

In this medical malpractice matter, the plaintiff contended that the defendants were negligent in permitting the decedent to discontinue Coumadin despite suffering from an upper extremity clotting disorder and in failing to timely asses and treat a lower extremity deep vein thrombosis which resulted in fatal pulmonary embolis. The defendants denied any breach of the standard of care.

The decedent, a male in his mid 40s, underwent a successful open reduction and internal fixation of his right tibial plateau due to a fracture sustained in an automobile crash. He was admitted on August 22, ________ to the Roe HMO Medical Center and eventually discharged on August 27, ________. His discharge orders properly included Coumadin to prophylactically anticoagulate. The plan was for the decedent to remain on the Coumadin for approximately a six-week period.

On October 27, ________, Roe nurse practitioner evaluated the decedent. A sonogram was scheduled at that time of the left antecubital space and performed on October 31, ________. At or around the time of the sonogram, the claimant’s decedent’s use of Coumadin was discontinued. On November 23, ________ the decedent presented to an outlying clinic of the Roe HMO with leg pain, including lower extremity swelling. Two days later, on November 23, ________, the decedent coded and died from a pulmonary embolism.

The plaintiff brought suit against the defendant HMO Medical Center, the clinic physician and the nurse practitioner, alleging negligence. The plaintiff contended that it was a breach of the standard of care to discontinue the decedent’s use of Coumadin when he suffered from an upper extremity clotting disorder. Secondly, the plaintiff alleged that the defendant physician was negligent in failing to properly assess and treat the decedent’s DVT. The decedent died two days later when the clot in the decedent’s leg broke off and resulted in a pulmonary embolis.

The defendants denied the allegations and maintained that discontinuing Coumadin when it was ordered was well within the standard of care. The defendant argued that a minor left upper extremity clot is not indicative or diagnostic of a DVT. The defendants further maintained that there was no deviation from the acceptable standard of care in failing to diagnose a DVT. Although a DVT was present, the decedent failed to present with any of the classic signs necessary for diagnosis.

The plaintiffs, who were the wife and children of the decedent, claimed damages consisting of $________ in general damages under MICRA, and loss of earnings and household services consisting of $________.

The matter was settled pending court approval of the minor’s petitions for the sum of $________.

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