Date of Verdict:
Court and Case No.:
C.P. Allegheny County, GD 12-017566.
Michael A. Della Vecchia.
Type of Action:
Cauda equina syndrome; neurological deficits.
John P. Gismondi, Gismondi & Associates, Pittsburgh.
James R. Miller, Dickie, McCamey & Chilcote, Pittsburgh.
Dr. Ira Mehlman, emergency medicine, New York, NY; Donal F. Kirwan, economics, Pittsburgh.
Dr. Roderick B. Groomes, emergency medicine, Kittanning, Pa.; Douglas S. King, accounting, Pittsburgh.
According to a the plaintiff’s pretrial memorandum, in the evening of Sept. 28, 2010, Thomas Mol, who was 34 and working as a financial manager, presented to the emergency room of the Forbes Regional Hospital. During the visit, Mol was seen by Dr. Elizabeth Moy, who was employed by EMP of Allegheny County LTD. The memo said that Mol complained of back pain and numbness. A CT scan was performed, and Night Hawk Radiology interpreted the readout. The memo said that Mol was sent home even though he was unable to walk under his own power.
The day after Mol was discharged, Dr. Joel Rosenbloom reviewed the CT scan readouts and recommended that Mol undergo a follow-up MRI in due course, the plaintiff’s memo said.
A few days later, Mol’s condition was diagnosed as cauda equina syndrome at another hospital. He underwent an emergency surgery, but subsequently suffered loss of bowel, bladder and sexual function, as well as reduced function of his legs.
Mol sued Western Penn Allegheny Health System-Forbes Regional Campus, Moy, Rosenbloom, EMP of Allegheny County, Night Hawk and Virtual Radiology Professionals, which had purchased Night Hawk. Mol alleged that the parties committed medical malpractice by failing to timely diagnose the cauda equina syndrome, which is damage to the bundle of nerves at the base of the spine known as the cauda equina.
Western Penn was discontinued from the case before trial, and Night Hawk settled for a confidential sum.
Mol, in his pretrial memo, alleged that Moy failed to perform a proper neurological examination, and that she failed to order an MRI, which Mol contended is better able to detect compression of the cauda equina than a CT scan. He further alleged that she failed to properly investigate his claims, or admit him to the hospital, as he was unable to walk without assistance.
Mol also alleged that Night Hawk made an improper preliminary interpretation of the CT scan, and that Rosenbloom failed to properly convey any urgency in obtaining an MRI.
The plaintiff’s emergency medicine expert, Dr. Ira Mehlman, said in his report that Moy did an inadequate examination and should have checked rectal retention, and that, based on the complaints, Moy should have ordered an MRI. He further opined in his report that Rosenbloom should have told Mol to return to the hospital immediately, based on his findings.
The pretrial memo filed on behalf of Moy, Rosenbloom and EMP of Allegheny County said that when Mol presented to the hospital, he described his condition as numbness in the legs and back pain that felt like pins and needles and increased with movement. Moy noted that pain was intact, that he had good motor strength, and that Mol’s gait was steady, the memo said. The CT scan report indicated only degenerative changes, with possible posterior disc bulge and mild stenosis, but no emergency condition, the memo said. Moy prescribed pain medications, and the plaintiff reported that his condition had improved before he was discharged. The memo additionally said Mol was told to return to the emergency department if his condition changed significantly. Rosenbloom’s follow-up read of the MRIs indicated severe spinal canal stenosis and compression of the thecal sac, and Rosenbloom advised staff to tell Mol he should get an MRI.
The memo said Mol waited two days while his condition worsened, and that when he arrived at the hospital, he had complaints of numbness and inability to move his bowels and bladder.
The defendant’s medical expert, Dr. Roderick Groomes, noted in his report that Mol had a 17-year history of back problems stemming from a lacrosse injury. He opined that back pain is the second-most-common complaint in emergency departments, and that advanced imaging is performed in only a small percentage of cases, therefore the fact that Mol underwent a CT scan showed that Moy had considered the severity of the injury, and had performed the only test available at the time. He also opined that there was no evidence that Mol reported an inability to walk to the triage nurse when he was admitted. The expert further opined in his report that based on the CT scan findings and Mol’s complaints, the visit met the standard of care.
According to the plaintiff’s memo, Mol presented to the hospital two days after he was discharged. An MRI showed compression of the cauda equina, and he was taken to emergency decompression surgery. Although the compression was relieved, Mol was left with permanent neurological deficits, including paraparesis in his lower legs, particularly on the right side, as well as bowel, bladder and sexual dysfunction, the memo contended. The memo said that Mol walks with Lofstrand crutches, that he performs self-catheterization several times daily and wears a diaper. Mol also contended in the memo that he was unable to return to work because he cannot perform any job that requires prolonged standing or walking.
The defendants’ expert accountant, Douglas King, said the report of plaintiff’s expert Donal Kirwan claiming that Mol sustained an economic loss of between $1.3 million and $1.5 million, was overstated. King further opined that there was no evidence that Mol’s unemployment was due to his injuries, and that he could return to sedentary work.
The jury found that Moy was negligent, but that Rosenbloom was not negligent. The jury also awarded Mol $410,000 for each of the categories of pain and suffering, mental anguish, disfigurement and loss of the ordinary pleasures of life. The jury also awarded $220,000 in diminished earning capacity.
Defense attorney James R. Miller did not return a call for comment.