Date of Verdict:

July 2.

Court and Case No.:

C.P. Philadelphia No. 110303678.


John Milton Younge.

Type of Action:

Medical negligence.



Plaintiffs Counsel:

Lawrence R. Cohan, Anapol Schwartz, Philadelphia.

Defense Counsel:

J. Michael Doyle and Joseph V. Conroy IV, Post & Schell, Philadelphia.

Plaintiffs Experts:

Dr. Albert Thomas, obstetrics and gynecology, Elmhurst, N.Y.; Dr. Ian Newmark, internal medicine/critical care medicine, Syosset, N.Y.; Dr. Philip Spergel, psychology, Jenkintown, Pa.; Royal Bunin, forensic economist, Wynnewood, Pa.

Defense Experts:

Gregory Kane, professor of medicine, Philadelphia; Dr. Arnold Cohen, obstetrics and gynecology, Philadelphia; Mark Ingerman, clinical associate professor of medicine, Philadelphia.


A Philadelphia jury by an 11-1 vote has awarded $1.9 million to the estate of a 25-year-old woman who died as a result of a medical misdiagnosis, a lawyer in the case said. The misdiagnosis resulted in the premature delivery of the woman's daughter, and ultimately her own death.

Mary Casiano began to show symptoms including fever, shortness of breath and a cough in June 2009, when she was approximately six months pregnant. Casiano complained of fever, shortness of breath and a cough, and went to Temple University Episcopal Hospital's emergency room in Philadelphia, according to the plaintiff's pretrial memorandum.

According to a pretrial memorandum filed by the Temple defendants, Casiano complained of fever, chills, malaise, congestion, sore throat, rhinorrhea, cough, abdominal pain and diarrhea for several days prior. Casiano's physicians at Episcopal determined that her temperature was 101.8 degrees and her blood work was abnormal. Doctors ordered flu panels, labs and urine analysis, and they diagnosed Casiano as having a fever and urinary tract infection while pregnant, according to the memo.

Physicians examined Casiano and found that she also presented symptoms of abdominal and cervical tenderness and, as a result, Casiano was transferred to Temple University Hospital, where she was admitted to the labor and delivery unit under the care of Dr. Shaliz B. Dolan and Dr. Todd Larson.

Physicians administered fetal heart monitoring and a speculum examination, and they did not find any complications with the pregnancy. According to the defense's pretrial memo, Casiano felt improved following the administration of IV fluids. Casiano was diagnosed as having viral syndrome with bronchitis and she was released with a prescription for the Z-Pak.

Two days later, Casiano returned to Episcopal complaining of the same symptoms, and she was again transferred to Temple University Hospital, where she was moved to the intensive care unit the following day for bilateral pneumonia, hypoxia and dehydration with tachycardia, according to the plaintiff's pretrial memo.

Casiano had to be intubated in order to breathe, and doctors performed a caesarean section because of fetal bradycardia, according to the memo.

Casiano's daughter was born healthy, but Casiano's condition worsened and she died several days later.

An autopsy revealed Casiano had suffered from alveolar damage, pneumonia, heart failure, shock or hypoxemia, and the caesarean section.

According to court papers, the estate claimed Temple defendants were negligent for failing to properly diagnose and treat Casiano.

According to the Temple defendants' memo, the physicians acted within the appropriate medical standards during the course of Casiano's treatment.

After an eight-day trial, the 12-member jury deliberated for a day-and-a-half before finding in favor of plaintiffs, awarding a total of just more than $1.9 million.

Casiano's attorney, Lawrence R. Cohan, said the estate is filing for an additional $100,300 in delay damages.

Cohan said the Temple defendants argued at trial that Casiano would have died regardless of her medical treatment because she had the H1N1 virus, commonly known as swine flu.

J. Michael Doyle, one of the attorneys for the Temple defendants, declined to comment on the case.

"The case was bitterly contested on negligence and causation," Cohan said.

The damages aspect of the case was difficult to prove, Cohan said, because Casiano had never held a job for an extended period of time, had not reported earnings history and had no education. In addition, she only suffered for a short period of time, he said. Cohan said one of the "tragic parts" of the case was that Casiano's child was delivered while the mother was comatose and, therefore, the mother never had a chance to meet her daughter.

Finally, he said winning the case was "particularly rewarding" because Casiano's two daughters will grow up with a little more in the way of financial opportunity.

— Kelly Flynn, for the Law Weekly •