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Date of Verdict:

April 7.

Court and Case No.:

C.P. Montgomery No. 2012-31789.

Judge:

Thomas P. Rogers.

Type of Action:

Medical malpractice.

Injuries:

Stroke.

Plaintiffs Counsel:

Robert F. Morris and Joshua J. Knepp, Morris Wilson, Plymouth Meeting.

Defense Counsel:

Michael E. McGilvery, Young & McGilvery, King of Prussia.

Plaintiffs Experts:

Nancy Futrell, neurology, Salt Lake City; Jeffrey Glassberg, emergency medicine, New York City.

Defense Experts:

Peter Hill, emergency medicine, Baltimore; Stanley Tuhrim, neurology, 
New York City.

Comment:

On the evening of Dec. 25, 2010, the plaintiff’s decedent, Sara Segal, 102, presented to Lankenau Hospital, in Wynnewood, with complaints of weakness, confusion and slurred speech. She was seen by emergency room physician David Patchefsky.

Segal’s son, who accompanied her to the emergency room, suspected that she was suffering from a stroke. About a month prior, she had presented to the hospital with similar complaints; she had been seen by Patchefsky, kept for about four days, and diagnosed with a failure to thrive (frailty, weight loss).

Patchefsky, after examining her on Dec. 25, suspected that her presentation was similar to that of the previous visit. A CT scan of her brain was negative, and Segal was kept overnight. The next day, she was diagnosed with a stroke, after she could not move one side of her body and suffered from facial droop. Segal died 14 months later, of unrelated causes.

Segal’s estate sued Patchefsky, Lankenau Hospital, and hospital-owner Main Line Hospitals Inc., alleging that Segal’s stroke was not diagnosed and treated in a timely manner.

The estate’s expert in neurology testified that Segal, upon her presentation in the emergency room, was suffering from a stroke, and that Patchefsky, pursuant to the standard of care, should have immediately administered tPA (tissue plasminogen activator), a medication to dissolve blood clots.

According to the estate’s expert in emergency medicine, Segal had all the signs and symptoms of a stroke that should have prompted Patchefsky to call for a stroke alert, which would have necessitated the tPA. It was critical that the medication be administered within three hours of diagnosis, since that is the window when it is most effective and prevents the stroke from worsening, the expert concluded.

Patchefsky’s experts in neurology and emergency medicine maintained that it was dangerous for tPA to be administered to Segal, given her comorbidities, which included atrial fibrillation (irregular heartbeat), dementia, a chronic bleeding disorder, arteriovenous malformation (poorly formed blood vessels), a fractured pelvis, and a hip replacement.

According to the experts, Segal was not suffering from a stroke in her initial presentation, and Patchefsky treated her in accordance with the standard of care.

Segal, upon her stroke diagnosis, was given a feeding tube. She was eventually transferred to an in-patient rehabilitation facility, and then discharged home, where her son cared for her until her death.

Segal’s son and granddaughter testified that she had been an active 102-year-old, who lived independently and participated in family vacations. Following her stroke, she was completely dependent on family members, as she was unable to walk, talk, eat (she had to use a feeding tube), or control her bowels and bladder. Her estate sought damages for past pain and suffering.

The jury found that Patchefsky was not negligent.This report is based on information that was provided by plaintiffs and defense counsel.

—This article first appeared in VerdictSearch, an ALM publication. •