Keith H. Gross, Esq. recently settled a medical malpractice and wrongful death case concerninga retired 66 year old MTA subway conductor. He had fallen at home and sustainedhead trauma, including a skull fracture and an intracranialbleed.
The patient was transported by ambulance to defendant Hospital,but its Emergency Department committed malpractice by failing to timelydiagnose and properly manage this patient’s brain bleed. Defendant Hospital,for instance, failed to timely administer Mannitol to reduce the intracranialpressure that resulted from the expanding hemorrhage within his skull. The enlargingintracranial bleed and increasing pressure resulted in progressive brain damage.He went from being alert and oriented times three to becoming unresponsiveduring his presentation in the defendant’s Emergency Room. His deteriorationwas also evidenced by the degeneration of his pupillary response from equaland reactive to light and accommodation to fixed and dilated.
This local Hospital did not have a Neurosurgical service. Perhapsdefendant’s most significant departure was its failure to timely have thepatient transported to a hospital with Neurological Surgery capability so thatan emergency surgery, a hemicraniectomy, could be performed to evacuate thehemorrhage and alleviate the intracranial pressure. The failure to timelytransport the patient was made even more egregious, since his brain bleed hadbeen confirmed by defendant’s CT scan in the face of undeniable neurologicaldeterioration. There were also apparent delays in intubating this patient toprotect his airway in anticipation of ambulance transport, even though he wassufficiently stable and could have been transported hours earlier than heactually was. In fact, an ambulance, which had traveled from the hospital whichhad a Neurosurgical Department, was waiting for the patient at the defendantHospital for about 1.5 hours before he was most belatedly discharged.
Despite heroic efforts at the receiving hospital in performing ahemicraniectomy and otherwise treating the patient, he suffered irreversiblebrain damage. While this patient likely would have sustained some permanentinjury from the brain bleed before he reached the defendant Hospital, as aconsequence of the malpractice and transport delays by defendant, he lost hisbest opportunity for a good outcome. That loss of a good outcome includes thispatient being so disabled that he was unable to be cared for at home. He wasconfined to skilled nursing homes, with intermittent hospital admissions, formore than 2.5 years until his death. Most tragically, during that time, he wasin a locked-in state of consciousness; that is, he was conscious but unable tomove, speak, or otherwise express himself except by slight finger movements inresponse to his family’s questions.
This patient is survived by several adult children.
This case was settled for a significant amount during directnegotiations with defense counsel.
Should you have a possible negligence or medical malpractice casethat you would like to discuss with experienced and dedicated attorneys, please call The Jacob d. Fuchsberg Law Firm.