Saint Vincent Hospital Misreads CT Scan Showing Recent Strokes: Client Obtains Multi-Million Dollar Judgment

Joe presented to the Saint Vincent Hospital emergency department with complaints of dizziness and lightheadedness.  The emergency department physician’s assistant ordered a CT scan, which showed recent bilateral occipital infarcts (strokes) between 24 hours and 2 weeks old. The resident radiologist in the emergency department, however, reported the age of the strokes as unknown. She had been trained and it was the standard practice in the Saint Vincent Hospital emergency department at the time not to report strokes as “subacute” or “recent”, or to give a range of age for recent strokes. The physician’s assistant consulted the on-call neurologist, and then diagnosed the condition as “vertigo”, discharging Joe home.  An attending radiologist interpreted the CT scan the next morning as “prior” bilateral occipital infarcts.

Raphaelson, Attorneys At Law presented expert testimony that had the CT scan been interpreted as showing recent strokes between 24 hours and 2 weeks old, as it ought to have been, then the average qualified emergency department physician would have arranged for a neurologist to begin managing Joe’s care immediately, and that the average qualified neurologist would have admitted Joe to the hospital for an immediate workup of his condition. We presented expert testimony that had a neurologist cared for Joe from the time of his ER visit, the neurologist would have tested for common causes of stroke and then for uncommon causes of stroke because the neurologist would have made two observations of Joe that were unusual for stroke: (1) Joe was suffering from progressive vision loss; and (2) the pattern of his injury on MRI was consistent with a disease process. By the end of the following week, a brain biopsy would have been indicated, which would have diagnosed intravascular lymphoma, an extremely rare cancer.

Joe responded promptly and extremely well to chemotherapy once administered, and he has been cancer-free for many years.  Intravascular lymphoma is very sensitive to chemotherapy. A relatively small number of cancer cells block the flow of blood in the brain’s blood vessels, causing stroke.  Once chemotherapy is introduced, the cancer cells are killed, eliminating the blockage and arresting the strokes.

Unfortunately, because of the hospital’s neglect — including its failure to transfer Joe’s pathology specimens to the treating facility with Joe on transfer, which delayed treatment further — Joe suffered significant neurological impairments from the strokes caused by the lymphoma.  Raphaelson, Attorneys At Law presented expert testimony that earlier diagnosis and treatment would have resulted in a much better medical outcome.

Defendants argued that there was no negligence, that the radiologists were consultants only who provided sufficient information to the clinicians to diagnose Joe’s strokes, and that its plan of care for Joe to call for a follow-up appointment with a neurologist was within the standard of care. They argued further that there was no causal relationship between any negligence and Joe’s injuries, because (a) Joe elected to see his primary care physician rather than call a neurologist for an appointment, (b) he suffered a rare disease that was extremely difficult to diagnose, and (c) his time course to diagnosis was within the standard of care.

The jury returned a verdict against defendant Saint Vincent Hospital. The Massachusetts Appeals Court upheld the verdict on appeal and affirmed the judgment.