Both MRIs were ordered through the hospital, but only the family physician's lumbar MRI request was processed, and results were negative for tumor. According to a hospital chart note written by a nurse on the MRI report, the results were reported to the neurologist at 6:30 pm.
The neurologist denied ever receiving this call. He claimed that the next day, he spoke with a radiologist who informed him that the spine had been scanned up and down, and no tumor had been found. The neurologist did not chart this conversation, and he could not recall the name of the radiologist with whom he spoke. The neurologist did not chart that the MRI was negative, nor did he ever read the MRI report. The neurologist reached a diagnosis of transverse myelitis.
Within four days, the patient had lost the ability to bear weight on her legs and had lost all bowel and bladder function. The neurologist saw her every day and maintained the diagnosis of transverse myelitis.
In late November, the woman began to experience new symptoms in her hands. Another doctor ordered an MRI of the thoracic spine, which revealed a large tumor at T10. In spite of surgery, the woman remained completely paraplegic. She was given a diagnosis of stage 3 multiple myeloma.
The plaintiff charged the hospital with negligence for failing to perform the MRI ordered by the neurologist. She also charged the neurologist as negligent for failing to follow up on his order by reviewing the existing MRI report; doing so would have alerted him to the fact that the MRI he ordered was never performed.
The hospital conceded some fault but claimed that the neurologist was also negligent. The hospital also placed blame on the family physician for trying to read his own x-rays and claimed that a radiologist would have seen evidence of the tumor.
According to a published account, a $775,000 settlement was reached. This included $500,000 from the hospital and $275,000 from the neurologist.
Follow-Up Instructions Misunderstood—or Unheeded?
After a January 2000 motor vehicle accident, a 24-year-old man was transported to a hospital emergency department (ED). Among his lab test results was an elevated creatinine level of 2.6, and his blood pressure was slightly elevated. The defendant ED physician claimed that he told the patient he had had an abnormal kidney function test and believed it was understood that the patient would follow up with his family health care provider regarding this concern and his injuries from the accident. Since the patient felt fine despite his injuries, he did not follow up with his family clinician.
In August 2002, the patient experienced acute renal failure; it was discovered that he had only one kidney, and it had failed. He was placed on dialysis and at the time of trial was on a waiting list to undergo kidney transplantation.
The plaintiff claimed that the defendant had not made it clear to him that the follow-up visit was needed to investigate his creatinine level. The defendant contended that when he released the patient from the ED, the patient signed discharge instructions, including an agreement to seek follow-up treatment. The defendant claimed that the patient's outcome was his own fault.
According to a published report, a verdict of $8.48 million was returned.