In sum, the defense focused on causation, not the failures of the hospitalists to treat severe CDI. The plaintiff maintained that severe CDI was far more likely than acute mesenteric thrombosis (given her clinical presentation and pain control with acetaminophen), and that had appropriate and timely treatment been given, M.S.’s severe CDI was a reversible condition without surgery.
Conclusion
This case further highlights the importance of family perception in the circumstances surrounding death. If M.S. had not fallen and suffered a visible injury, or if Dr. Hospitalist 3 had responded immediately to the fall with care and treatment, it is very likely that this case would not have been filed.
Nonetheless, the hospitalist care appeared deficient in several important aspects – particularly the approach to sepsis and the possibility of severe CDI. Also, it is not easy to defend a hospitalist who failed to respond to an 89-year-old inpatient who is status post a fall with a deep forehead laceration and a pH of less than 7.1. That being said, this case went to trial, and the hospitalists received a full defense verdict from the jury.
Dr. Michota is director of academic affairs in the hospital medicine department at the Cleveland Clinic and medical editor of Hospitalist News. He has been involved in peer review both within and outside the legal system.
