Friday, May 29, 2009

Lisa Strong: Doctors' Bungling Leaves her Without a Leg to Stand On

"Fla. amputee gets rare second chance to sue docs"
The Associated Press (May 29, 2009)

"When the sharp pain shooting through Lisa Strong's back got worse, she thought it was another kidney stone and expected the discomfort to pass. This time was different.

"Through a series of mistakes, miscommunications and misdiagnoses, she wound up having her arms and legs amputated. She sued the doctors, who essentially blamed one another for what everyone involved agrees were profound errors.

"Everyone except the jury that ruled against Strong.

"The verdict came in the face of such overwhelming evidence that in a rare move, the judge tossed out the jury's decision and ordered a new trial...."

The bad news is that, due to what appears to be a nearly perfect storm of medical nincompoopery, Lisa Strong is four limbs short of her quota.

When she tried to sue the doctors whose bungling caused the mess, a jury decided that she didn't have a leg to stand on. Never mind the facts of of the case. Why this happened is a puzzle.

"...Lawyers involved think so many mistakes were made, the jury had a hard time fixing blame....

The Associated Press article does a pretty good job of summarizing how an in-your-face-obvious - and treatable - kidney stone got called "cholecystitis, a gallbladder condition unrelated to the kidneys." And, how the good doctors sliced and diced Lisa Strong before noticing (finally) and removing a kidney stone: and eventually cutting off her arms and legs.

What the AP doesn't say is how much they charged for their services.

Finally, Something Went Right

"...Broward County Circuit Judge Charles M. Greene reversed the jury's verdict and concluded the it was 'contrary to the law and the manifest weight of the evidence.'

"Such reversals are extraordinary. According to the National Center for State Courts, judges set aside jury verdicts in only 78 of 18,306 civil trials nationwide in 2005, the most recent year complete statistics are available. That's less than one-half of 1 percent...."

Two doctors involved are fighting the judge's decisions. I can't say that I blame them. Even in the medical profession, a screw-up on this scale must be embarrassing. I'm sure they'd like to hang on to the jury's exoneration.

Lisa Strong has a website: http://www.lisastrong.org - A journey in faith and spirit. ("Read Lisa’s story, hear about her new ambitions, and be inspired by her will to live life to the fullest despite one set back after another.")

Her account is not, I think, particularly vindictive. On the other hand, I'd stay away if you want to believe that 'doctor knows best.'

Most Doctors Mean Well, I Hope

I think a lesson here is that doctors are people. Many - I hope most - are in the business because they want to help people, not for the pay and perks. Or, for a culturally-sanctioned opportunity to play God now and then.

I think the same can be said for judges and others in positions of power and authority.

It's anyone's guess whether the doctors will succeed in keeping their little oopsie from going through the courts again. On the one hand, there's that "manifest weight of the evidence" thing. On the other, doctors as a group have a much higher standing in society than Lisa Strong.

That's changed in my lifetime. I remember when shows like "Ben Casey," "Dr. Kildare," and "Marcus Welby, MD" reflected a widely-held veneration of doctors. Back then, many people really believed that 'doctor knows best.' And, sometimes, doctor does.

I don't know whether it was a more educated population, or the lobotomy craze that did it, but Americans don't have quite the same unquestioning trust in the medical profession that they did in the good old days.

Which I think is a good thing.

Doctors and Patients: With Me, it's Personal

I've got a personal stake in the issue of doctors paying attention. My mother suffered a debilitating stroke in the sixties, and took about four decades to die. She was comparatively functional for much of that time, thanks more to her iron will than to contemporary medicine.
It Started With a Headache
She'd gone to a doctor because she had headaches. Maybe the doctor was busy that day. At any rate, he didn't bother with little formalities like taking her blood pressure. He just whipped out a prescription, and sent her on her way.

Later, after she'd taken the medication, her blood pressure crashed. And some of the blood vessels in her brain collapsed. By the time we got her to a hospital, important parts of her brain were dead.

Turns out, the prescription was for a drug that's useful: when someone has lethally high blood pressure, and medicos have to get the pressure down NOW - and deal with damage to the system later.

Reconstructing what happened, I think that the doctor may have heard "headache." Knowing that some headaches may be caused by high blood pressure, he decided - illogically, but understandably - that these headaches must be caused by high blood pressure.

Why he used such a dangerously effective drug, I don't know.
Anther Stroke of Luck
Then there was the doctor who used me as part of a medical experiment. But that's another story.

So What?

My family and I see a doctor now and again, and I'm walking on replacement hip sockets. I have no quarrel with traditional Western medicine.

I do not, however, have blind faith in anybody with a "MD" after his or her name.
Doctor Shopping
"Doctor shopping" has been used to describe people who want a particular prescription drug, or are convinced that they have a particular condition, and 'shop' until they find an obliging doctor. I don't think that's a good idea.

Actually, I think it's rather dangerous.

On the other hand, I think it's simple common sense to 'shop' for a doctor who seems to be competent, willing to listen to the patient, and whose attitude toward euthanasia is similar to the patient's.

I also think it's a good idea to use the online resources at places like the CDC and Mayo Clinic (Like Mayo's Symptom Checker).

Even a real-life Marcus Welby, MD, won't have quite the same sort of interest in your well-being that you do.

Related posts:

3 comments:

Anonymous said...

First what happened to Ms. Stong could happen to anyone. She got Necrotizing fasciitis likely caused by the bacterium Streptococcus pyogenes. Since this bacteria is everywhere, those who get this usually but not always have an inhibited immune system disorder such as diabetes or something else, even depression can reduce the immune system.

To prove malpractice one must prove four elements: Duty, Breach, Cause, Damages. The plaintiff must prove each element or they lose in court.

The first is Duty. That is a duty to care was owed by her doctors and the hospital.

Second that there was a breach of that duty that somehow the standard of care was violated.

Third, plaintiff much prove cause. Cause is broken down into two areas one is proximate cause and the other is cause in fact or legal cause.

An illustration will help: Suppose a man drives a truck of TNT into a small town. A car coming into an intersection runs a red light and crashes into the truck. A large explosion kills ten people. Was the driver of the car that ran the red light legally liable for the damages to the destruction of the town and the loss of life. The answer is no.

While he did have proximate cause by virtue of the fact he caused the crash, he did not have legal cause beyond the damage to the truck. The explosives caused the damage not the driver.

The final thing that a plaintiff must show is damages caused by the breach of duty. If the plaintiff fails to prove any one element by the preponderance of the evidence, that is just a balance in their favor of say 51% to 49% then she loses the case.

1) diagnosis or lack of a diagnosis is irrelevant. The woman came to an ER with some pain syndrome. Whether she came with a fever or not it doesn't look like the ER Doctor did much to obtain a diagnosis. But even if she botched the diagnosis, she had the patient admitted to the hospital and the minute this was done, her liability ended.

2) delay of treating a stone, is not relevant to her condition unless it can be shown that the delay caused the Necrotizing fasciitis which it would not cause because at this point the skin was not breached.

3) what about the surgery? Plaintiff says the surgery was unnecessary. Maybe so in retrospect but that too is irrelevant even if contestable. She must have signed an informed consent which included the risks of surgery and potential for infection.

4) When did she get the Necrotizing fasciitis and who caused it? The bacteria is everywhere. Streptococcus pyogenes was clearly in the hospital. Who brought it to her surgical wounds? The surgeon? Not likely because this is a rare event... In recovery by a nurse changing the dressings, installing an IV, or did a visitor bring it on a plate of food?

That is the problem with this case. Plaintiff can't prove cause. So even if the medical care was a fiasco and it sounds like it was. A kidney stone did not cause the fasciitis nor can it be shown that any of the doctors's delays of diagnosis or taking the patient to surgery, actually was the legal cause of Ms. Strong's damages.

The law must be precise in the way justice is administered. The entire purpose of the law is to make sure that someone is not wrongly accused of causing harm to another. If plaintiff's attorney fails to prove any one element, they don't win.

When a judge attacks an independent jury's verdict and renders it void, it invites reversal at the appellate court. Roughly 50% of the lower court decision to disrupt a Jury verdict are reversed.

The judge has some controversial decisions. One was to jail a court reporter for not completing a court transcript. He ordered her arrested and placed in jail. A judge with this kind of behavior is a bully.

Dr. Bombay here.

Brian, aka Nanoc, aka Norski said...

Anonymous, AKA Dr. Bombay,

You could be right.

Jared said...
This comment has been removed by a blog administrator.
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