$20.5 million in a fat embolism case

in Uncategorized | 10 responses

Bad doctor, or a one in 47,000 event?

Anthony Youn: “If the surgeon maxed out his malpractice insurance policy it will cover the first $1 million of it, leaving the remaining $19.5 million to come from everything else he (or the nurse) owns or will ever own (depending on state and national laws) . . .

. . . What I do know is that nothing will ever bring that 18 year old girl back, but massive awards like this can never be paid off during any doctor’s lifetime. This is a tragic case for all involved.”

Comments

Pete
I met this doctor once. I’m starting medical school this fall and I used to volunteer at an outpatient clinc where he worked. He was very friendly to me, gave me his card and told me to call him anytime I wanted to learn more. Interestingly, he said those things at the tail end of the conversation. Our conversation started with him asking me why I was there. I told him it was because I wanted to go to medical school. His response?
“Why on earth would you ever want to go into a field where people want to sue you for everything you have?”
Anonymous
It is hard to feel sorry for this guy. Why is he doing plastic surgery on an 18 year old?
Supremacy Claus
These awards rarely collect more than the insurance limit. Plaintiffs are shocked. Furthermore, such devastating verdicts only mean the opening of sincere settlement negotiations between the parties.
If the lawyer goes after the assets of the doctor, “blood money,” he knows first his family will die, then he will follow them. It is the rare lawyer who does not understand that. The lawyer is a land pirate with the full protection of the government, a wholly owned subsidiary of the lawyer profession, the world’s biggest and most powerful criminal syndicate. Their lives have no more moral value than that of a Mafia member extorting money from legitimate business.
Doc have a bad temper. Like Dr. Doom or Boom, here.
http://www.judicialaccountability.org/articles/divorceexplodesdoctor.htm
Nonetheless, doctors should satisfy their curiosity.
1) In one’s state, does each spouse independently own the entire set of assets (joint tenancy), or half (tenancy in common)? If the spouse owns half, as in California, then the assets might be sold, and half may go to the plaintiff. Or, offer half the rooms to the plaintiff and a sixth to the plaintiff attorney. Throw in the wife for free. Move to a nice hotel.
http://en.wikipedia.org/wiki/Concurrent_estate
2) In most states, retirement accounts are off limits to creditors. These should be maxed out, for asset preservation. One should look up that rule for one’s state.
3) Doctors should lobby for the homestead exemption of Florida’s Constitution. That means the value of the primary residence is exempt from collection, no matter how high the value. Professional societies won’t do that on behalf of clinicians, naturally. They are not the friends of clinical care.
http://en.wikipedia.org/wiki/Homestead_exemption_in_Florida
4) Other asset protection schemes, outside of insurance coverage, are scary. If you put your money in a foreign bank, and corrupt people steal it, what are you going to do? Call the police? They carry high fees as well.
A review here:
http://www.texansinsurance.com/insurance_briefs_article.aspx?articleid=445
SarahW
There you go again, with that “tragic for all involved”
soft pedal of the real issues in the case that resulted in that large verdict.
It wasn’t so much that the girl had a rare complication “caused” by the doctor, so much as they believed he denied her a chance to survive it, for selfish motives. The jury believed he was lying, and that he had in fact delayed calling for help, done so recklessly, and this delay brought her beyond the point where the complication might have been successfully treated.
From the article:
“The lawsuit, filed in August 2001, claims, among other things, that Glunk delayed in calling an ambulance for Amy and that the delay was what caused her death.
“She pleaded, she begged, ‘Please call an ambulance for my daughter.’ But he wouldn’t. He refused,” McLaughlin said.
The jury found yesterday that Glunk and his nurse anesthetist, Edward DeStefano, were negligent. It awarded $5.5 million in compensatory damages. The liability is split 75 percent for Glunk and 25 percent for DeStefano. Glunk is on the hook for an additional $15 million in punitive damages.
DeStefano’s attorney, Steven Levy, declined to comment yesterday.
“The more that he talked and said things that weren’t supported by what other witnesses said and what the evidence was, they got angrier and angrier,” McLaughlin, of the Beasley Firm, said of the plastic surgeon. “And obviously a $15 million punitive award is an angry jury.”"
Anonymous
And, sarahw, you don’t get it either.
Any ER doc will tell you that a fat embolism is rare. They occur after fractures of long bone or hips, and are a known complication of liposuction. The treatment is supportive. That means you can try a ventilator if it was a pulmonary fat embolism. There is no treatment if it was a cerebral fat embolus. You can try corticosteroids, but the there is little evidence corticosteroids help. This disease will get worse in the following 24-48 hours after the onset. If the patient got that sick that quickly, then there was little chance of survival.
What happened here is every physicians worse nightmare. The physician did his job was successfully portrayed as an arrogant, unsympathetic pig humping lizard that steals form the poor. What else would give you an “angry” jury?
The physician’s counsel obviously failed miserably. Is this grounds for a malpractice suit? If the physician lost due to a negative outcome, can the physician’s attorneys lose for the same reason? (Bet that “frivolous” lawsuit never sees the light of day)
The only outcome of delay of the call to the ambulance was to exclude the paramedics, ER Doc, nurses, hospital and ambulance owners from the list of defendants. (And who knows, maybe they were named and let out of the suit … how much did that cost in monetary and emotional terms?)
There should be no award, in this case, for a well known but rare complication of this procedure. Maybe there were other problems not presented in the article that deserved an award, but not this.
So physicians are left with the perception of another “jackpot jury” case.
Memo to self: Make appointment with attorney for asset protection.
Supremacy Claus
To win a legal malpractice case differs from other negligence cases.
One must prove that a deviation from professional standards resulted in a harm. OK, so far so good.
Once that gets proven, one must show that the original case would have been won. One must retry the case and win it this time.
The expense and risk of winning two trials is quite high.
OK. Win these two trials within a trial. Now the lawyer asserts the defense of exercising a legal judgment. The rigging is airtight.
Anonymous
The key to this enormous verdict was in shifting the trial from the suburbs to Philadelphia — a common trick of plaintiff lawyers in the Phila. area.
Johnny Cochrane shifted the OJ trial from Brentwood to downtown LA for the same reason: science matters less, emotions more.
SarahW
You say I don’t get it, but I do.
And one other logical flaw physicians repeat and repeat and repeat ( though I don’t think it has much to do with this specific case) with regard to tort liability and medical outcome – the rareness of a complication is not necessarily mean the complication is a fluke, that it’s just something that tragically happens when no mistake has been made. It’s perfectly possible that the rare complication happens when a rare contellation of chance and farking up occur, or sometimes, just plain error.
That’s not the point I was trying to make, as it’s not really what underlies the anger of the jury here.,,but might as well make it since you bring it up.
The cocktail chatter mentioned in the top comment supports a speculation that the doctor refused to acknowlege what was happening to his patient, despite the alarm raised,
I’m not privy to the case files here, but there would have been evidence that but for the delay, the patient MIGHT have survived. If she had any chance, the doctor took it away.
The jury believed he was lying. They had evidence that she might have survived but for his reckless omission. The formed a belief that his delay was self-serving, dangerous and not only klled this girl but could harm others.
You say the delay had no effect, He says…there was no delay. Other people there said, oh yes he did…here’s exactly what he did.
Ass covering can lead to paradoxical outcomes.
Throw that little observation away at your own peril.
What do you think the chances of this doctor, as evidenced in the top comment, was concerned for his own hide to the extent his handling of an adverse incident was affected? I
If he had handled the incident differently, there would not be any 21 million dollar verdict at all, but a modest settlement if there were some suggestion he did not carry out the procedure properly. I don’t know what case was made or might be made that he caused the embolism through improper technique. I do that he is alleged to have ignored his patient’s distress afterward, and that the jury believes he lied about it.
SarahW
More information on the specific case:
“According to the plaintiffs’ pre-trial memorandum, a blood vessel in Amy Fledderman’s neck was severed during the liposuction, and she was administered medication to which she was allergic. Despite a respiratory emergency, the plaintiffs’ memorandum alleged, Glunk and DeStefano kept Fledderman in Glunk’s office for 2 1/2 hours and did not call an ambulance until she was on the verge of death, including appearing cyanotic, or blue, and her oxygen levels had dropped from the normal high 90s to the 60s.
Fledderman died two days later as she was being transferred from Montgomery Hospital to the Hospital of the University of Pennsylvania, the plaintiffs’ memorandum said.”
Anonymous
” The physician did his job was successfully portrayed as an arrogant, unsympathetic pig humping lizard that steals form the poor.”
How do you know he wasn’t one? You know him? Maybe the jury got it exactly right.
“The key to this enormous verdict was in shifting the trial from the suburbs to Philadelphia — a common trick of plaintiff lawyers in the Phila. area.”
Why do you think it didn’t belong in Philadelphia? Are you familiar with the PA venue requirements for malpractice claims?

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