On August 28, 2013, a federal judge in Baltimore, Maryland awarded $346,272 to the family of a veteran who died on October 11, 2007 as a result of medical malpractice at the Veterans Administration Medical Center in Baltimore. The 59-year-old veteran had been discharged to home from the VA Medical Center by a second-year resident the day before, after the resident negligently failed to consider as part of the differential diagnosis that the veteran may have been suffering from the very rare but very serious condition known as AEF (aortoenteric fistula).
The veteran had previously had aortic graft surgery in July 2002 to bypass a blockage in his aorta. AEF is a known possible complication from prior aortic graft surgery. Typically, AEF occurs between two to six years after aortic graft surgery.
Due to the veteran’s history of aortic graft surgery five years earlier, the standard of care required that the resident consider AEF as part of the differential diagnosis, which requires that the most life-threatening conditions be ruled out first. Initial testing indicated that the veteran was suffering from blood loss – the main clinical manifestation of AEF is gastrointestinal bleeding.
The resident ordered medical tests for gastritis and renal stones. A CT scan without contrast found no gastritis or renal stones but the radiologist who reviewed the scan recommended that a CT scan with contrast be performed to examine the veteran’s aortic graft. The resident instead gave the veteran pain medications, advised him to follow-up with a gastroenterologist one week later, and discharged him to home.
The U.S. government argued that because AEF is so rare, and the resident was reasonable in suspecting gastritis or renal stones as the source of the veteran’s symptoms, the resident’s care was appropriate and the resident did not breach the medical standard of care.
The federal judge who heard the case determined otherwise: “[B]ased on Mr. Johnson’s presentation, a reasonable physician would have first had to rule out AEF. Dr. Weld testified that she knew of the complications from an aortic graft and that the risk of an AEF was catastrophic. By not including secondary AEF in her differential diagnosis, Dr. Weld failed to meet the standard of care.”
The estate of the veteran and his four children had filed the federal lawsuit under the Federal Tort Claims Act in December 2010. The federal judge heard the case from August 12 to August 16, 2013 and issued his written opinion on August 28, 2013, awarding $75,000 to the veteran’s estate for his pain and suffering, $6,260 to the veteran’s estate for his medical care at the hospital that subsequently treated him after his discharge from the VA Medical Center, $5,012 to the estate for funeral expenses, and $260,000 to the four surviving children of the veteran for their pain and suffering that resulted from the veteran’s death.
Goodie, et al. v. United States of America, U.S. District Court for the District of Maryland, Case No.: 1:12-CV-03478-RDB.
Source: The Daily Record
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