In it decision filed on November 10, 2016, the Appellate Court of Illinois First Judicial District Sixth Division (“Illinois Appellate Court”) affirmed an Illinois medical practice defense verdict, stating that in reviewing a medical malpractice jury’s verdict in favor of the defendant, an appellate court will set it aside only if it is against the manifest weight of the evidence (a verdict is against the manifest weight of the evidence when the opposite conclusion is clearly evident or the jury’s findings are unreasonable, arbitrary, and not based on the evidence).
In the case it was deciding, the Appellate Court stated that there was conflicting evidence presented at trial regarding whether the defendant violated the standard of care when performing the real-time ultrasound-guided percutaneous renal biopsy (“PRB”) on the plaintiff’s kidney: the jury made a credibility determination in favor of the defendant and his experts. It is the province of the jury to resolve conflicts in the evidence and to determine the credibility of the witnesses, and the appellate court will not substitute its judgment therefor. The Illinois Appellate Court held that the Illinois medical malpractice jury’s finding in favor of the defendant was not against the manifest weight of the evidence.
The Underlying Facts
The Illinois medical malpractice plaintiff had been suffering from chronic end-stage kidney disease for several years. By December 2010, it had advanced to stage IV or V.
On January 12, 2011, the defendant performed a real-time ultrasound-guided PRB on the plaintiff’s kidney with the long-term aim of preserving his kidney function. During the procedure, the plaintiff laid on his stomach and was scanned with the ultrasound machine and the images were projected onto a video monitor. The defendant used the ultrasound images as a guide to the proper positioning of the needle into the kidney, and as a guide to the removal of tissue samples that were examined by the pathologist. The results of the PRB showed that the plaintiff had 80% loss of kidney function secondary to hypertensive glomerulonephritis, a condition that could not be reversed or treated.
The plaintiff suffered significant bleeding and pain after the PRB. On January 14, 2011, the defendant performed a renal angiogram on the plaintiff, in which he injected dye into the kidney to identify the source of the bleed. The defendant located one vessel that was bleeding and he performed an embolization by inserting a small metallic coil into the vessel to stop the bleed. The same vessel subsequently began to bleed again, necessitating a blood transfusion. The defendant performed another angiogram and embolization on January 16, 2011.
The defendant wanted to perform a third surgery to repair the vessel, but the plaintiff refused to undergo an additional surgery by the defendant and instead opted for another interventional radiologist to perform a third angiogram. The plaintiff remained in the hospital for two more weeks before going home with a protruding stomach, swollen legs, and in severe pain.
A week after returning home, the plaintiff was in so much pain that he was admitted overnight to a local hospital where a CAT scan was performed and showed that the plaintiff had a very large blood clot on his kidney. The plaintiff went to another hospital where he received medications to shrink the blood clot and regulate his blood pressure, and he was informed that he needed to go on dialysis.
The plaintiff’s medical experts testified at trial that the defendant violated the standard of care because he did not have an adequate visualization of the kidney when inserting the biopsy needle, based on the experts’ review of certain still pictures of the ultrasound moving picture.
The defendant testified on his own behalf during trial and stated that he had adequate visualization by ultrasound when he performed the PRB on the plaintiff (the entire ultrasound film was not saved after the procedure; certain still images were retained but were not of the same quality as the ultrasound film he viewed when performing the procedure). The defendant and his experts testified that he complied with the standard of care when performing the PRB on the plaintiff, notwithstanding that a blood vessel was injured.
One of the defendant’s medical experts, a nephrologist, testified at trial that, to a reasonable degree of medical certainty, the biopsy and complication did not accelerate the plaintiff’s need for dialysis and that the plaintiff would have needed dialysis within three to six months, regardless of whether he had the biopsy or the complication (the plaintiff started dialysis exactly six months after the biopsy).
Source Lipscomb v. Gaba, 2016 IL App (1st) 141695-U
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