Home Forums Discussions General Discussion Failure of Communication Leads to $1.8M Malpractice Award The Case

Can anyone tell me why the physician should be found negligent in this case?

Failure of Communication Leads to $1.8M Malpractice Award

The Case: After deliberating only three hours, a Penobscot County jury rendered a $1.8 million verdict in favor of a Millinocket couple in a case involving the failure to communicate lab test results. The jury found that all parties to the case, including the patient, breached their standards of care.

The Facts: The patient sued his physician and the hospital that performed the blood tests, which occurred when he visited the emergency room with complaints of recurring fever, shortness of breath and lack of energy. The test results showed he had a streptococcal infection, but the hospital failed to communicate them to his treating physician.

The evidence showed that a hospital nurse did call the patient with the results and told him to return to the hospital, which he did not do, although he did return to his physician a few days later. The progress notes from that visit showed that he stated the test results were negative. The patient testified that he did not remember the content of his conversation with the nurse, nor did he remember what he said to his doctor. Treatment was delayed for several months until the patient underwent emergency heart surgery for damage to his heart valves.

How the Lawyers Saw It: The plaintiffs? attorney characterized the underlying facts as being, ?about a problem in health care that affects everyone, the lack of communication between providers, with results that can be catastrophic.? Attorney Ben Gideon went on to say that in this case there was a break in trust between the patient and the doctor and hospital involved. Because the jury also found that the patient was partially at fault, it reduced the award from the original $2.1 million amount.

The hospital?s attorney, James Martemucci, admitted to the jury that his client had made an error in failing to send the test results to the patient?s doctor. The hospital has changed its practice and now duplicates its communications, both sending the test results to the physician and calling the physician to report the results.

The physician?s lawyer stressed the role of communication in this case. ?Inaccurate communication got everything steered down the wrong path,? said Mark Lavoie. ?If you rely on a patient to accurately communicate test results, you do so at your peril.

Important Lesson: This case illustrates the importance of communication, both in the physician-patient relationship and in the relationship between the physician and other members of the treatment team such as hospital emergency departments, nurses and labs. It also shows that communicating results to a patient may not be enough, since a patient may be too sick to remember or pass on the results or may simply fail to do so. According to research reported in the November Journal of the American College of Radiology, cases involving a failure to communicate test results accounted for 2.31% of cases (and $91 million in payments) in the National Practitioner Data Bank in the year 2009.

It sounds like reading between the lines that he had strep SBE and the ER did a BC that was +.

They called the patient to come back but he did not (his mistake). They did not contact the PCP with the results (ER's mistake)

PCP saw the patient and took his account but did not verify the results from ER (PCP's mistake).

The strep was not treated and after several months it lead to valve damage and heart surgery (the damages)

Yes, we take out patient's word about ER testing all the time, But when it turns bad, it looks like we did not exercise due diligence in getting reports.

Greg

I guess it depends on what the patient said the test was. Thanks for the explanation. I would have to put maybe 5% on the doctor. Plus, several months is a long time to have bacteremia and not have other symptoms unless the body cleared it on its own.

I guess it also depends what he went to the doctor for. I have a hard time believing anyone was wrong except for the lab not sending the results to the physician. The physician couldn't reconcile the lab test since he/she did not order it.

Our ED calls the patient all the time. It also seems the lab was at fault, because at times they only report the positive blood culture to the ordering physician and not the PCP.

But, I look at it like the ED did the right test, got the positive result and called the patient. The patient failed to come in. I put nearly 100% of the blame on the patient.

But, I asked for opinions, and you gave a good viewpoint.

This kind of stuff keeps me up at night! Our hospital is TERRIBLE about giving us records. Since they decided to meet MU, they got an EMR that just spits out an unreadable useless document that they call an ER summary. It has the results of all their clicky clicks, but no words from the actual doctor. Bert, can you give me the source, as I'd like to give this to the CEO? The physician should not have been responsible at all, IMO, as he did the best with what he had. The patient could have gone back to the ER, could have brought all the tests to the PMD, and done many other things for his own health. It always comes back to people in America wanting to blame someone else.

http://bangordailynews.com/2016/01/...rded-1-785-million-in-malpractice-trial/

I send my patients to both of these hospitals. I admit to EMMC. I rarely get calls about lab results from EMMC. I have never received a call from St. Joe's. We usually get the ED report from St. Joe's with the labs included. We should always get the ED reports from EMMC as well as the lab reports, but they don't always make it here.

I will say that when a patient comes to our practice for F/U ED of either hospital, if it is somethere where having that report is beneficial we will pull it from the Internet portal or call St. Joe's to have them fax it.

A patient could go to one of the EDs and get a blood culture and, if it were negative, we wouldn't hear about it. We would probably get a call from the ED if it were positive. The ED would contact the patient as they were the ones who drew the cultures and they were the ones first notified. I suppose if a patient of mine had a positive blood culture, and I didn't know I would be upset. But, if the ED called them, they would either have them come in or they would call me.

It would also be a bit strange for a parent to bring a kid in and say they were at the ED and they did labs and they were negative.