Despite diagnosis of brain swelling, patient not referred to surgeon
Medical Malpractice Verdict – Despite diagnosis of brain swelling, patient not referred to surgeon – $4,000,000 Settlement
By: Virginia Lawyers Weekly
This case arose from medical care provided to the plaintiff at INOVA Mt. Vernon Rehabilitation Hospital by defendant doctor from Sept. 14 to Oct. 9, 2010. Plaintiff contended that he is now permanently blind because, while under defendant’s care, he developed an extremely elevated intracranial pressure caused by hydrocephalus.
Plaintiff was in a single vehicle motorcycle accident on Aug. 14, 2010. He sustained severe head and facial injuries in the accident, for which he was transported to INOVA Fairfax Hospital for treatment. On Sept, 14, 2010, exactly one month later, he was discharged from Fairfax and admitted to defendant’s care for rehabilitation therapy at INOVA Mount Vernon Rehabilitation Hospital. Following what plaintiff argued was a seizure, defendant ordered a head CT scan two days later on Sept. 16. Plaintiff’s last head CT before being admitted to Mt. Vernon was on Sept. 2 at INOVA Fairfax. Defendant compared the Sept. 16 head CT to the Sept. 2 CT and concluded that the plaintiff had developed hydrocephalus since the Sept. 2 CT scan.
Post-traumatic hydrocephalus is a common phenomenon in cases of traumatic brain injury that was well known to the defendant. However, he did not request a neurosurgery consult upon diagnosing it on Sept. 16. He did not examine plaintiff’s eyes for the frequent hydrocephalic sign of swollen optic nerves (papilledema). From the outset, members of plaintiff’s rehabilitation team informed the defendant that the plaintiff was experiencing incontinence along with visual and gait disturbances – the classic triad of elevated intracranial pressure from hydrocephalus.
Additional head CTs taken at Mt. Vernon on Sept. 27 and Oct. 5 showed continuing hydrocephalus to such a degree that cerebrospinal fluid was ultimately forced into the cellular matter of the brain itself. Despite the two additional CTs that showed progressing hydrocephalus and two additional episodes the plaintiff contended were seizures, defendant did not mention his new diagnosis of hydrocephalus to any other physician until family members demanded on Oct. 8, 2010, that he do so because of plaintiff’s declining condition.
When the defendant finally acquiesced to the family’s demand to call plaintiff’s neurosurgeon because of his deteriorating condition, the neurosurgeon requested that plaintiff be transferred to Fairfax. There, plaintiff underwent brain surgery for the implantation of a ventriculoperitoneal shunt to relieve the intracranial pressure caused by hydrocephalus. By then, however, it was too late and plaintiff suffered permanent blindness in at least his left eye (plaintiff conceded he would have been blind in his right eye because of the severity of the brain injuries he experienced in the accident) because of defendant’s delay in requesting an appropriate consultation to treat the hydrocephalus. Plaintiff maintained that this result would have been avoided had defendant acted on his diagnosis of hydrocephalus on or about Sep. 16, 2010.
Plaintiff’s counsel requested the jury to return a verdict of $3,500,000, but the jury awarded $4,000,000.