Recent Verdicts & Settlements Edited by Mitchell A. Greenberg


Mitchell A. Greenberg, of the Greenberg Law Office in Baltimore, received his J.D. from the University of Baltimore School of Law. He is a member of MTLA’s Board of Governors and serves as Vice-Chair of MTLA’s Trial Reporter Committee. Mr. Greenberg is a member of MTLA’s Membership Committee and serves as MTLA’s delegate to the Task Force for the Rehabilitation of Injured Workers. He is a member of the Maryland State, Baltimore City, and American Bar Associations and also a member of ATLA. His practice concentrates in workers’ compensation, criminal defense, and serious personal injury.


Medical Negligence


Anonymous Plaintiffs v. Anonymous Health Care Provider


Court in which case was file: Withheld upon request


Docket Number: Withheld upon request


Description: Plaintiff, now 48 years old, with a wife and minor child, was born with a well known but rarely occurring benign mass called a craniopharyngioma located in the third ventricle of his brain. Plaintiff ’s tumor was attached to the front part of the hypothalmic region right be- hind the pituitary region and grew upward. MRI scans of plaintiff’s brain, taken after the tumor was detected in July 1996, show that it had grown to a size of approximately 3.5 x 2.5 x. 2.5 cm (roughly the size of a small plum). The size and location of plaintiff’s tumor were such that, according to plaintiff’s medi- cal experts, numerous unmistakable symptoms were present for well over one full year before the total obstruction of cerebral spinal fluid occurred in July 1996 and during all three of plaintiff’s visits to defendant, anonymous health care pro- vider with headache complaints. It was the failure of the defendant, anonymous health care providers to appreciate - or even detect - these easily recognizable symptoms that lead to plaintiff’s cata- strophic brain injuries and total, permanent disability requiring full-time attendant care for the rest of his life. On January 3, 1995, plaintiff was seen for the first time ever at defendant. The documentation of this visit is quite poor but indicates that the reason for plaintiff’s visit was headaches and neck pain. The history that was obtained indicates that plaintiff was suffering from headaches and neck pain for two weeks, cardinal signs of an intra-brain pathology in the absence of any trauma to account for these symp- toms. Plaintiff was assessed by defendant


50


with muscle spasm, prescribed some muscle relaxants and anti-inflammatory medication. On June 24, 1996, plaintiff again re- ported to defendant. According to the chart, plaintiff indicated that he was suf- fering from headaches for approximately six days. Additionally, he was suffering from yellow nasal drainage and coughing. Plaintiff was assessed with sinusitis and prescribed antibiotic and decongestant. On July 19, 1996, plaintiff presented for a final time to defendant. According to the chart, plaintiff ’s chief complaint was severe headaches.


The history ob-


tained indicates that plaintiff was suffering from “couple weeks frontal headache” but had “no headache now.” Defendant’s plan was to restart the antibiotic and start an analgesic. Three days later, on July 22, 1996, plaintiff was found by his wife uncon- scious on the floor of their kitchen at home. He was transported by ambulance to anonymous non-party hospital and was diagnosed with acute hydrocephalus sec- ondary to craniopharengioma. He was transferred to anonymous non-party hos- pital and ultimately underwent a right frontal partial craniotomy (opening of the skull) for removal of the tumor and a ven- triculostomy (a surgical procedure to establish an opening in the third ventricle) for treatment of the hydrocephalus. Plain- tiff was discharged to a long-term care facility where he has remained since, to- tally dependent for the activities of daily living. He is unable to dress, feed, bathe or wash himself without assistance. He is totally dependent in his bathroom activi- ties and wears Attends. He is dependent in propelling his manual wheelchair and is unable to transfer himself to a wheel- chair or recliner or bed. He is unable to turn himself at night and must be turned frequently to prevent bed sores.


Allegations of Liability: Defendants sim- ply failed to obtain any information about the nature and severity of plaintiff’s head- aches. Had they obtained an adequate


Trial Reporter


history, they would have learned that headaches frequently caused plaintiff to wake at night and that he would fre- quently return home from work, skip dinner, and go straight to bed because of his headache pain. In 1994, the year pre- ceding plaintiff’s first visit to defendant, he reported to the occupational nurse at his job site eight times with complaints of headache. In 1995, there were eigh- teen visits to the nurse for headaches. In the first six months of 1996, there were sixteen visits for headache complaints. In fact, during the period between the June 24th


and July 19th visits, plaintiff came


home early from work complaining to his wife of headache and commenting that his sinus medication was not working. An adequate history would also have included questions about excessive thirst, excessive urination, diabetes insipidus and whether sexual function was impaired. In addition, questions could have been asked to determine and evaluate the patient’s ability to calculate, extract and interpret proverbs, memorization, remote memory, judgment, and insight. Had these ques- tions been asked during any of the three visits, they would have revealed that plain- tiff was suffering from excessive thirst and a loss of libido and sexual impotence for some time. This type of tumor affects endocrine function and thus sexual dys- function is a key piece of medical history. Subsequent treating physicians at anony- mous non-party hospital documented a history of impaired sexual function. De- fendants did not. According to plaintiffs’ experts, an ap-


propriate neurological examination of a headache complaint would include exami- nation of the cranial nerves, motor function, checking vision, sensation, re- flexes and looking in the eye grounds with a funduscope to look for abnormalities or signs of increased intracranial pressure. Although defendants were trained in fun- doscopic examinations and routinely examined patients with a funduscope, no one use it on plaintiff during any of the three visits. Funduscopic examination of


Winter 2003


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