Sam Flood was 76-years-old when he and his wife of 46 years, Sarah, moved into a new apartment. They were in the process of decorating their new home when Sam lost his balance and fell from a stepladder while attempting to hang a clock on the wall. After a few days of dealing with pain and difficulty breathing, Sam was taken by ambulance to a local hospital. He was then transferred to a much larger medical center in a nearby city where chest X-rays and a CT scan revealed twelve rib fractures and small pleural effusions (i.e. fluid between the lungs and chest wall). Sam was admitted and kept overnight. The next morning, a repeat chest X-ray showed no significant changes in the amount of pleural fluid. Nevertheless, the attending physician in charge of Sam’s care, Dr. Rogers, ordered a chest tube to remove the fluid.
In X-rays, fluid appears in shades of gray. Sam’s initial X-ray (left) showed only a small amount of fluid in his chest cavity … The following morning, a repeat chest X-ray (right) revealed no significant change in the amount of fluid.
Dr. Rogers used ultrasound to verify where to place the needle connected to the chest tube. The ultrasound, though, like the previous radiology exams, revealed only a small amount of pleural fluid. Two nurses heard Dr. Rogers say, “we do not have good visualization” and left Sam’s bedside to attend to his other patients stating, “I’m going to rounds”. Dr. Rogers’ team of residents, Doctors Lahey and Palmer, though, stayed behind and proceeded with the chest tube procedure anyway. Worse yet, they inserted the chest tube through Sam’s spleen and mesocolon. Unaware of the damage they had caused, Doctors Lahey and Palmer then walked away.
This ultrasound is an example of what an emergent amount of fluid looks like in the chest cavity. Unlike X-rays, fluid appears black in ultrasound studies. Normally, there is no fluid in the pleural space. Here, the absence of fluid in Sam’s chest cavity increased the risk for the chest tube to lacerate his organs.
Over the next hour, Sam nearly bled to death. The hospital’s Chief Trauma Surgeon, Dr. Brate, intervened at the last minute. Dr. Brate first opened Sam’s chest expecting to find the source of bleeding; however, there was no blood in the chest cavity. Only after exploring Sam’s abdominal cavity did Dr. Brate discover that the chest tube had perforated Sam’s spleen and mesocolon. Dr. Brate was ultimately able to stop the bleeding and saved Sam’s life by removing his spleen and a section of his colon. Sam’s struggle, though, had only just begun.
Sam managed to survive for 375 days following the chest tube incident. He spent all of his remaining days attached to a colostomy bag to process his bodily waste. Nearly half of those days were spent inpatient at two different hospitals due to infections and other complications, many of which required additional surgeries. When Sam finally passed away in the hospital, he was 70-pounds lighter than he was the day of the chest tube incident.
This was hardly the end Sam deserved. He had spent his life doing whatever he was physically capable of. Sam served for U.S. Special Forces, sailed ships for hire across the Atlantic Ocean, and worked as a ski instructor. In his later years, he loved to wander around Boston for hours at a time and take care of his wife, Sarah. After this incident, though, for the first time in his life and for what remained of his life, Sam was practically immobile.
We put the hospital and the physicians who were involved in his care on notice that we were pursuing a claim for medical malpractice. The insurer and attorney for the hospital and physicians took the position that the doctors acted within the applicable standards of care at all times during their care and treatment of Sam. This, counsel argued, included the placement of the chest tube, which had only been inserted into the abdominal cavity because Sam’s diaphragm had retracted upwards due to built-up scar tissue caused by his rheumatoid arthritis.
We engaged the services of a medical expert affiliated with one of the finest hospitals in the country. Our expert prepared a detailed report, which set forth exactly what mistakes had been made and how those mistakes led to a disastrous medical outcome for Sam. Aside from the chest tube procedure being improperly performed by the resident doctors, it was not indicated by the radiology exams or the ultrasound. Furthermore, the attending Dr. Rogers failed to give his residents clear directions to not place the chest tube. As for the hospital, its safety protocol failed to include a step to make sure everyone involved with the chest tube procedure was actually aware it was taking place.
The insurer and attorney for the hospital and physicians agreed to go to mediation in an effort to reach a settlement with Sam’s wife, Sarah, and their children. With the assistance of a highly qualified and experienced mediator, we were able to settle the case without litigation for $2,250,000. While this can never fully compensate for the losses that Sam and his family have suffered, it does mean that Sarah can enjoy her remaining years without financial worries and pass on a considerable estate to Sam and Sarah’s children.
In order to protect the privacy of the injured person and witnesses, all names have been changed. Any resemblance to names of real persons, past or present, is merely coincidental and not intended.
