Anthony J. Fernandez Defends Emergency Room Physicians in $8 Million Malpractice Claim

April 15, 2019 06:00 PM
Anthony J. Fernandez

IADC member Anthony J. Fernandez and Dominique Barrett, both partners in the Phoenix office of Quintairos, Prieto, Wood & Boyer, P.A., achieved a defense verdict in a 3-plus week jury trial for their board certified emergency medicine physician.

The events began when the 18 year old decedent drove her car into a utility pole, while unrestrained and intoxicated. She was brought to a community hospital in Yuma, where the ER physician began his trauma protocol treatment on her arrival. She remained in the ER for several hours, where she was assessed and treated for potential helicopter transfer to a Level 1 trauma center in Phoenix. While in the ER, she was intermittently hypotensive; intermittently belligerent/uncooperative; showing signs of cardiac tamponade; and alert and oriented. She was eventually transferred to the operating room under the care of the co-defendants cardio-thoracic surgeon, perfusiologist and anesthesiologist.

During surgery, it was discovered that she had (since the moment of the accident) an undiagnosed 2-3 inch tear of her heart. Despite heroic efforts in the operating room and emergency room, she suffered a permanent brain injury due to surgical complications. The family withdrew care several weeks later and she passed away. The wrongful death claim was brought by the decedent’s mother, who also happened to be a nurse on staff at the community hospital at the time of the care at issue. The mother requested $8 million from the jury, with the supposition that – as far as the ER care – her daughter’s care was allegedly delayed and led to her being a worse surgical candidate.  In an attempt to whip up anger in the jury, Plaintiff’s theme throughout trial was that the daughter was treated as just another “drunk teenager” by the -ER staff. 

The jury heard emotional testimony from numerous health care providers as well as expert testimony from a variety of specialists in neurology, cardio-thoracic surgery, emergency medicine, trauma/vascular surgery, critical care, and hospital imaging procedures. The hospital resolved its claim in the middle of trial. The defense of the emergency medicine portion of the case centered on the fact that the decedent’s massive cardiac rupture was not diagnosable and not foreseeable. Thus it was reasonable to order and wait for a series of full-body trauma protocol CT scan results rather than perform a focused (“FAST”) ultrasound which potentially could have diagnosed blood around the heart in several minutes after ER arrival. Only in retrospect was it known (or could be known) that it was a heart injury. The immediate concern was to rule out a host of potential deadly injuries which were not diagnosable by FAST ultrasound technology.

The jury sided with the defense in concluding that the ER physician followed consistent trauma protocols for injuries sustained from car accidents and that ER staff had administered conventional emergency procedures to detect sustained injuries.

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