Evans v. Metcalf, et al

29 May 2014 5:40 PM | Lynette Pitt (Administrator)

Plaintiff was a patient at Wayne Memorial Hospital from September 20, 2010 through October 3, 2010.  During that time, his presenting problems of COPD exacerbation and bronchitis were evaluated and treated by the Defendant Hospitalists and Defendant Pulmonologist/Intensivist.  Approximately one week into his hospitalization, Plaintiff began complaining of lower extremity weakness.  One of the Hospitalist Defendants ordered a physical therapy evaluation, which revealed that Plaintiff could not stand independently.  Plaintiff’s weakness was attributed to deconditioning.  During his hospitalization, Plaintiff also complained of abdominal pain.  A surgical consult was obtained, and Plaintiff’s gallbladder was ultimately removed, which seemed to resolve his pain.  Despite multiple recommendations that Plaintiff be discharged to short term rehabilitation, he refused to go and was discharged home on October 3, 2010.

On October 7, Plaintiff was returned to Wayne Memorial by EMS, where admitting documentation states that Plaintiff was “completely unable to move his legs and has had loss of his bladder function.”  An MRI on October 8 revealed a severe compression fracture of T5 resulting in a spinal cord compression.  Plaintiff was transferred to Pitt County Memorial where a neurosurgeon decided that, since symptoms had been present for so long, emergent surgery would result in no improvement of function.  On November 17, 2010, Plaintiff was discharged home with home health for wheelchair mobility.

Plaintiff was a 51-year-old divorced male on disability since 2004 for psychiatric issues.  He had a long history of polysubstance abuse, and despite his diagnosis of severe COPD, he continued to smoke.  Defendants argued that his sedentary lifestyle, prior drug abuse, and comorbidities contributed to the degree and quickness of onset of deconditioning.  Accordingly, Plaintiff’s prior drug use was allowed, over objection, into evidence. 

Plaintiff’s experts contended that the Plaintiff’s weakness was the result of spinal cord impingement and could not be deconditioning because the Plaintiff had severe weakness in his lower extremities, but normal strength in his upper extremities.  They contended that the Defendant Hospitalists and Defendant Pulmonologist/Intensivist were negligent in failing to diagnose a neurological deficit and order either a neurological consultation or an MRI, which would have revealed a spinal cord impingement.  Defendants’ experts contended that the physicians appropriately diagnosed deconditioning and that Plaintiff did not, in fact, have a spinal cord impingement to diagnose during the hospitalization.  They contended that his spinal cord was injured when his family attempted to move him at home after discharge. 

At trial, Plaintiff’s experts contended that the nurses were negligent in failing to perform appropriate neurological assessments in light of Plaintiff’s complaints of weakness and in failing to communicate their findings to the Defendant Hospitalists and Defendant Pulmonologist/Intensivist.  Counsel for the hospital argued in a motion for directed verdict that Plaintiff failed to prove the element of causation because there was no proof that, if the nurses had communicated their findings to the Defendant physicians, the physicians would have done anything differently.  Rather, the evidence showed that the physicians were aware of the Plaintiff’s weakness and had attributed it to deconditioning.  At the conclusion of all evidence, Judge Jenkins granted the Hospital’s motion for a directed verdict.

Defendants also put on evidence of contributory negligence, arguing that Plaintiff was negligent in 1) failing to report a fall that occurred two weeks before the hospitalization; 2) failing to report back pain during the hospitalization; 3) failing to follow the advice of his physicians to go to short term rehabilitation; and 4) failing to return to the hospital when his condition changed at home.  Defendants also entered evidence, over objection, that the Plaintiff subsequently filed a lawsuit against the home health agency, claiming that all of his injuries occurred after a home health visit.

Because the trial was bifurcated by consent of the parties, the Plaintiff was unable to present evidence of the Plaintiff’s current condition, which would have included incredibly sympathetic testimony about the Plaintiff’s daily activities.

The jury deliberated for roughly four hours and thirty minutes before returning the defense verdict for the Defendant Hospitalists and Defendant Pulmonologist/Intensivist.

Defense attorneys:  Leigh Ann G. Smith, Randolph L. Lee, and Arienne P. Blandina, Batten Lee, PLLC, Raleigh, NC for Dr. Metcalf, Dr. Mayo, Dr. Willis, and Eastern Medical Associates, P.A.

Barry S. Cobb and Mindi L. Schulze, Yates, McLamb & Weyher, LLP, Raleigh, NC for Wayne Memorial Hospital

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