Facts

The patient, in his mid-40s, underwent a successful open reduction and internal fixation of the right tibial plateau, due to a fracture sustained in an automobile accident. He was admitted to Roe HMO Medical Center on Aug. 22, 2005, and eventually discharged on Aug. 27. His discharge orders properly included Coumadin to prophylactically anticoagulate. The plan was for him to remain on Coumadin for a period of approximately six weeks.

On Oct. 27, 2005, Roe nurse practitioner evaluated the patient. At that time, a sonogram of the left antecubital space was scheduled for and performed on Oct. 31. At or around the time of the sonogram, the patient was automatically discontinued. On Nov. 23, the patient was presented to an outlying clinic of Roe HMO with leg pain, including lower extremity swelling.

Two days later, the patient coded and died from a pulmonary embolism.

PLAINTIFFS' CONTENTIONS:
Plaintiffs claimed defendants breached the standard of care. Plaintiffs contended that defendants permitted decedent to discontinue Coumadin, despite having an upper extremity clotting disorder. Plaintiffs alleged that Roe physician, on Nov. 23, 2005, failed to appropriately assess and treat a lower extremity DVT. As a result, two days later, the clot in the decedent's leg broke off, resulting in a pulmonary saddle embolis.

DEFENDANTS' CONTENTIONS:
Defendants' experts testified that discontinuing the Coumadin when it was ordered was well within the standard of care. A minor left upper extremity clot is neither indicative nor diagnostic of a DVT.

Defendants further contended that on Nov. 23, 2005, Roe physician did not breach the standard of care in failing to diagnose a DVT. Although an admitted DVT was present, decedent did not have the classic signs necessary for diagnosis. As such, Roe physician was within the standard of care.

Settlement Discussions

Plaintiffs demanded $1,999,999.99. Defendants offered $100,000.

Damages

Plaintiffs, the decedent's wife and children, claimed a total of $250,000 general damages pursuant to MICRA. Additionally, they claimed economic damages for loss of earnings and household services totaling $2,240,000.

Result

The case settled for $500,000. The matter settled pending court approval of the Minor's Compromise Petitions.