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CONFIDENTIAL

Dec. 21, 2004

Personal Injury
Medical Malpractice
Failure to Inform

Confidential

Settlement –  $50,000

Judge

James J. McBride

Court

San Francisco Superior


Attorneys

Plaintiff

David S. Rosenberg


Defendant

J. Randall Andrada


Experts

Plaintiff

Paul R. Linquist
(medical)

Defendant

Thomas R. Norris
(medical)

H. Relton McCarroll
(medical)

Facts

Coleen Byrne, 32, fell from a wall in Boston on Aug. 13, 2001. She returned to San Francisco after x-rays taken at Massachusetts General Hospital indicated that her left elbow was fractured vertically through the medial condyle and continuing into the trochlea. On Aug. 20, 2001, orthopedic surgeon David Lowenberg performed an open reduction and internal fixation. Films taken on Aug. 29 demonstrated excellent reduction of the fracture. However, one film indicated the presence of a horizontal fracture of the medial aspect of the trochlea. Lowenberg thought that this second fracture was a minimal displacement of one to two millimeters. He testified that he showed the film to Byrne, explained that the displacement was minimal, and told her that she could immediately return to surgery or treat the fracture with conservative management, which he recommended. He testified that Byrne agreed and his dictated note referred to the conversation. Lowenberg read films taken on Sept. 12 to show minimal displacement, although the radiologist who took the x-rays reported in writing that the fracture was displaced. Lowenberg advised Byrne of the difference of opinion and proposed a fluoroscopy to evaluate the displacement, which Byrne underwent on Sept. 26, 2001. Lowenberg concluded that the fracture was minimally displaced and recommended that Byrne continue on a conservative course, to which she agreed. After Byrne continued to complain of pain and stiffness, Lowenberg performed a manipulation under anesthesia and thought that the fracture was non-displaced, but movable. He told Byrne after he awoke her, and advised her that she could have surgery then or in a few days. She opted to wait. After the open reduction performed by Lowenberg left Byrne with improved range of motion, but unsatisfactory residual pain, she underwent surgery performed by elbow specialist Jesse Jupiter, who removed all of the screws in the joint and excised the trochlea fragment because all cartilage was missing and there was a non-union. The plaintiff experienced almost immediate improvement and, by the fall of 2002, had nearly complete range of motion.

Specials in Evidence

$69,618 $80,000

Damages

$250,000 for pain and suffering.

Injuries

Byrne has some arthritis from the vertical fracture of the medial condyle into the trochlea and minimal arthritis in the area of the trochlear fragment. She claimed that she will probably need surgery in the future, and that she has limited range of motion in her left elbow. The defense claimed that the arthritis resulted from the initial injury, and that she had excellent recovery, with only a 10-15 degree limitation in range of motion.

Other Information

The jury could not reach a verdict and a mistrial was declared. The case settled thereafter.


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