Facts

Blair Marsh, 32, was in a motorcycle accident on June 9, 2001, was taken to Henry Mayo Hospital ("Henry Mayo"), suffering from considerable trauma including broken ribs and a punctured lung. He was discharged on June 16, 2001. During the initial hospitalization, he was given pain medication through the insertion of an epidural catheter.

On June 21, 2001, the plaintiff reported to Henry Mayo Emergency Room complaining of back pain. An infection was noted at the catheter insertion site. The plaintiff was referred for an MRI to rule out an epidural abscess. A preliminary MRI report was given by the hospital's after hours "nighthawk" service by a Dr. Klein that ruled out an epidural abscess."

On the morning of June 22, 2001, Dr. To, a staff radiologist for Henry Mayo Hospital, reviewed the MRI film and preliminary MRI report and wrote a final MRI report which concluded "no evidence of epidural abscess."

Dr. Watkins, a pain management specialist, saw Blair Marsh on June 25, 2001, and diagnosed him as having "superficial wound infection catheter site" and prescribed serious pain medication due to his complaints of continued back pain and told him to continue the Keflex. He also set a follow-up appointment for July 6, 2001. The plaintiff failed to appear. On Aug. 1, 2001, the plaintiff had an office visit with Dr. Watkins who referred him to Dr. Singh who referred him to the emergency room for treatment. On Aug. 3, 2001, the plaintiff again went to the emergency room and Dr. Watkins discouraged a repeat MRI by the emergency room doctor by describing the plaintiff as a drug seeker and stating that a "recent" MRI had ruled out any underlying problem. On Aug. 8, 2001, the plaintiff visited the Quartz Hill Emergency Room and was admitted and an MRI showed an epidural abscess. All experts agreed the superficial infection at the epidural catheter site had subsequently spread to the epidural space, formed an abscess, which compressed the plaintiff's spinal cord causing paralysis. An operation was performed but it was too late to prevent paralysis, which all expert doctors agreed could have been prevented as late as Aug. 7, 2001.

The Court bifurcated Dr. To's trial so that the first trial would deal solely with the issues of negligence and causation of the injury, i.e. the paralysis. The issue of the amount of damages, if any, was reserved for later trial.

PLAINTIFF'S CONTENTIONS:
The plaintiff contended that Dr. To fell below the standard of care by failing to report the abnormal increased signal intensity in the paraspinal muscles, beneath the superficial infection which could have represented an infection near the epidural space. The plaintiff alleged the clinicians would have treated the plaintiff with multiple antibiotics and would have repeated the scan to be certain an epidural abscess did not develop.

DEFENDANT'S CONTENTIONS:
The defense contended that Dr. To was within the standard of care to not report the finding as it was non-specific and most likely related to trauma and bleeding from the motorcycle accident. The defense also contended that Dr. To's failure to report the non-specific finding did not cause or contribute to the plaintiff's subsequent neurologic residual deficits and paralysis due to the intervening negligence of others.

Settlement Discussions

The plaintiff demanded $1,250,000 per C.C.P. Section 998; the defendant made no offer.

Damages

Complete paralysis of below T7. Present cash value of future medical care is $1,400,000 to $1,570,000. Past medical specials paid by Medi-Cal. The case had previously been resolved to completion as to all other defendants except Dr. Jeffrey Blodgett, Dr. John Blodgett, and Quartz Hill Walk-In Medical Group who are currently in arbitration. Dr. Watkins settled out of the case for $500,000 before trial.

Result

Defense.

Other Information

In its Statement of Decision, the Court concluded that Dr. To's basic finding of "no evidence of epidural abscess" was correct. The Court noted all experts agreed that if a radiologist doing the final report notes a finding that is deemed significant that is not in the preliminary report, the standard of care required the radiologist to call the physician who requested the MRI to report the difference with the preliminary report. The Court also concluded Dr. To was not negligent by failing to report the abnormal signal intensities (which were readily viewable to a lay person) since the finding was non-specific and likely to be blood or bodily fluids resulting from the motorcycle trauma. The Court rendered a verdict for the defense finding Dr. To was not negligent in this matter and furthermore stated that even if the Court were to find Dr. To negligent, the evidence failed to establish that any negligence of Dr. To was the cause of the ensuing paralysis.

Length

10 days