Confidential
Settlement – $400,000Court
Case Not Filed
Attorneys
Plaintiff
Experts
Plaintiff
Marianne Inouye MBA
(technical)
John Lawrence
(medical)
Alberto Marchevsky
(medical)
Daniel J. Wallace
(medical)
Robert Uyeda
(medical)
Facts
The decedent, a 42-year-old woman with a long history of a mixed connective tissue disorder, developed
abdominal pain, weakness and some fever. She was having mild shortness of breath. She had been restarted on
Prednisone during the prior week for her connective tissue disorder, which had been quiescent for years.
In the respondentÆs emergency room, the decedent was seen by the ER doctor, who took a history, did a
physical examination, and decided that decedent had gonorrhea. The decedent denied this possibility, as did the
husband. He demanded that he be tested for gonorrhea, but the ER doctor refused to do so. There was no
vaginal discharge in decedent at the time the ER doctor diagnosed gonorrhea. No smear was sent for gram
stain to try to find Neisseria Gonorrhea, no culture for gonorrhea was sent, no ultrasound of the abdomen was
done, no surgical consultation was obtained and no rectal examination was performed.
Decedent was sent home with antibiotics and with a return appointment five days later. During the next few
days, despite treatment with anti-gonorrheal antibiotics, the decedent continued to be weak. Before the return
appointment, the decedent was found dead at home.
The autopsy showed massive peritonitis and a perforated appendix. There was no sign of sexually transmitted
disease. Cultures of the peritonitis fluid showed no gonorrhea or sexually transmittable organisms.
Other Information
Respondent effectively conceded liability early in the case. Most of the negotiations centered on damages, since the autopsy done on the decedent showed a substantially worse pathological picture of advanced connective tissue disease than had been clinically suspected. In particular, the autopsy showed signs of pulmonary hypertension, and the microscopic evaluation of the lungs showed advanced onion-skin lesions involving most of the pulmonary arterial tree. Consultants from each side debated the likely response of decedent to full bore medical treatment for mixed connective tissue disorder, and the opinions about the decedent's work life and life expectancy varied from 0 and 1-2 years, respectively, for respondent's experts to 3-5 and 5-10 years respectively for claimant's experts. The possibility was raised of a Molien claim for the husband, in light of the misdiagnosis of gonorrhea and the rendering of false information on this point to the decedent.
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