Facts

In November 2004, plaintiff Hugo Reyes, a 30-year-old maintenance worker, was diagnosed by defendant Frederick Rundall, M.D., with low-grade Myelodysplasia syndrome (MDS), a disease of the bone marrow that causes lowered production of red blood cells, white blood cells and platelets. Dr. Rundall treated Reyes with six months of chemotherapy using two medications, Topotecan and Cytarabine. The side effects of these medications caused Reyes to develop nausea and line infection, resulting in a five-day hospitalization in which IV antibiotics were given. A biopsy of his bone marrow performed approximately six months after the chemotherapy was completed revealed no signs of MDS. Reyes sued Dr. Rundall in medical malpractice, alleging negligence in the treatment and diagnosis of MDS.

PLAINTIFF'S CONTENTIONS:
Reyes contended that the initial diagnosis of MDS was incorrect, and that he never had the disease. Reyes introduced testimony from Virginia Nelson, the pathologist who had conducted the original bone marrow biopsy, which indicated that although the test results were suggestive of MDS, they were not conclusive.

Reyes argued that the MDS diagnosis was negligent as Dr. Rundall had insufficient information to support such a diagnosis. Reyes also contended that even if the diagnosis of MDS was correct, he should not have been treated, as the diagnosis was for low-grade MDS and this was usually not treated until the patient became symptomatic. Reyes further contended that even if treatment was required, Topotecan and Cytarabine should not have been used, or that they should have been used at a lower concentration. Reyes argued that these drugs are known to be toxic and have many side effects, and that because of this, they are normally used only in cases of high-grade MDS.

Reyes also alleged that Dr. Rundall never discussed with him the risks and possible side effects of the chemotherapy prior to treatment.

DEFENDANT'S CONTENTIONS:
Dr. Rundall contended that although the original bone marrow biopsy did not conclusively establish that Reyes suffered from MDS, it was suggestive of MDS and that when considered together with other symptoms experienced by Reyes, including abnormally low platelet and red blood cell levels, fatigue, and unexplained weight loss, there was sufficient information to support a diagnosis of MDS. Dr. Rundall contended that the only logical explanation to explain why the first biopsy was suggestive of MDS and the second showed no signs at all of MDS is that Reyes did have MDS and the chemotherapy cured it.

Dr. Rundall argued that although Nelson's testimony indicated that the biopsy was not conclusive, it also indicated that according to Nelson, it was suggestive of MDS and it is within the treating hematologist's discretion and authority to consider all the symptoms and make the final diagnosis.

Dr. Rundall argued that his decision to treat Reyes was appropriate, as low-grade MDS can become high-grade MDS. High-grade MDS can be fatal, if not treated, and treatment is easier before the disease has progressed to such an extent.

Dr. Rundall also contended that his choice of medication was reasonable, arguing that although these drugs were normally used for high-grade MDS, it was appropriate to use them here as he administered a lower dosage than what was normally used with these medications.

Although Dr. Rundall conceded that he could not specifically remember informing Reyes of the risks and side effects of the proposed treatment and that there was no documentation of such a conversation, both Dr. Rundall and his physician's assistant testified that he customarily did have such discussions with his patients before treatment.

Settlement Discussions

The defendant made a C.C.P. Section 998 offer of $29,999.

Injuries

Reyes suffered nausea and infection. Reyes claimed that due to the allegedly unnecessary chemotherapy treatment, he suffered nausea and an infection in his arm where the IV to administer the Topotecan and Cytarabine was inserted. Reyes was hospitalized for the infection for approximately five days and was treated with intravenous antibiotics. Reyes further claimed that he suffers an increased risk of developing leukemia due to his treatment with these drugs.

Result

The jury returned a verdict for the defendant, finding no negligence in his diagnosis and treatment of Reyes.

Other Information

FILING DATE: Aug. 22, 2006.

Deliberation

one day

Poll

12-0

Length

seven days