By Paul Sableman (Rush University Medical Center) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
CHICAGO — On Dec. 15, a state appeals court affirmed a Cook County judge's judgment in favor of Rush University Medical Center in a dispute involving a former patient who claimed his leg amputation could have been avoided had the defendants properly referred him to a vascular surgeon, but who the hospital argued had been uncooperative with medical professionals, costing them the opportunity to save his leg.
Justice Shelvin Louise Marie Hall of the Illinois First District Appellate Court delivered the decision in an unpublished order, with justices Bertina Lampkin and Jesse Reyes concurring. The ruling was issued under Supreme Court Rule 23, which limits its use as precedent.
In the decision, Hall stated a medical expert who testified on behalf of plaintiff Samuel Lord did not show the defendants’ failure to refer him to the surgeon lessened the effectiveness of medical services, but rather the expert’s testimony “provided affirmative evidence supporting summary judgment for the defendants.”
Lord went to the emergency room at Mercy Hospital in 2010 for leg pain that was diagnosed as peripheral vascular disease, or PVD. He was advised to see a vascular surgeon and follow up at the Family Health Center in a few days, which he did not do, according to court records.
His primary doctor purportedly advised him to see a vascular surgeon before his leg got worse. He was admitted to Mercy Hospital on May 23, 2010, and Mount Sinai in June 2010, but he discharged himself from the hospital against the doctors’ orders on both occasions, according to court documents. A doppler arterial exam was performed at Mount Sinai in June 2010, and Lord was advised that his right leg could be revascularized, but the doctors needed an Magnetic Resonance Angiogram (MRA) for a more complete imaging of the plaintiff’s right leg.
“Despite multiple attempts, including two under anesthesia, a Magnetic Resonance Angiogram (MRA) could not be performed due to the plaintiff’s uncooperativeness and unwillingness to undergo the MRA,” Hall said in the decision. "He was seen at Mount Sinai again [on] July 13, 2010, and on July 14, an interoperative angiogram was performed. After being informed that it was no longer feasible or safe to proceed with the bypass graft, Lord consented to the amputation on July 15, 2010."
Lord claimed in his lawsuit and appeal that, if the defendants had timely referred him to a vascular surgeon after diagnosing him with PVD, the amputation may have been avoided.
However, there was evidence in Lord’s medical records indicating he had not followed up with his doctors as ordered, and had not done the biopsy recommended until July, by which time the lesion on Lord’s leg was inoperable, according to the decision. Hall said Lord’s medical expert’s “opinion did not allow even the inference that the defendants’ breach of the standard of care was a proximate cause of the amputation of the plaintiff’s right leg.”
Lord argued he did not need to prove that a better result would have occurred, but Hall noted a plaintiff must show “with a reasonable degree of medical certainty that the negligent delay in diagnosis or treatment lessened the effectiveness of medical services rendered to the plaintiff.”
The appellate court justices found Lord failed to establish proximate cause by expert testimony “to a reasonable degree of medical certainty.”
“The plaintiff not only failed to present expert testimony that the defendants’ delay in referring the plaintiff to a vascular surgeon was a proximate cause of the amputation of the plaintiff’s right leg, but his expert witness provided affirmative evidence that the plaintiff was seen by a vascular surgeon at a time when the plaintiff could have undergone successful bypass surgery and not suffered the amputation of his right leg,” Hall said in the decision.
According to Cook County Circuit Court records, Lord was represented in the action by attorney Peter Coladarci, of Chicago.
Rush University Medical Center was defended by the firm of Anderson Rasor & Partners, of Chicago.