In the world of medicine, the choices of one doctor with regard to patient care may invariably impact the course of action taken by another. However, if one makes a poor choice, it doesn’t excuse the other for liability for failing to meet the professional standard of medical care.

brain01-240x300Still, there have been conflicting court renderings cropping up on this issue throughout Florida, which is why the Florida Supreme Court recently chose to weigh in on the medical malpractice case of Saunders v. Dickens, which arose out of Florida’s Fourth District Court of Appeals.

Our Naples medical malpractice attorneys understand that in cases where multiple physicians share fault, the case becomes increasingly complex. The extent to which one doctor relies on the determination of another may reduce his or her fault comparatively, but it does not excuse or preclude negligence.

In the Saunders case, the patient sought treatment from a neurologist due to back pain, leg pain and numbness in his hands and feet. The neurologist determined the tingling was caused by diabetes, but he didn’t perform a diabetic neuropathy test to confirm it.

Still, he recommended the patient be admitted to the hospital. At that time, an MRI was ordered, and the results showed the brain was normal, but the lumbar spine showed signs of severe narrowing of the spinal canal.

Based on this, the neurologist requested a consultation from a neurosurgeon. The neurosurgeon conducted a complete medical exam, and based on this, the neurosurgeon performed surgery.

However, the patient didn’t significantly improve. Months later, the neurosurgeon ordered several more MRIs, which showed compression in the lower back and neck. The patient also indicated the numbness in his arms and hands had gotten worse since the surgery. The neurosurgeon recommended cervical decompression surgery for the following month. Although the patient was initially cleared for surgery, the doctor didn’t schedule it immediately, and the patient developed deep vein thrombosis that prevented him from undergoing surgery.

Another doctor saw the patient the following month and determined a second lumbar surgery was necessary, as was a cervical spine surgery. The latter was never performed, however, because the patient’s condition worsened to the point he became quadriplegic.

He and his wife filed a lawsuit against all physicians involved, though he died while the appeal was pending.

Aside from the neurologist, all other defendants settled with the plaintiff out of court. Against the neurologist, the plaintiffs claimed negligence via failure to diagnose. The wife additionally brought a claim for loss of consortium. The neurologist asserted it was the neurosurgeon – not him – who had been negligent, and that it was the neurosurgeon’s negligence that caused the patient’s injury.

The plaintiff presented expert testimony indicating the neurologist had breached the standard of professional care because the upper body symptoms indicated to a reasonable physician that a problem existed in the neck or brain, and when brain issues were ruled out, the neck would be the next reasonable area to evaluate – not the lower back. He testified the doctor breached the standard of care when he failed to consider other causes for the numbness and tingling.

An orthopedic surgeon further testified the quadriplegia was caused by cervical spine injury, and that failure to diagnose led to a delay in treatment that resulted in the patient’s injury.

The neurologist presented testimony from the neurosurgeon, who testified even if he had known of the issues in the neck, he would not have immediately operated because the patient hadn’t yet had major problems with his upper extremities. The neurologist said this made it impossible that he could have been the cause of the patient’s injury.

A lawyer for the defendant told the jury during closing statements that because the neurosurgeon wouldn’t have done anything differently had the neurologist ordered an MRI, the neurologist couldn’t be found liable for negligence. The state supreme court later determined this was a misstatement of the law. The reality is that the plaintiffs were only required to show that the neurologist’s care fell below the standard for a reasonably prudent doctor and that, more likely than not, adequate care by the neurologist could have prevented the severe injuries of the patient.

The jury decided in favor of the defendant.

On appeal, the state supreme court found the trial court erred in allowing the defense counsel to mislead the jury, and ruled this error was harmful.

On the issue of conflict between rulings in other cases, the court held that testimony that a subsequent treating physician wouldn’t have acted differently had the original doctor acted within the applicable standard of care is irrelevant, inadmissible and will not serve to insulate a defendant doctor from liability for his own negligence.

If you have been a victim of medical malpractice in Naples, call Chalik & Chalik at (954) 476-1000 or 1 (800) 873-9040.

Additional Resources:

Saunders v. Dickens, July 10, 2014, Florida Supreme Court

More Blog Entries:

Florida Medical Malpractice Claims and Medical Diagnosis Hearsay Exception, July 5, 2014, Naples Medical Malpractice Lawyer Blog