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Rosa Fellin, as conservator of the property of David Fellin, conservatee, and David Fellin, indiv. v. Vivek S. Sahgal, M.D. and Long Island College Hospital

Case Name

Rosa Fellin, as conservator of the property of David Fellin, conservatee, and David Fellin, indiv. v. Vivek S. Sahgal, M.D. and Long Island College Hospital

Type of Injury

QUADRIPLEGIA AND SEVERE BRAIN DAMAGE

Occupation

elevator mechanic

Location

Kings, NY

Verdict

$41,444,531. Breakdown: $9,000,000 for past pain and suffering and lost enjoyment of life; $20,000,000 for future pain and suffering and lost enjoyment of life; $570,000 for past lost earnings

Verdict Amount

$41,444,531.00

Case Details

XVIII/7-1 MEDICAL MALPRACTICE FAILURE TO TIMELY PERFORM TESTS FAILURE TO TIMELY DIAGNOSE CEREBRAL ANEURYSM 23-YEAR-OLD MAN SUFFERS QUADRIPLEGIA AND SEVERE BRAIN DAMAGE

Rosa Fellin, as conservator of the property of David Fellin, conservatee, and David Fellin, indiv. v. Vivek S. Sahgal, M.D. and Long Island College Hospital 4129/93 15-day trial Verdict 6/30/00 Kings Supreme

Judge: Jules L. Spodek

Verdict: $41,444,531. Breakdown: $9,000,000 for past pain and suffering and lost enjoyment of life; $20,000,000 for future pain and suffering and lost enjoyment of life; $570,000 for past lost earnings; $3,922,581 for future lost earnings; $7,951,950 for future care and maintenance. Past care and maintenance was not presented to the jury because of a collateral source hearing; Justice Spodek will determine this award. A post-trial motion is pending.

Pltf. Atty: Robert J. Bohner and Frank J. Livoti of Shaw, Licitra, Bohner, Esernio & Schwartz, P.C., Garden City

Deft. Atty: Richard V. Caplan of Aaronson, Rappaport, Feinstein & Deutsch, Manhattan

Facts: On 1/31/91 at 11:40 AM, Pltf., a 23-year-old elevator mechanic, presented to the emergency room of Deft. Hospital complaining of severe pain in the back, radiating to his head and causing a headache. Pltf. had been working on the elevators outside of Deft. s emergency room when the pain began. Pltf. contended that he should have been questioned more thoroughly by the triage nurse before she categorized him as urgent due to pressure on back. Shortly after he was admitted, Pltf. s headache worsened, and he began vomiting. Pltf. contended that throughout the afternoon his aneurysm was leaking from the subarachnoid space into the subdural space, causing pressure and shifting of his brain. No treatment was rendered, and Pltf. slipped into a coma. Surgery was finally performed at 6:45 PM, 7 hours after he had been admitted to the Hospital, and revealed that Pltf. had suffered a ruptured cerebral aneurysm, resulting in severe brain damage.

Pltf. contended that Deft. Hospital negligently delayed treatment and failed to conduct a proper neurological exam when he presented to the emergency room. He claimed that the triage nurse failed to conduct the initial interview and failed to upgraded his status to emergent and call a doctor when he began vomiting. Pltf. claimed that emergency room personnel should have recognized the severity of his symptoms and started an immediate course of testing and treatment, and he contended that a timely CAT scan would have shown the bleeding in his brain from the aneurysm. He also claimed that Deft. Dr. Sahgal, a resident, was negligent for failing to consult with the attending doctor after he examined Pltf. He claimed that if a neurosurgeon had timely examined him, a course of treatment could have been prescribed that would have reduced the intracranial pressure and kept his blood pressure under control.

Defts. contended that Pltf. had a congenital aneurysm that began leaking blood while he was working at the Hospital. They contended that after the triage nurse obtained a negative history from Pltf., she triaged him as urgent and sat him across from her as she triaged other patients. At 12:30, she examined him, took his vital signs, and determined that his chief complaint was a pulled muscle in his back. When Pltf. vomited at 1 PM, the triage nurse placed him on a stretcher and turned him over to another nurse, who followed up with him at 1:30 and found that he had normal vital signs . The nurse testified that Pltf. was alert, aware of his surroundings, but complained of a severe headache. A nurse requested that Dr. Sahgal examine Pltf., and Dr. Sahgal contended that his examination revealed no abnormal signs other than a painful headache. Deft. claimed that shortly after his examination, Dr. Sahgal spoke to his attending physician about performing a CAT scan. At 3 PM, before the CAT scan could be ordered, Pltf. s aneurysm ruptured.

Defts. contended that a CAT scan taken after the aneurysm ruptured showed a large mass of blood that was secondary to the event at 3 PM, and Pltf. was prepared for surgery with anesthesia starting at 5:30 PM and the initial incision at 6:45 PM. Defts. contended that good and accepted standards of medical care require that when a patient is suspected of having a bleed into the brain, appropriate testing includes a CAT scan which, if it reveals blood, leads to the performance of an angiogram to determine the origin of the blood. Defts. contended that performing surgery without first performing an angiogram to obtain a clear picture of the anatomy of the brain is not in accordance with good medical practice. Pltf. s expert neurosurgeon conceded that the standard of care in Pltf. s case included a CAT scan and an angiogram with the scheduling of surgery thereafter.

The jury found that Deft. Hospital was negligent in its failure to obtain a timely CAT scan and operate on an emergency basis, and in failing to give Pltf. any medications to control his blood pressure and intracranial pressure, in accordance with accepted medical standards.

Pltf. suffered quadriplegia and severe brain damage with impairment to his intellectual, emotional, and cognitive abilities. He is permanently confined to a nursing home, and requires around-the- clock care. Carrier: Fireman s Fund.

Pltf. Experts: Dr. Craig Smestad, emergency medicine and internist, Smithtown; Dr. Lawrence Shields, neurologist, Manhattan; Dr. Stanley Stellar, neurosurgeon, Englewood, New Jersey; Edmond Provder, Ph.D., Occupational Assessment Services, life care, Manhattan; Conrad Berenson, Ph.D., economist, Woodbury.

Deft. Experts: Dr. George Tyson, neurosurgeon, Stony Brook Hospital; Dr. Rene Kotzen, treating neurosurgeon (assisted at Pltf. s surgery), Brooklyn.