$1,500,000 – Stroke Victim Due to Delayed Diagnosis

A Montgomery County jury last Friday retuned a $1.5 million verdict in a medical malpractice case where a plaintiff alleged his doctors failed to diagnose a condition that led to a stroke.

Michael F. Barrett

The plaintiffs: attorney, Michael Barrett of the Philadelphia firm Daniels, Saltz Mongeluzzi &: Barrett, said that the jury award has been called by Montgomery County-based colleagues the largest ever in medical malpractice case there.

There had been no settlement offer from the defense side throughout the litigation, and Barrett said he plans to file a petition for $580,000 in delay damages.

Defense counsel Kevin H. Wright of Wright, Young & in Plymouth Meeting could not be reached for comment.

The jury took four and one-half  hours to reach its verdict, after a four-day trial before Judge S. Gerald. Barrett said.

Plaintiff John M. McCaughey, now 40, was 33 when he was seeing the defendant osteopaths, Leonard A. Winegrad and Stephen D. Weiner, over a fine-month period.

Winegrad and Weiner allegedly failed to make a timely diagnosis of subacute bacterial endocarditis [SBE], a bacterial infection that attaches to leaflets of the heart valves. Furthermore, they did not treat the  condition or refer their patient, a former U.S. Marine Corps sergeant and sheet metal mechanic Philadelphia Naval Ship, Yard to a specialist.

McCaughey suffered a mycotic aneurysm, a stroke struck that has left him paralysis in his right upper arm and lower leg. According to Barrett,  McCaughey is unable to work, and suffers from cognitive deficeiencies in speech and reading comprehension, as well as depression.

"Our expert testified that the defendants should have diagnosed the condition because the plaintiff had - preexisting, known and documented to and by the defendants - a hear murmur," Barrett said.

"Our expert testified that the defendants should have diagnosed the condition because the plaintiff had - pre-existing, known and documented to and by the defendants - a hear murmur," Barrett said.

Another pre-existing condition that predisposed McCaughey to SBE was a history of valvular heart disease, according to Barrett.

He first went 10 the defendant osteopaths in March 1990, and for five months presented symptoms of fever, ache, pain and night sweats. If they persist in a patient with McCaughey's history of heart disease, SBE is a highly possible diagnosis, plaintiffs experts said,

''My client was sick for five months with the same symptoms, and they just did nor put it together," Barrett said. Proper treatment, according to expert witnesses, would have been intravenous antibiotics.

Because that was not initialed promptly, the risk of occurrence of stroke was substantially increased," Barrett saiid.

According to Barrett, the first day of trial was consumed by mainly jury selection, during which Corso gave both sides great latitude in voir dire to explore possible bias.

The panel was whittled from a venire pool of 50 to a 10-Woman. two-man jury with two alternates, Barrett said.

"Many of the jurors had contacts with the health care in industry, with family or friends involved in the health care business," Barrett recalled. "And all of them expressed the opinion that too many lawsuits are filed.

"We were able to do a tremendous amount of voir dire, and took the time to explore possible bias."

Barrett's first move was to call the defendants to the stand and examine them as on cross.

They acknowledged that they found that John was more susceptible to contracting SBE, but that they did not consider that [as a diagnosis for the symptoms he presented with]," Barrett said.

Winegard was an experienced family practitioner, while Weincr had just recently completed his residency program, Barrett said.

The plaintiff's main expert on liability was an internal medicine specialist, who testified to the defendant's failure to make the SBE diagnosis and the proper course of treatment for the condition. The expert was board-certified in internal medicine at Cooper Hospital in New Jersey.

Barrett did not call family practitioner even though the defendants were seeing McCaughey in a general family practice.

A basic issue in both general practice and internal medicine is the timely diagnosis and treatment of SBE," Barrett said.

Barrett also called an economic expert for the damage phase, but in the main relied on non-experts from the Office of Vocational Rehabilitation to testify to McCaughey's damages.

They illustrated the psychological neurological and physical effects of the stroke on McCaughey.

"It was clear to the jury' that [the personnel from the Office of Vocational Rehabilitation] came with no bias or interest in the case." he said. "And their examinations all found significant impairment."

Barrett characterized the defense as focusing on the difficulty of diagnosing SBE, which is not made generally until 60 days after the onset of symptoms, and also causation of McCaughey's stroke.

Defense experts included a board-certified neurologist from the Hospital of the University of Pennsylvania, and a board-certified family practitioner from Paoli.

The sides disagreed over the commonality of SBE, with the plaintiff's expert saying he had seen the condition "hundreds of times" over the course of his career.

Of the jury award of $1.520,000, Barrett estimated that about one-third was for pain and suffering. McCaughey claimed $130,000 in medical bills and a range of $800,000 to $1 million in tangible damages.

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