Sample Case Report

Medical Malpractice

Docs failed to timely identify cause of blood in urine: suit

$1,620,000.00
Failure to Diagnose, Medical Malpractice - Delayed Treatment, Medical Malpractice - Lost Chance of Recovery, Wrongful Death - Survival Damages
Patricia M. Cetrano, individually and as administratrix ad prosequendum of the Estate of Lawrence Cetrano v. Liviu T. Holca M.D., Walter P. Miller M.D., Community Medical Associates, Southern Ocean County Hospital, William A. Morgan MD and Deborah Heart & Lung Center, No. OCN-L-1788-05
Ocean County Superior Court, NJ
E. David Millard
01-17-2013
Plaintiff(s):
Attorney(s):
  • Andrew R. Spirt; Golomb & Honik; Philadelphia, PA, for Patricia M. Cetrano, Estate of Lawrence Cetrano

Expert(s):
  • Roger Schual M.D.; Urology; Fairfield, CT called by: Andrew Spirt

  • Blanche Borzell M.D.; Family Medicine; Watkins Glen, NY called by: Andrew Spirt

Defendant(s):
Attorney(s):
  • David J. Bishop; Crammer Bishop & O'Brien P.C.; Absecon, NJ, for Southern Ocean Medical Center
  • Richard J. Bolger; Mensching & Lucarini; Toms River, NJ, for William Morgan
  • Louis John DughiJr.; Dughi, Hewit & Domalewski, P.C.; Cranford, NJ, for Liviu Holca
  • William J. Salmond; Law Offices of Peter N. Laub Jr. & Associates, L.L.C.; Branchburg, NJ, for Walter Miller
  • Anthony M. Tracy; Ronan, Tuzzio & Giannone; Tinton Falls, NJ, for Community Medical Associates
  • Yves C. Veenstra; Parker McCay P.A.; Mount Laurel, NJ, for Deborah Heart and Lung Center

Expert(s):
  • Kenneth Jacobson M.D.; Cardiology; Maplewood, NJ called by: Louis Dughi, William Salmond

  • Richard Creech M.D.; Oncology; Philadelphia, PA called by: Louis Dughi, William Salmond

  • Kevin Bell M.D.; Family Medicine; Warren, NJ called by: Louis Dughi, William Salmond

Insurers:

  • PMSLIC for Miller
  • Princeton Insurance Co. for Holca

Facts:

On Oct. 24, 1997, plaintiff's decedent Lawrence Cetrano, 70, a retired welder and mechanic, was admitted as a patient at a nursing and rehabilitation facility in Ocean County following an automobile accident in which he suffered a broken lower leg.

One month into the admission, Cetrano had an episode of hematuria (blood in the urine), generally regarded as a possible sign of kidney cancer. Family-medicine practitioner Walter Miller ordered testing to identify the source of the blood. According to court papers subsequently filed on behalf of Cetrano's estate, despite the fact that initial tests did not identify the cause for the blood, neither Miller nor another attending family doctor, Liviu Holca, ordered further tests.

Over the next four years, Cetrano remained under the care of Holca, both through office visits and multiple hospital admissions for heart and lung conditions. Despite several urinalysis tests, performed for other reasons, which showed microscopic blood in the urine, Holca still failed to order any tests to investigate the cause of the blood or the possibility of kidney cancer, according to court papers filed on behalf of Cetrano's estate

Approximately, five-and-a-half years later, Cetrano reportedly had another episode of excessive blood in the urine. Further testing revealed stage IV kidney cancer and a tumor that measured 12-by-12-by-14 centimeters in size. Cetrano died four months later.

Cetrano's widow, Patricia, individually and on behalf of her deceased husband's estate, brought a medical-malpractice lawsuit against Holca and Miller, as well as various medical facilities, and an additional doctor, believed to have been involved in his treatment following his admission to the Ocean County rehabilitation facility. All of the defendants except for Holca and Miller achieved either voluntary or involuntary dismissals well in advance of trial.

At trial it was contended by counsel for the estate that the signs of blood in Cetrano's urine should have prompted the treating physicians to order diagnostic tests that would have confirmed or ruled out the presence of kidney cancer. The failure to order such tests, it was argued, constituted a deviation from accepted medical standards; if proper procedure had been followed, there would have been an early diagnosis of Cetrano's cancer, at a time when it would have been treatable, it was argued.

The doctor-defendants argued that the blood in Cetrano's urine was attributable to causes other than kidney cancer. They further argued that the tumor that was ultimately discovered was not present during the earlier time periods during which blood in Cetrano's urine was detected, and that Cetrano had died as a result of his other cardiac and pulmonary conditions, many of which, it was alleged, were exacerbated by Cetrano's own non-compliance with physician instructions and medication regimens, and by a long history of smoking and asbestos exposure.

Injury:


Cetrano died as a result of his stage IV kidney cancer. He was survived by his wife and five daughters.

The doctor defendants did not dispute that Cetrano suffered from kidney cancer, but reasoned that there were other medical conditions that had led to his death.


Verdict Information:

The jury found that Holca's negligence had been a proximate cause of Cetrano's death; the claim against Miller resulted in a defense verdict.

The jury returned a total damages award of $1.62 million, allocating $120,000 to the survival aspect of the action and $1.5 million as to the wrongful-death portion.


Estate of Lawrence Cetrano

$120,000 Wrongful Death: Survival

$1,500,000 Wrongful Death: wrongful death

Editor's Comments:

This report is based on information that was provided by plaintiffs' counsel. Defense counsels for Holca, Miller, and the early-dismissed care-facility defendants all declined to contribute. Defense counsel for the early-dismissed physician-defendant did not respond to the reporter's calls.

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