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Earlier endocarditis diagnosis wouldn’t have changed outcome: docs

Type:

Verdict-Defendant

State:

New Jersey

Venue:

Middlesex County

Court:

Middlesex County Superior Court

Injury Type(s):

other-abscess; other-valve replacement; cardiac-endocarditis; arterial/vascular-aneurysm

Case Type:

Medical Malpractice – Cardiac Care, Failure to Test, Delayed Diagnosis, Negligent Treatment

Case Name:

Robert Pilukaitis and Cynthia Pilukaitis v. Steven Georgeson M.D., Anthony Frisoli M.D. and Robert Wood Johnson University Hospital,
No. MID-L-6923-10

Date:

August 26, 2013

Parties

Plaintiff(s):

Robert Pilukaitis (Male, 50 ), 

Cynthia Pilukaitis (Female)

Plaintiff Attorney(s):

Anthony J. Macri;
Law Office of Anthony J. Macri;
Parsippany,
NJ,
for
Robert Pilukaitis, Cynthia Pilukaitis

Plaintiff Expert(s):

Leonard Moss;
DO;
Cardiology;
Cedar Knolls,
NJ called by
Anthony J. Macri ■ Richard Podell;
M.D.;
General Practice;
Summit,
NJ called by
Anthony J. Macri

Defendant(s):

Anthony Frisoli, 

Steven Georgeson, 

Robert Wood Johnson University Hospital

Defense Attorney(s):

Gregory J. Giordano;
Lenox, Socey, Formidoni, Giordano, Cooley, Lang & Casey, LLC;
Lawrenceville,
NJ,
for
Anthony Frisoli ■ Scott Eichhorn;
Marshall Dennehey Warner Coleman & Goggin, P.C.;
Roseland,
NJ,
for
Steven Georgeson ■ None Reported;

for
Robert Wood Johnson University Hospital

Defendant Expert(s):

Bruce Mindich;
Cardiothoracic Surgery;
Ridgewood,
NJ called by
Scott Eichhorn ■ Edward Julie;
Cardiology;
Clifton,
NJ called by
Scott Eichhorn ■ Robert Perkel;
General Practice;
Philadelphia,
PA called by
Gregory J. Giordano

Facts:

On July 13, 2009, plaintiff Robert Pilukaitis, a retired police officer and part-time house appraiser who was in his 50s at the time, presented to Steven Georgeson, a cardiologist. Pilukaitis later claimed that the reason for this visit was that he wasn’t feeling well, as evidenced by a decreased exercise tolerance. (He also later claimed he complained of a fever during the visit; however, Georgeson disputed that claim.) Georgeson ran some cardiac tests on Pilukaitis, and determined that he was likely suffering from a virus/flu. Georgeson reportedly told Pilukaitis to follow up with his general practitioner, Anthony Frisoli, and also ordered an echocardiogram. On July 14, 2009, Pilukaitis presented to Frisoli with his complaints, and his claim of having experienced fevers on-and-off for nine days was recorded by Frisoli. Pilukaitis was sent for blood work, and Frisoli made a similar assessment as Georgeson — that Pilukaitis was suffering from a virus/flu. On July 21, 2009, Pilukaitis underwent the echocardiogram ordered by Georgeson. The echo showed no vegetation on the aortic valve, and Georgeson did not change his diagnosis. Pilukaitis returned to Georgeson on July 28, 2009, allegedly in a worsened condition (including loss of some weight). Georgeson ordered a blood culture, which came back positive for infection. Pilukaitis was diagnosed with endocarditis, and was admitted to the hospital the next day, where he started receiving antibiotics. On July 31, 2009, Pilukaitis was transferred to a different hospital and underwent an aortic-valve replacement, as well as removal of an abscess on the aortic valve. Pilukaitis subsequently claimed his new valve had a leakage problem. Pilukaitis sued Georgeson and Frisoli for medical malpractice, alleging negligent treatment, failure to test, and delayed diagnosis. (Also originally named as a defendant was a hospital believed to have been the site of some of the treatment events underlying the lawsuit; the claim against the hospital was dropped relatively early in the litigation, court records indicate.) Pilukaitis claimed both defendant-doctors had failed to timely diagnose Pilukaitis’ endocarditis, either on the July 13 visit with Georgeson, or the July 14 visit with Frisoli. It was claimed that a blood culture should have been ordered on either date, due to Pilukaitis’ condition upon presentation, which, it was argued, included a congenitally bicuspid aortic valve and the symptoms indicative of a possible infection. Counsel for Pilukaitis argued that as a result of the delayed diagnosis, Pilukaitis had to undergo the aortic-valve replacement, which could have been avoided. It was claimed that even if this surgery was unavoidable, an earlier surgery would have yielded a better result; the delay resulted in the growth/removal of the abscess, and the valve leakage, it was argued. Both defendant-doctors disputed Pilukaitis’ claims, arguing that Pilukaitis’ presenting picture on July 13 and July 14 was not indicative of endocarditis, and that the treatment/workup on both dates had been appropriate and in conformance with the applicable standards of care. Georgeson claimed that when Pilukaitis presented on July 28, he was in noticeably worse condition, and was properly tested and diagnosed for endocarditis. It was further argued that even if the endocarditis had been diagnosed earlier, Pilukaitis still would have required an aortic-valve replacement, which the defense reasoned was unavoidable. Defense counsel further argued that an earlier surgery would not have altered the result, and that some valve leakage is not uncommon, irrespective of the occurrence of any negligent treatment.

Injury:

Pilukaitis claimed that as a result of the defendants’ negligence, he required the aortic-valve replacement and abscess removal, which resulted in the subsequent leakage. He further claimed the delayed surgery caused an aneurysm of the aorta. Pilukaitis alleged that his current condition has led to restrictions on his physical activity, and that he doesn’t exercise as rigorously or as often as he used to. Pilukaitis sought damages for pain and suffering; his wife had a derivative claim. The defense argued that Pilukaitis had had a very good result from his surgery, and noted that he still actively exercises. It was further claimed that the aneurysm was not related to the subject surgery, and that valve leakage is a common result of valve-replacement surgery.

Result:

The jury rendered a defense verdict.

Trial Information:

Judge:

Barry Weisberg

Trial Length:

2
 weeks

Trial Deliberations:

2
 hours

Jury Vote:

8-0 (as to Frisoli); 7-1 (as to Georgeson)

Editor’s Comment:

This report is based on court records and on information that was provided by defense counsel for Georgeson. Neither defense counsel for Frisoli nor plaintiffs’ counsel responded to the reporter’s phone calls. The early-dismissed hospital-defendant was not asked to contribute.