Pennsylvania Verdicts

Plaintiff(s):

April Mendel (Female, 50 Years)

Plaintiff Attorney(s):

Marsha F. Santangelo, M.D.;
The Beasley Firm;
Philadelphia,
PA,
for
April Mendel

Plaintiff Expert(s):

David Hopkins; A.S.A.; Economics; King of Prussia,
PA called by:
Marsha F. Santangelo, M.D. ■ Edgar Kenton III; M.D.; Neurology; Atlanta,
GA called by:
Marsha F. Santangelo, M.D. ■ Gregg Zoarski; M.D.; Radiology; Wilmington,
DE called by:
Marsha F. Santangelo, M.D. ■ Irene Mendelsohn; Vocational Rehabilitation/Counseling; Penn Valley,
PA called by:
Marsha F. Santangelo, M.D. ■ James Aragona; M.D.; Orthopedic Surgery; Clark,
NJ called by:
Marsha F. Santangelo, M.D. ■ Barbara Levin; B.S.N., R.N.; Nursing Policy & Procedures; Hingham,
MA called by:
Marsha F. Santangelo, M.D. ■ Elizabeth McGettigan; Life Care Planning; called by:
Marsha F. Santangelo, M.D.

Defendant(s):

Andrew Beaver, M.D., 

Eric Williams, M.D., 

Robert Ocasio, M.D., 

Vilas Saldanha, M.D., 

Einstein Practice Plan Inc., 

Underwood-Memorial Hospital, 

Albert Einstein Medical Center, 

Albert Einstein Healthcare Network, 

Einstein Regional Orthopaedic Specialists

Defense Attorney(s):

Joseph G. Zack;
Post & Post LLC;
Berwyn,
PA,
for
Andrew Beaver, M.D., Eric Williams, M.D., Vilas Saldanha, M.D., Einstein Practice Plan Inc., Albert Einstein Medical Center, Albert Einstein Healthcare Network, Einstein Regional Orthopaedic Specialists ■ None reported;

for
Robert Ocasio, M.D., Underwood-Memorial Hospital

Defendant Expert(s):

Chad Staller;
Economics;
Philadelphia,
PA called by:
Joseph G. Zack ■ Jane Mattson;
Life Care Planning;
Norwalk,
CT called by:
Joseph G. Zack ■ Kevin McGrail;
Neurosurgery;
Washington,
DC called by:
Joseph G. Zack ■ Roger Nieman;
Infectious Diseases;
Abington,
PA called by:
Joseph G. Zack ■ Scott Rushton;
Orthopedic Surgery;
Wynnewood,
PA called by:
Joseph G. Zack ■ Justin Doheny;
Hospital Administration & Procedures;
Wayne,
NJ called by:
Joseph G. Zack ■ Kathleen Ashton;
Nursing;
Hammonton,
NJ called by:
Joseph G. Zack

On Aug. 11, 2008, plaintiff April Mendel, 50, a bus driver, presented to Underwood-Memorial Hospital, in Woodbury, with complaints of fever and severe low-back pain that radiated into her legs. On July 31, Mendel had undergone a lumbar laminectomy (surgery to remove part of a vertebrae, usually to give access to the spinal cord or to relieve pressure on nerves). The operation was perfomed by orthopedic surgeon Eric Williams at Albert Einstein Medical Center, in Philadelphia. Mandel had been discharged Aug. 4; about six days later, she reportedly developed the fever and pain, and also drainage from the wound site. This prompted her, on Aug. 11, to call Williams’ office, but she was reportedly told by an employee that the physician had no available appointments that day, and that Mendel would have to see him the next day, or present to an emergency room. Mendel was taken by ambulance to Underwood-Memorial Hospital, where she was diagnosed with an infection, and was seen by internist Robert Ocasio, who contacted Williams. It was determined that Mendel would be transferred to Albert Einstein Medical Center, but there were no beds available until the next day, so Mendel remained at Underwood overnight. When Mendel arrived at Albert Einstein, around noon on Aug. 12, her condition had reportedly deteriorated. About three-and-half hours later, she received some antibiotics and a small amount of intravenous fluids. Approximately six hours after her arrival at the hospital, Mendel was taken to the operating room, where Williams reopened the surgical site from L3 to S1 and cleaned the infection, which had destroyed the blood vessels in her spine and rendered her paraplegic. Mendel sued Williams, Albert Einstein chief resident Andrew Beaver, and Albert Einstein Medical Center (and its related entities), alleging they negligently failed to provide appropriate care, constituting medical malpractice. (Mendel also sued Albert Einstein resident Vilas Saldanha, Underwood-Memorial Hospital, and Ocasio, but all were dismissed, prior to trial.) Mendel’s expert in orthopedic surgery maintained that she should have immediately had surgery when she arrived at Albert Einstein Medical Center, on Aug. 12. Given the degree of infection and its catastrophic results, which manifested into paralysis, Williams should have emergently performed the surgery, said the expert. The expert further criticized Williams for arriving at the hospital five-and-half hours after Mendel arrived. Mendel’s counsel faulted Williams and his office’s conduct on Aug. 11. It was inappropriate for an office staff with no medical training to "triage" Mendel’s call, and a staff member reportedly admitted that she did not tell Williams of Mendel’s call, asserted Mendel’s counsel. Moreover, Williams, when he received the call from Underwood, should have had Mendel immediately transferred to Albert Einstein, or given specific medical directives to Underwood for Mendel’s care. Mendel’s counsel faulted Beaver for his alleged failure to keep Williams apprised of Mendel’s condition from the time she arrived at the hospital. According to counsel, there was a complete breakdown of communication between Beaver and Williams, since missing in the records were nursing notes and physician’s orders during the six-hour time-frame of Mendel’s arrival and her surgery. The lack of record-keeping was the focus of Mendel’s expert in nursing, who maintained that it was the responsibility of nurses to properly document the patient’s condition and contact the physicians if the condition changed. The defense maintained that Mendel was instructed to come to Albert Einstein Medical Center on Aug. 11, but failed to do so. The defense criticized Underwood for transferring an unstable patient on Aug. 12. Given that Mendel’s condition deteriorated while at Underwood, she should have been assessed and treated by a spine surgeon there. Mendel’s paraplegia, the defense contended, did not result directly from her wound infection, but due to a spinal infarction, or spinal stroke (a sudden, irreversible condition in which vessels feeding the spinal cord have an interruption in blood flow). The defense maintained that the infarction occurred prior to Mendel’s arrival at Albert Einstein Medical Center, on Aug. 12; therefore, whether or not she received emergent washout surgery at Albert Einstein Medical Center, as suggested by Mendel’s counsel, it would not have made a difference. The defense also maintained that Mendel was medically unstable when she arrived at Albert Einstein Medical Center and was in no condition to undergo immediate surgery. She was initially placed in the surgical intensive care unit for stabilization. The hospital asserted that Beaver properly apprised Williams of Mendel’s condition before the orthopedic surgeon arrived at Albert Einstein. Albert Einstein Medical Center’s expert in orthopedic spine surgery testified that Williams’ treatment of Mendel met the standard of care. He testified that Williams gave appropriate instructions to the emergency-room physician at Underwood. Mendel should have been seen by the spine-surgery specialist at Underwood, and was too unstable to be transferred from Underwood to Albert Einstein Medical Center. The spinal infarct occurred prior to Mendel’s arrival at Albert Einstein Medical Center, the expert said.

During the surgery to clear the infection, Williams drained the accumulated pus that pressed on the blood vessels in Mendel’s lumbar spine; however, the vessels were irrevocably damaged and she suffered paralysis from T10 through S1. After three weeks of hospitalization, Mendel was transferred to a rehabilitation facility, where she received inpatient care through the end of 2008. Upon discharge, Mendel, wheelchair-bound, received minimal outpatient therapy and relied on the care of in-home nurses (two-to-four hours a day) and her two adult children, who lived in her residence. Other than taking pain medication and following up with her doctor, no further treatment was administered. The jury was informed that Mendel had outstanding medical costs of approximately $850,000, but due to the Medical Care Availability and Reduction of Error (MCARE) Act, she was only allowed to recover about $20,000. Mendel’s expert in radiology explained how pressure on the spinal blood vessels from infection slowed blood flow to her spinal cord Mendel’s expert in life-care planning presented a life-care plan of approximately $1.8 million to $5.9 million. The range was based on scenarios of Mendel remaining in her current residence and receiving live-in care and on her moving into a handicapped-accessible ranch home with less care. Mendel’s expert in neurology opined that, based on her paralysis and physical limitations, she was permanently disabled. Mendel’s counsel presented a document from Williams, about a year after her surgery, who wrote that she was disabled from her injury. Mendel’s expert in vocational rehabilitation estimated her future lost earnings at $250,000 to $750,000, based on retirement ages of 62 to 70. Mendel reportedly takes round-the-clock narcotic pain medication due to electrical pains she experiences in her legs. The medication reportedly makes her drowsy and disrupts her executive functions. Mendel testified that she is frustrated being stuck in a wheelchair and she spends most of her day by herself. Due to her loss of bowel and bladder function, she is required to wear an adult diaper. Mendel claimed that she is unable to change herself, so she is sometimes forced to sit for hours smelling her unchanged diaper. Living near a school, the sound of busses reportedly causes reminds her how much she misses going to work. Mendel discussed the emotional toll of losing her independence and relying on her children for assistance, and how she has become a burden on them. Mendel sought damages for past and future pain and suffering. The defense maintained that Mendel could work in a sedentary capacity, as a bus dispatcher or in telecommunications.

The jury found that Williams was 34 percent liable, Beaver was 33 percent liable, and Albert Einstein Medical Center was 33 percent liable. Mendel was determined to receive $4,875,200.14.

April Mendel: $20,180 Personal Injury: Past Medical Cost; $2,825,566 Personal Injury: Future Medical Cost; $266,444 Personal Injury: Past Lost Earnings Capability; $263,010 Personal Injury: Future Lost Earnings Capability; $750,000 Personal Injury: past non-economic damages; $750,000 Personal Injury: future non-economic damages

Judge:

John M. Younge

Offer:

$2 million – $500,000 high-low agreement

Trial Length:

7
 days

Trial Deliberations:

3
 hours

Jury Vote:

12-0

Jury Composition:

7 male/ 5 female

This report is based on information that was provided by plaintiff’s and defense counsel. Ocasio and Underwood-Memorial Hospital were not asked to contribute.