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Misplaced femoral line led to leg amputation, plaintiff argued

Amount:

$4,700,000

Type:

Verdict-Plaintiff

State:

Georgia

Venue:

Fulton County

Court:

Fulton County, State Court

Injury Type(s):

other-ischemia other-necrosis other-prosthesis other-phantom pain cardiac-heart cardiac-cardiac arrest foot/heel-foot amputation-leg(leg (below the knee)) pulmonary/respiratory-respiratory distress

Case Type:

Medical Malpractice – Failure to Test, Delayed Treatment, Failure to Detect, Failure to Consult

Case Name:

Connie Lockhart v. Glenn R. Bloom, M.D., Cherokee Emergency Physicians LLC, Sachin Lavania, M.D., Cherokee Lung & Sleep Specialists P.C. and Northside Hospital-Cherokee,
No. 16EV003451

Date:

January 31, 2019

Parties

Plaintiff(s):

Connie Lockhart (Female, 50 Years)

Plaintiff Attorney(s):

Angela R. Fox;
Summerville Firm LLC;
Atlanta,
GA,
for
Connie Lockhart ■ Lloyd N. Bell;
Bell Law Firm;
Atlanta,
GA,
for
Connie Lockhart ■ Darren Summerville;
Summerville Firm LLC;
Atlanta,
GA,
for
Connie Lockhart ■ David Schlachter;
Bell Law Firm;
Atlanta,
GA,
for
Connie Lockhart

Plaintiff Expert(s):

Eric Gluck; M.D.; Critical Care; Chicago,
IL called by:
Angela R. Fox, Lloyd N. Bell, Darren Summerville, David Schlachter ■ Paul Collier; M.D.; Vascular Surgery; Sewickley,
PA called by:
Angela R. Fox, Lloyd N. Bell, Darren Summerville, David Schlachter ■ Bruce Seaman; Ph.D.; Economics; Atlanta,
GA called by:
Angela R. Fox, Lloyd N. Bell, Darren Summerville, David Schlachter ■ Susan Riddick-Grisham; R.N.; Life Care Planning; Richmond,
VA called by:
Angela R. Fox, Lloyd N. Bell, Darren Summerville, David Schlachter ■ Jeffrey Greenwald; M.D.; Hospitalist Medicine; Boston,
MA called by:
Angela R. Fox, Lloyd N. Bell, Darren Summerville, David Schlachter

Defendant(s):

Glenn R. Bloom, 

Sachin Lavania, 

Northside Hospital-Cherokee, 

Cherokee Emergency Physicians LLC, 

Cherokee Lung & Sleep Specialists P.C.

Defense Attorney(s):

None reported;
;
for
Northside Hospital-Cherokee ■ J. Gabriel Banks;
Weathington McGrew Attorneys at Law;
Atlanta,
GA,
for
Glenn R. Bloom, Cherokee Emergency Physicians LLC ■ Paul E. Weathington;
Weathington McGrew Attorneys at Law;
Atlanta,
GA,
for
Glenn R. Bloom, Cherokee Emergency Physicians LLC ■ Robert G. Tanner;
Weinberg Wheeler Hudgins Gunn & Dial;
Atlanta,
GA,
for
Sachin Lavania, Cherokee Lung & Sleep Specialists P.C.

Defendant Expert(s):

Kent Cohen;
Emergency Medicine;
Lawrenceville,
GA called by:
J. Gabriel Banks, Paul E. Weathington ■ Bruce Morgan;
General Surgery;
Seeley Lake,
UT called by:
Robert G. Tanner ■ James Leo;
Internal Medicine;
Long Beach,
CA called by:
Robert G. Tanner

Insurer(s):

Doctors Co. for Lavania

Facts:

On Feb. 23, 2012, plaintiff Connie Lockhart, 50, a legal assistant, suffered cardiac arrest while in the intensive-care unit at Northside Hospital-Cherokee, in Canton. Her right leg was later partially amputated. Lockhart sued the hospital, alleging claims of medical malpractice. She also sued two of her treating physicians while hospitalized, Glenn Bloom, M.D. and Sachin Lavania, M.D., and their respective practices, Cherokee Emergency Physicians LLC and Cherokee Lung & Sleep Specialists P.C., alleging claims of negligent treatment. Lockhart settled with the hospital for an undisclosed amount prior to trial. However, due to the remaining defendants attributing liability against the hospital, Northside Hospital-Cherokee remained on the verdict slip for apportionment purposes. Lockhart was taken by ambulance to Northside Hospital-Cherokee on the afternoon of Feb. 23 after attempting suicide by taking two handfuls of blood-pressure medication. Upon arrival, she was conscious and alert, but hypotensive, having an extremely low blood pressure and heart rate. She was given fluids and monitored. She was seen by Bloom, an emergency medicine physician. Around 5 p.m., Bloom attempted to place a catheter in Lockhart’s jugular vein to administer epinephrine via a central line. Bloom was unsuccessful in establishing the central line. Lockhart was then sedated and put on a ventilator. A catheter was placed through her groin at 7 p.m. However, Lockhart alleged that, instead of placing the catheter in her femoral vein, Bloom placed the catheter in the femoral artery, which caused the epinephrine to shock her system. At about 7:15, Lockhart went into cardiac arrest. A code blue was called and Lockhart was resuscitated. After being resuscitated, Lockhart was transferred to the intensive-care unit and came under the care of Lavania, a pulmonologist. However, it was not yet discovered that the femoral line had been misplaced. Instead, Lockhart was given vasoconstriction medication to elevate her blood pressure. Lavania left for the evening between 9 and 9:30 p.m. and remained on call. The next morning at 5:16 a.m., Lavania was contacted by a nurse, who informed him that Lockhart’s lower right leg had turned cold and mottled and was without a pulse. A medical emergency was called, and Lavania ordered a venous ultrasound. At 6:45 a.m., the results were called back to Lavania, who was told that the study showed a diminished arterial flow in Lockhart’s right leg. The radiologist recommended a dedicated arterial study of the leg’s vasculature, which Lavania then ordered. At 8 a.m., another nurse drew blood from Lockhart’s leg and noted that it was bright red, which indicated arterial blood. Lockhart alleged that it was at this time the nurse realized the femoral line had been misplaced and contacted Lavania, who immediately stopped the medication into the femoral line. Lockhart argued that Lavania did not come to the hospital to see her for another four hours. Lockhart asserted that, once Lavania did see her, he failed to immediately consult a vascular surgeon and that one was not consulted until three days later on Feb. 27. In the ensuing days, Lockhart maintained that her leg progressively worsened, as her circulation deteriorated, her toes went from blue to black, blisters developed and necrosis set in. On March 3, Lockhart was transferred to another part of the hospital and her right leg was amputated below the knee on March 9. Lockhart’s expert in critical care faulted Bloom for negligently misplacing the catheter into Lockhart’s femoral artery, instead of her femoral vein. The expert maintained that Bloom further failed to check and confirm the catheter’s proper placement. Lockhart’s expert in hospitalist medicine faulted Lavania for not discovering that Bloom had misplaced the femoral line. According to the expert, Lavania had an opportunity to discover the misplaced line when he attempted a procedure in the intensive-care unit when he attempted to place a femoral monitoring line in the exact same area as the misplaced catheter. The expert stated that Lavania was unable to place the monitoring line, which should have caused Lavania to realize the femoral line had been misplaced. The expert further faulted Lavania for ordering a venous ultrasonography upon learning of Lockhart’s compromised leg condition, instead of a dedicated arterial study, which would have properly detected the issue. The expert determined that Lavania also breached the standard of care by not immediately ordering a vascular consult. Lockhart’s expert in vascular surgery testified that, had Lavania immediately ordered a vascular consult upon learning of Lockhart’s leg condition, the proper testing and medication would have been administered to save her leg and prevent it from being amputated. The defense maintained that Lockhart’s primary care physician, Christopher Parman, M.D., should be found liable because he initiated the chain of events that caused Lockhart to become suicidal. Prior to her admission at Northside Hospital-Cherokee, Parman had put Lockhart on an antidepressant that came with an increased suicide warning. According to the defense, when Lockhart was not benefiting from the drug, she contacted Parman’s office and the physician’s assistant doubled the dose. Two days later, she tried to take her own life. This was a breach in the standard of care, the defense asserted. As a result of this defense, Parman was placed on the verdict slip for apportionment purposes. Lavania’s expert in critical care determined that Lavania was not responsible for discovering that Bloom had misplaced the femoral line and that his order of a venous ultrasonography, rather than a dedicated arterial study, was appropriate. The expert stated that it was also appropriate for Lavania not to consult with a vascular surgeon since a cardiologist had already been consulted the day after Lockhart went into cardiac arrest. Lavania’s expert in vascular surgery determined that when Lavania first received the call about Lockhart’s leg at 5:16 a.m. on Feb. 24, Lockhart’s condition was irreversible and nothing could have been done to prevent her leg from necrotizing and eventually being amputated. Therefore, a vascular consult would not have been effective, the expert concluded. Lavania’s counsel argued that any liability should be found against Northside Hospital-Cherokee. Bloom argued that when he attempted to initially insert a central line in Lockhart’s neck, he could not safely do it because Lockhart was combative. Bloom’s expert in emergency medicine testified that, due to Lockhart’s combativeness, Bloom was forced to insert the central line into her groin. However, the expert maintained, because her blood pressure was so low, the usual indicators for correct placement, such as feeling the difference between artery and vein, failed him. The expert concluded that Bloom did not breach the standard of care and that Lockhart was comparatively negligent. Bloom’s counsel filed a motion for a directed verdict in favor of Bloom and his practice, arguing that Lockhart’s expert was a critical care specialist and not an emergency physician. The court granted the motion and Bloom and his practice were dismissed from the case.

Injury:

Following her leg amputation, Lockhart remained in the hospital for another few days. She was then transferred to a rehabilitation facility where she treated for two weeks. In April 2012, Lockhart was fitted with a prosthesis. In the ensuing years and at the time of trial, Lockhart continued to treat with pain medication for phantom pain and also underwent physical therapy to learn how to walk with her prosthetic leg. Lockhart’s expert in life-care planning outlined Lockhart’s future care, which included future prostheses, pain medication, doctor’s visits and physical therapy. Lockhart testified about the challenges of having an amputated leg. She stated that she has fallen up to seven times at her home and has suffered bumps and bruises. She lives independently and continues to adapt to her physical limitations. Despite her leg, she said she tries to be mobile by walking a short distance every day. Lockhart sought approximately $360,000 in medical costs, as well as approximately $1 million in future medical expenses, as calculated by her expert in economics. Lockhart also sought damages for past and future pain and suffering. The defense did not dispute Lockhart’s life-care plan.

Result:

The jury apportioned 3 percent liability to Lockhart, 27 percent liability to Lavania, 10 percent liability to Parman and 60 percent liability to Northside Hospital-Cherokee. The jury determined that Lockhart’s damages totaled $4.7 million. After adjusting the award based on the jury’s apportionment of liability, the net verdict against Lavania was $1,269,000.

Actual Award:

$1,269,000

Trial Information:

Judge:

Jane Morrison

Trial Length:

3
 weeks

Trial Deliberations:

8
 hours

Post Trial:

Lockhart and Lavania negotiated a post-verdict settlement. Lavania’s insurer agreed to tender its policy, which provided $1 million of coverage.

Editor’s Comment:

This report is based on information that was provided by plaintiff’s counsel. Lavania’s counsel did not respond to the reporter’s phone calls, and the remaining defendants’ counsel were not asked to contribute.