$2,350,000 Recovery in Wrongful Death Aortic Dissection Case
Daryl L. Zaslow of Eichen Crutchlow Zaslow, LLP (Edison, Red Bank and Toms River), obtained a $2,350,000 settlement on behalf of the Estate of a 53 year old man who died from an aortic dissection. At the time of his death on October 18, 2013, Plaintiff left surviving a wife and two adult children. The case was scheduled for trial on March 11, 2019 and the settlement was reached on March 6, 2019 during a settlement conference before the Honorable Craig L. Wellerson, J.S.C.
Jonathan Rabkin was a 53 year old man when he presented to the Community Medical Center Emergency Department at 0109 on 10/18/2013 complaining of the sudden onset of upper abdominal pain radiating to the back. There was associated nausea and vomiting. He was seen by the Defendant attending emergency physician. After ordering labs and after a chest x-ray demonstrated an apparent wide mediastinum the emergency room physician ordered a chest CT angiogram (a CT with contrast) to rule out an aortic dissection, however, the physician subsequently canceled the contrast administration due to concerns regarding the elevated creatinine. As such, the CT scans of the chest and abdomen were ultimately performed at 0341 on 10/18 without IV contrast.
The Defendant radiologist, provided a preliminary interpretation of the CT scans at 0404 and a final read of these CT scans at 0501. This Defendant’s interpretation of the Chest CT noted a 5.2 cm fusiform ascending thoracic aortic aneurysm. Although the final report of the Chest CT prepared by the radiologist notes that the results were “relayed to the emergency room” the emergency room physician testified he was never told that the CT demonstrated a 5.2 aortic aneurysm and that the radiologist nformed him there “was no acute process” noted on the CT scan. As such, at 0407, Mr. Rabkin was admitted to the hospital for observation status and he was passed off to the on-duty hospitalist who was also a Defendant. It was not until 0903 that a contrast enhanced CT scan was performed of the chest revealing an extensive Type A aortic dissection with hemopericardium. At that time, arrangements were being made to emergently transfer Mr. Rabkin to Pennyslvania Hospital for the surgical repair of the aortic dissection, however, at 10:25 Mr. Rabkin became profoundly unstable and despite full resuscitative he could not be resuscitated. He was pronounced dead at 1148 on 10/18/13.
Mr. Zaslow and his experts maintained that a noncontrast CT scan cannot reliably diagnose or exclude the diagnosis of aortic dissection which is a life-threatening condition. As such, they argued that once the emergency physician ncluded an aortic dissection in his differential diagnosis it was incumbent on him to ensure that test was performed. Here, the Defendant initially ordered the correct test when he ordered the CT angiogram, however, his decision to cancel this and proceed instead with a noncontrast CT of chest was a decision that fell below the standard of care and caused unnecessary delay in diagnosing the aortic dissection.
Mr. Zaslow and his experts also maintained that the radiologist also deviated from accepted standards of radiology by not immediately contacting the emergency room physician and advising him of his finding of an ascending thoracic aneurysm and of the urgent need for a CT angiogram with contrast to exclude a dissection. As per these issues, Plaintiffs’ experts maintained that in a setting in which the ordering physician is considering an aortic dissection the finding of an aortic aneurysms is a critical finding that must be immediately communicated to the ordering physician and that the radiologist must also recommend the necessary study to ensure a timely diagnosis.
Plaintiffs’ experts were also critical of Defendant Hospitalist for contributing to the delay in not ordering the CT angiogram as soon as she became responsible for the patient upon his admission to the hospital at 0407.
Mr. Zaslow and his experts in thoracic surgery maintained that had a timely diagnosis been made, Mr. Rabkin could have easily been transferred from Community Medical Center to a hospital that was actually capable of performing the requisite surgical repair of acute ascending aortic dissections. As per this issue, Community Medical Center, which is part of the RWJ Barnabas Health System, is not a cardiac surgery center capable of performing emergent surgical repair of an aortic dissection. Jersey Shore University Medical Center is a cardiac surgery center fully capable of performing the surgery Mr. Rabkin required to save his life and was the closest such hospital to Community Medical Center.
The Defendants’ experts opined that even if Mr. Rabkin was diagnosed with an aortic dissection at approximately 0407, it would still have taken 6-10 hours to effectively transfer him to another institution that was capable of performing this surgery and therefore Mr. Rabkin would not have been saved.