Defense Verdict for Attorney Kevin Popham

Plaintiff, a 62 year old female, presented to the emergency department with complaints of chest pain, shortness of breath, nausea and vomiting.  An EKG revealed atrial fibrillation with rapid ventricular response.  A CT scan revealed a worsening pericardial effusion and bilateral pleural effusions.  The patient was admitted to the care of our defendant cardiologist, whose plan was to perform a pericardiocentesis.  The patient’s pericardial effusion progressed to cardiac tamponade necessitating urgent drainage.  The cardiologist, who was assisted by a cardiology fellow, performed pericardiocentesis draining 700ml of fluid.  However, the patient did not experience improvement of tamponade signs and symptoms, the size of the pericardial effusion was unchanged, and follow-up injection of agitated saline did not opacify the pericardial space.  As a result, the physicians determined that the catheter tip had slipped into the pleural space and the fluid was pleural rather than pericardial.  The pericardiocentesis catheter was removed and the procedure was re-initiated.  Upon the second insertion the patient suffered injury to the left ventricle, and she was taken for emergent open heart repair during which she experienced pulseless electric activity and ventricular fibrillation required open chest massage.  Plaintiff alleged negligence in failure to take additional measures to further determine the location of the catheter prior to removal, as well as permanent neurologic injury secondary to anoxic encephalopathy.  The theory of defense was that ventricular injury is a known risk and accepted complication of the procedure, that the physicians took all appropriate measures before making the determination to re-initiate the procedure, and that there was no evidence of neurologic injury secondary to the pericardiocentesis or subsequent surgical repair.  The jury returned a 6-2 defense verdict after 1 hour of deliberation.

 

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