Listen to this articleThe decedent was a 25-year-old male with a significant cardiac history, including rheumatic fever with consequent rheumatic heart disease, heart valve replacements, and aortic root replacement.
In 2012, he required further cardiac surgery, which was complicated by respiratory failure, ARDS and infection. He was also treated for C-diff colitis based on substantial diarrhea in the setting of having received antibiotics.
The patient was ventilator-dependent for several weeks and eventually transitioned to requiring the vent only at night. He had experienced significant muscle atrophy and weight loss during the approximately three-month hospitalization.
The decedent was eventually cleared to be discharged to a long-term pulmonary rehabilitation facility. He arrived alert and oriented. The next morning, however, his lab studies revealed an elevated white blood count and his oxygen saturation had dropped to the 50s to 60s, requiring intervention.
He had a CXR that raised the question of pneumonia, and he was noted to have been increasingly agitated. The morning nurse documented that he had not made any urine during her shift.
The defendants were the morning nurse and the attending doctor. The plaintiff claimed that they failed to recognize that there were signs and symptoms of sepsis and that the delay in recognition of his condition led to a failure to treat it in a timely manner with IV antibiotics and transfer to tertiary care.
The defendant doctor claimed that the decedent’s condition was entirely consistent with his baseline after having been so dramatically compromised for months following the surgery. The nurse claimed that the information about the decedent’s condition was all readily available to the doctor and that she had no responsibility for diagnosis of his condition.
However, on cross-examination, the doctor was forced to concede that the nurse had not apprised her of several hours without urine production, which she testified was below the standard of care expected of the nurse. The defense also tried to claim that the death was from C-diff, not pneumonia as alleged by the plaintiff, and it would take 12 hours of antibiotics at a minimum to prevent death from C-diff. Thus, even with earlier diagnosis, there was not sufficient time to prevent the plaintiff’s death.
Plaintiff’s counsel illustrated the lack of any clinical evidence of active C-diff at rehab, and the plaintiff’s expert opined that signs of it on autopsy were merely present because of the prior episode of it after the surgery.
Action: Medical malpractice
Injuries alleged: Wrongful death
Case name: Adriano v. Liang, et al.
Court/case no.: Superior Court/No. MICV 1582CV06408
Jury and/or judge: Jury/Judge Maureen B. Hogan (settled on last day of evidence)
Amount: $2.85 million
Date: Nov. 14, 2023
Attorneys: Adam R. Satin and Griffen Rose, of Lubin & Meyer, Boston (for the plaintiff)
