Doctor Botched Young Girl's Laser Treatment, Suit Claims; More

Wayne Guglielmo, MA

December 20, 2019

The family of an 8-year-old girl who sustained severe injuries 2 years ago after receiving laser treatments to remove a birthmark has sued her Minnesota dermatologist for malpractice, according to a report in the Star Tribune.

Shortly after her birth in 2011, the girl began receiving laser treatments for a port-wine stain on the left side of her face. At the time, a physician at a multispecialty group practice headquartered in Minneapolis employed a pulsed dye laser (PDL) to treat the girl's birthmark.

PDL uses a concentrated beam of light to target and superheat the hemoglobin in red blood cells; the intent is to lighten or, in a small number of cases, completely clear the port-wine birthmark. In all, the dermatologist administered more than 25 PDL treatments to her young patient over the next 6 years.

Beginning in 2017, though, the doctor recommended a new approach to the girl's mother, using the more powerful Nd:YAG laser. The mother consented to the new treatment, but in her suit against the doctor and University of Minnesota Physicians, she claims that the dermatologist withheld pertinent information, including her inexperience with using the Nd:YAG laser and its greater risks compared with PDL.

On October 25, 2017, the physician initiated preliminary Nd:YAG laser testing, administering five pulses in each of two sites on the child's face. On December 13, nearly 2 months later, the child had completed a full round of treatment. During this later procedure, the lawsuit claims, the physician "at times doubled and more than doubled the energy used" compared with the test procedure, and significantly increased both the number of pulses and the size of the treatment area.

The suit states that the girl developed painful injuries soon after the December 2017 treatment. Photos of those injuries — including "several circle-shaped, deep, open wounds stretching in a curve from near the girl's nose to near her ear" — were submitted as part of the lawsuit, which was filed last month in Hennepin County (Minn.) District Court. (The plaintiff has also claimed that the physician "endorsed improper wound care" over the phone instead of referring the girl for proper care.)

"No one can look at these pictures and…reasonably reach the conclusion that this young child received appropriate medical care," said Jeff Storms, the plaintiff's attorney.

But Ryan Ellis, the attorney for the physician and her medical group, sees things differently: "We sympathize with this patient and her family. [But] the physician and her group fully stand by and support the medical care and treatment provided to this patient and plan to defend this case."

Woman Who Should Not Have Received Liver Transplant Can Move Her Case Forward

A lawsuit against the University of Pittsburgh Medical Center (UPMC) will move forward after Pennsylvania's high court overturned a ruling with regard to a state statute, as a story in American Legal News reports.

The ruling stems from a suit involving a family in which the mother, Susan Yanakos, suffered from alpha-1 antitrypsin deficiency (AATD). In the summer of 2003, a general surgeon at UPMC told her that her disease had progressed to the point that she required a liver transplant. After extensive testing involving a UPMC gastroenterologist, it was determined that Yanakos' son, Christopher, was a suitable donor.

At this point, the boy advised his doctors that, like his mother, several members of his family had AATD but was uncertain whether he was among them. Additional lab tests were ordered for him, and in September 2003 the transplant moved forward.

But 12 years later, in 2015, the family learned that Christopher did in fact have AATD, after additional testing made it clear that his mother still had the condition. The family alleged that, at the time of the transplant, UPMC doctors never revealed the fact that Christopher, too, had AATD. As a result, Susan received a portion of a liver from someone (albeit a direct relation) with the same condition that had irreparably damaged her organ in the first place.

The family sued UPMC and the physicians, claiming medical malpractice. The trial court dismissed the suit, however, arguing that the claim fell outside of the state's statute of repose, part of the Medical Care Availability and Reduction of Error (Mcare) Act of 2002, which gave plaintiffs in the Keystone State a total of 7 years after sustaining and discovering an injury to file a suit. Since nearly 12 years had elapsed since Susan Yanakos' transplant, according to the law the family would not be permitted to have its case heard. (In contrast to the statute of repose, Pennsylvania's statute of limitations gives medical malpractice plaintiffs 2 years after discovering an injury to file a claim.)

The plaintiffs appealed the ruling, but the appellate court upheld the lower court's decision. The Supreme Court of Pennsylvania, however, took issue with both the trial and appellate court decisions. Arguing that the statute of repose both denies public access to the courts and "is not substantially related to an important government interest," the high court reversed the two lower court rulings and "remanded [the case] for further proceedings."

Although the high court finding doesn't tilt the scales in favor of the plaintiffs, they will nevertheless be permitted to have their day in court.

Patient's $30 Million Award Is Put on Hold

A federal appeals court has handed down a split decision in the $30 million case of a man who underwent a kidney transplant after being treated by an East St. Louis, Illinois health clinic, explains a report in the St. Louis Post-Dispatch.

In 2008, after failing a pre-employment physical because of his high blood pressure, Kevin Clanton went to a clinic run by the Southern Illinois Healthcare Foundation, a state- and federally funded provider of primary care services with multiple locations throughout southern and central Illinois.

There, he saw a nurse practitioner who was an employee of the US Public Health Service. Over the course of two visits, the NP diagnosed Clanton with obesity and severe hypertension, prescribed sample medications to lower his blood pressure, and instructed him to return in a week.

For the next two years, Clanton apparently failed to follow the NP's treatment instructions. It was only after flunking another employment screening that he sought treatment again.

This time, the same NP prescribed more medication and told Clanton to return in a week. Three weeks later, he arrived for a follow-up appointment, during which the provider saw that her patient's blood pressure had risen even higher — to 240/160 mm Hg — and his vision was blurred.

When further treatment failed to lower his blood pressure, she sent Clanton to the emergency department of a local hospital, after which she started him on several different drugs and scheduled a series of follow-up appointments.

During this period, the NP noted that Clanton had failed to follow his new medication regimen, but the NP "didn't follow up on lab results, consult a doctor, or fully explain [her patient's] condition," according to the district court judge who eventually heard Clanton's suit.

On December 22, 2012, Clanton was taken to Barnes-Jewish Hospital in St. Louis. While there, he learned he had kidney damage and that "high blood pressure" and "hypertension" were two terms describing the same medical condition. Had he understood what hypertension meant, he would have been more compliant with his treatment regimen, his legal team contended.

By February 2013, Clanton had been diagnosed with stage 5 chronic kidney disease, and by November of that year he had been placed on a transplant waiting list. He received a new kidney approximately 2 years later, although in the future he may still require additional dialysis and transplants.

In 2015, Clanton sued the federal government for the NP's alleged malpractice.

Two years later, a US District Court decided in his favor, noting that his injuries were the "proximate result of the NP's deviations from the standard of care." The court awarded him just shy of $30 million.

The government then appealed the district court's decision. Last month, the three-judge appeals panel upheld the district court's award but not its apportioning of blame. In other words, Clanton could still receive his mega-award, but the trial court must now reexamine to what extent he was responsible for his own injuries. It could decide to reduce the award if it finds that his own negligence — that is, his failure to follow the prescribed drug regimen — contributed to those injuries.

At press time, no date had been set for further deliberations.

Wayne J. Guglielmo, MA, is an independent journalist based in Mahwah, New Jersey.

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