Unnecessary angiogram caused quadriplegia: patient
|Negligent Treatment, Medical Malpractice - Brain Injuries, Medical Malpractice - Failure to Detect, Medical Malpractice - Hospital, Medical Malpractice - Neurologist, Medical Malpractice - Neurosurgeon, Medical Malpractice - Unnecessary Procedure|
|Robyn Frankel v. Palo Alto Foundation Medical Group Inc. and Stanford Hospital & Clinics, No. 1-08-cv-103310|
|Superior Court of Santa Clara County, San Jose, CA|
|Carol W. Overton
- David A. Bovino; Law Offices of Bovino & Associates; Aspen, CO, for Robyn Frankel
- Jeffrey S. Mitchell; Emison Hullverson Mitchell LLP; San Francisco, CA, for Robyn Frankel
- Issam Awad M.D.; Neurosurgery; Chicago, IL called by: Jeffrey Mitchell, David Bovino
- Joseph Capell M.D.; Physical Medicine; Fresno, CA called by: Jeffrey Mitchell, David Bovino
- Carol Hyland M.A.; Life Care Planning; Lafayette, CA called by: Jeffrey Mitchell, David Bovino
- Chi Zee M.D.; Neuroradiology; Los Angeles, CA called by: Jeffrey Mitchell, David Bovino
- Robert Taylor M.D.; Neuroradiology; Minneapolis, MN called by: Jeffrey Mitchell, David Bovino
- Edward Herskovits M.D.; Neuroradiology; Philadelphia, PA called by: Jeffrey Mitchell, David Bovino
- Phillip Allman Ph.D.; Economics; San Francisco, CA called by: Jeffrey Mitchell, David Bovino
- Marc G. Cowden; Galloway, Lucchese, Everson & Picchi; Walnut Creek, CA, for Stanford Hospital & Clinics
- Susan E. Foe; Dryden, Margoles, Schimaneck & Wertz; San Francisco, CA, for Palo Alto Foundation Medical Group Inc.
- Frank E. Schimaneck; Dryden, Margoles, Schimaneck & Wertz; San Francisco, CA, for Palo Alto Foundation Medical Group Inc.
- Erik Gaensler M.D.; Neuroradiology; Berkeley, CA called by: Frank Schimaneck, Susan Foe
- Scott Kush M.D.; Life Expectancy & Mortality; Menlo Park, CA called by: Frank Schimaneck, Susan Foe
- Bruce Adornato M.D.; Neurology; Palo Alto, CA called by: Frank Schimaneck, Susan Foe
- Van Halbach M.D.; Neuroradiology; San Francisco, CA called by: Frank Schimaneck, Susan Foe
- Randall Higashida M.D.; Neuroradiology; San Francisco, CA called by: Marc Cowden
- Bruce McCormack M.D.; Neurosurgery; San Francisco, CA called by: Frank Schimaneck, Susan Foe
On Oct. 20, 2006, plaintiff Robyn Frankel, 42, a commercial realtor, presented to Stanford Hospital & Clinics to undergo a scheduled angiogram. However, it is reportedly unknown who ordered the test.
Frankel was previously diagnosed with developmental venous anomaly after falling off a horse as a teenager. A subsequent CT scan showed an abnormal cluster of blood vessels in her brain. This resulted in her developing migraines in her adult life.
In the mid-1990s, she came under the care of neurologist Joseph Lacey at the Palo Alto Medical Foundation. Frankel's migraines became so severe that she was forced to quit her job as a financial analyst and go on temporary disability. Compounding her condition, in the late '90s, she was diagnosed with the clotting disorder polycythemia vera.
After experiencing an exacerbation of migraines in 2006, Frankel presented to Lacey, who suspected that the exacerbation was caused by the medication she was taking for her polycythemia vera. An MRI was administered and showed no change in her brain. Lacey then recommended that she see Paul Jackson, a neurosurgeon at the Palo Alto Medical Foundation, who ordered another MRI. Since the physician did not observe a change in the cluster of blood vessels, he felt that Frankel's increased migraines were not related to her clotting medication, but attributed it to her classic migraine complex. Frankel claimed that Jackson told her he would consult with interventional neuroradiologist Michael Marks of Stanford Hospital & Clinics.
According to Frankel's counsel, Jackson presented Marks the films, but there is no documentation as to what the two physicians discussed. Frankel's counsel cited Marks' deposition testimony in which he said that upon looking at the MRI films, he observed developmental venous anomaly as well as venous sinus occlusion. According to Frankel's counsel, Marks testified that he did not recommend any course of action to Jackson. Frankel's counsel also cited Jackson's deposition testimony whereby he said that he had a 40-minute conversation with Marks, and Marks not only recommended an angiogram, but he agreed to take ownership of the patient (Frankel). Thus, Frankel's counsel claimed that Jackson left the MRI films with Marks and did not speak to Frankel thereafter.
Frankel alleged that she followed up with Lacey again, which is supported by medical records. In the records, Lacey wrote, "Headaches getting better. By the way, she's having an angiogram at Stanford recommended by Jackson."
On Oct. 20, 2006, Frankel presented to Stanford to undergo the scheduled angiogram, but when dye for the angiogram was injected into the blood vessels of her brain, a vasospasm occurred and caused Frankel to suffer a devastating stroke. She was rendered comatose, and when she awoke roughly two months later, she was a quadriplegic.
Frankel sued Palo Alto Foundation Medical Group Inc. and Stanford Hospital & Clinics, alleging that the angiogram was an unnecessary and unwarranted procedure.
Stanford Hospital & Clinics ultimately settled for a confidential amount on the first day of trial, and was subsequently dismissed from the case.
According to Frankel's retained expert interventional neuroradiologist, the physicians at Palo Alto suspected that Frankel suffered from a micro-arteriovenous malformation -- a condition that can only be confirmed via an angiogram. However, the suspicion was gravely inaccurate since the condition is so rare that there are only 13 reported cases in the world, stated the expert. Moreover, the expert testified that an angiogram is a highly risky procedure that contains a 1-in-100 chance of stroke and/or death. Thus, the expert opined that it is extraordinarily unlikely for a physician to detect something new in an angiogram that cannot already be seen in Frankel's previous, multiple MRIs. These theories were further supported by Frankel's retained neuroradiology experts.
Palo Alto's counsel maintained that Stanford ordered the test, and that the test was necessary and appropriate to evaluate the anatomy of Frankel's brain, since the physicians suspected that she suffered a micro-arteriovenous malformation. This theory was supported by Palo Alto's retained medical experts.
Frankel suffered a vasospasm when dye for the angiogram was injected into the blood vessels of her brain, causing a devastating stroke. She was subsequently rendered comatose, and when she awoke roughly two months later, she was a quadriplegic.
Frankel remained hospitalized for three months at Stanford Hospital & Clinics and was then discharged to her home in Menlo Park, where she currently resides. She remains wheelchair-bound, requiring around-the-clock care for eating, mobility, toileting and transportation. According to her attorney, Frankel speaks in a slow, halting matter, but her cognitive faculties remain intact. Frankel undergoes regular speech, occupational and physical therapies. She has two children, ages 10 and 16, and an ex-husband (the couple divorced following the incident).
Thus, Frankel sought recovery of approximately $16 million in damages for a life-care plan, which included damages for future care and about $2 million in damages for her past and future lost earnings. Frankel, who testified about the quality of her life pre- and post-injury, sought further recovery of unspecified amounts in non-economic damages for her past and future pain and suffering.
Palo Alto's life-expectancy expert criticized Frankel's life-care plan, testifying that given that Frankel suffered a severe stroke and is quadriplegic, she only had 16 more years to live.
The jury found that the physicians at Palo Alto Foundation Medical Group were negligent in the care and treatment of Frankel, and determined that the group's negligence was a substantial factor in causing her harm. Thus, Frankel was awarded $22,014,384 in total damages. The jury further noted that the present value of Frankel's future economic loss was $8,906,965 as of the date of verdict.
$1,577,894 Personal Injury: Past Medical Cost
$12,680,844 Personal Injury: Future Medical Cost
$421,956 Personal Injury: Past Lost Earnings Capability
$1,333,690 Personal Injury: FutureLostEarningsCapability
$2,000,000 Personal Injury: past non-economic loss
$4,000,000 Personal Injury: future non-economic loss
Frankel and Palo Alto Foundation Medical Group Inc. entered into a confidential settlement.
This report is based on information that was provided by plaintiff's counsel. Counsel for Palo Alto Foundation Medical Group Inc. declined to contribute. Counsel for Stanford Hospital & Clinics did not respond to the reporter's phone calls.