State Court Returns Unanimous Defense Verdict
5/2/2012
On April 17, 2012, a state court jury in Garland County, Arkansas, returned a unanimous verdict in favor of Dr. Joel Hardin and St. Joseph’s Mercy Health Center, rejecting plaintiff’s allegation that the doctor was negligent in failing to diagnose a fractured lumbar vertebra during an emergency room examination. The doctor and the hospital were represented at trial by DRI members Edwin L. Lowther and David P. Glover of Wright, Lindsey & Jennings LLP in Little Rock, Arkansas.
The plaintiff’s claims arose out of Dr. Hardin’s examination of plaintiff Dianne Arbec after she had been involved in a single-vehicle accident that occurred on July 8, 2006. Before she arrived at the hospital by ambulance, Ms. Arbec reportedly complained of neck and back pain. By the time she reached the ER, plaintiff was refusing to verbally communicate with the doctor or nurses. Dr. Hardin performed a complete physical and neurological assessment of Ms. Arbec, and finding no clinical evidence of a fracture, cleared her lumbar spine. He ordered a series of CT studies, including one of the abdomen and pelvis, but did not order a dedicated CT of the lumbar spine.
Later in the day, Dr. Hardin received a report from Dr. Michael Hickman, a radiologist, that there were no significant abnormalities on any of the CT films. Dr. Hardin medically cleared the patient. Because there was some question as to whether Ms. Arbec’s accident was actually a suicide attempt, he made arrangements to have her transferred to a psychiatric hospital. The morning after the transfer, Ms. Arbec was unable to move her legs. A neurosurgeon ordered a dedicated CT of the lumbar spine which revealed a fracture of the L-1 vertebra that had impinged the spinal cord, leading to Ms. Arbec’s paralysis.
Plaintiff sued Dr. Hardin and his employer, St. Joseph’s, alleging that Dr. Hardin could not have conducted a complete neurological assessment on a patient who refused to cooperate and provide a history or any other information. She claimed that due to her altered mental status, Dr. Hardin could not clinically conclude that she had not injured her lumbar spine, and should have requested a dedicated study of the spine. She argued that if a dedicated study had been ordered, the radiologist would have easily detected and reported the fracture to Dr. Hardin. With that information, Dr. Hardin would have requested a neurosurgical consult, which would have resulted in surgery preserving Ms. Arbec’s motion function in the legs. Plaintiff sought $11 million in damages.
Dr. Hardin and his expert witnesses testified that he performed a complete clinical examination of Ms. Arbec, and that based on this examination, the standard of care permitted him to conclude that there was no significant injury to the lower back. They also noted that Dr. Hardin ordered a CT scan of the abdomen and pelvis, and that on this CT scan, the radiologist could have, and should have, seen the fracture at L1. The radiologist, who had been sued by Ms. Arbec but settled her claims against him before trial, acknowledged that the fracture was visible on the film, and that he had no good explanation for why he had not seen it. Both plaintiff and defense experts testified that an emergency medicine physician may rely on a diagnostic radiologist’s findings. Plaintiff argued, however, that despite the radiologist’s report that the film was negative, because Dr. Hardin had not done a complete assessment earlier, he needed to perform another examination of Ms. Arbec after she had become more lucid to assure himself that she had no other complaints.
Following a seven-day trial, the jury deliberated for one and a half hours and returned a unanimous verdict in favor of Dr. Hardin and St. Joseph’s