Doctor Sued For Requiring Receptionist's Abortion Also Caused Patient to Lose Limbs, Court Finds

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Dr. Meenakshi Prabhakar, an infectious disease specialist, probably wishes August would hurry up and end already. Earlier this month, we wrote about Prabhakar's receptionist, who sued the doctor for allegedly forcing her to get an abortion. Why? Tough to say. But someone from Prabhakar's office told us it was a "shakedown."

Now, per a Dallas state appeals court opinion, the doctor may be out $5.2 million to compensate a patient who developed a nasty, hospital-acquired, antibiotic-resistant case of pneumonia that necessitated the amputation of every necrotic limb by the time Prabhakar and others diagnosed it. David Fitzgerald, the plaintiff, says their bumbling cost him his body.

In 2003, Fitzgerald showed up at RHD Memorial in terrible shape -- rapid weight loss, stomach pain, nausea, vomiting and a history of reflux. Dr. Richard Holmes, the admitting doctor, diagnosed him with an ulcer that would require surgery. He discharged Holmes from the hospital and performed the surgery 11 days later. Everything seemed to go well, and Holmes placed Fitzgerald on a course of antibiotics. In three to five days he should have been ready to go home. But after three days, he got worse. His blood pressure fell, and his temperature rose. His body showed all the hallmarks of sepsis, with infection attacking his entire body. By that evening, Fitzgerald slipped into septic shock, meaning his vital organs weren't receiving enough blood.

Enter Prabhakar, the infectious disease expert, who suspected the patient was suffering from peritonitis, a surgery-related abdominal infection. Prabhakar, the opinion says, prescribed a broad-spectrum antibiotic that would wipe out most common pathogens -- except Methicillin-resistant Staphylococcus aureus (MRSA), a hospital-grown superbug most antibiotics can't touch.

Other specialists were brought in, but none could find the source of infection. Meanwhile, Fitzgerald was slipping away. His body went into survival mode, pulling blood away from his extremities and to the vital organs. A few days later, his arms and legs were cool to the touch from lack of circulation. The doctors prescribed a drug called Xigris to keep blood moving through Fitzgerald's limbs. Holmes performed an exploratory surgery, but didn't find the abdominal infection Prabhakar predicted. In the process, he had to discontinue the use of Xigris temporarily. Fitzgerald's kidneys failed. A consulting nephrologist gave him a dose of Vancomycin, an antibiotic intended to prevent skin pathogens from infecting the dialysis injection site. The drug also happens to kill MRSA.

After a few days, they began to suspect Fitzgerald might have pneumonia, not peritonitis. They sampled mucus from his lungs, grew it in culture and treated the bacteria with Vancomycin. What they found was MRSA pneumonia, that stubborn, antibiotic-resistant disease acquired in the hospital. Fitzgerald recovered, but the damage to his limbs due to poor circulation was already done. He developed gangrene. Both arms were amputated below the elbow and both legs below the knee.

Holmes and the other physicians settled with Fitzgerald before trial, but Prabhakar held out. Fitzgerald claimed he would still have his limbs if Prabhakar had prescribed Vancomycin to treat what turned out to be the second-most common hospital-acquired infection. The jury agreed, and found the doctor 100 percent responsible for Fitzgerald's injuries and awarded him nearly $18 million in damages. The court reduced the figure to $5.2 million to reflect the state statutory cap on damages and the settlements already paid by the other doctors.

The appeals court upheld the trial court's award Friday.

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"After a few days they began to suspect ... pneumonia not peritonitis"  Ever hear of chest  x rays? Seriously...

This appears to be a pretty typical "old school" malpractice suit where every medical practitioner who touched the patient plus the facility was sued.  Obviously the patient had multiple medical conditions. Trial lawyers love this sort of thing and expert witnesses can be found to profess to negligence almost 100% of the time.( a typical expert makes $300 -$400/hr.per deposition-- trials  cost more-- it's an industry )Juries are very sympathetic  to injured parties with terrible outcomes and will  allow large monetary awards

The MRSA  may have been acquired as a result of the initial surgery or maybe not--since it is prevalent in gyms schools etc.  Peptic ulcer disease and pneumonia are so completely different clinically that the article seems incoherent and illogical.  the final settlement figure may be significantly smaller that the amt quoted because the of the Malpractice Ins co limits.  You seem to have a vendetta against this  physician  Both stories (the disgruntled receptionist, the patient ) seem  to lack convincing detail.

holmantx topcommenter

Get used to it.  


Th Affordable Healthcare Act is dumping 40 million new covers on the existing doctor supply, removes $700 Billion from Medicare to make it revenue neutral, and doctors already are saying they are over-worked.


The NHS (National Healthcare Service) in the UK now employs 40% third world and East European trained doctors because nobody wants to be a doctor - too much work, too little pay, too much schooling, too much debt, too much liability.  That's our future Mein Katz.


And six of the seven Muslim terrorists who drove a truck bomb into the Glasgow airport terminal were imported doctors.  The seventh was an imported med tech.  All in on fast track medical visas.


We are imploding the best system on the planet, while the UK's NHS is converting big chunks of their back to the private sector.


Fortunately, help is on the way.

Myrna.Minkoff-Katz topcommenter

RHD... hmmm.  I never heard of it.  I wonder how it rates compared to a great facility like Baylor. There must be some sort of ranking of Dallas area hospitals somewhere.

ScottsMerkin topcommenter

will 5.2 million buy him artificial arms and legs and rehab the rest of his life.  doubt it.  

Myrna.Minkoff-Katz topcommenter

 @holmantx "Help" in the form of a certain hypocrite who fashioned the prototype for Obamacare with his Massachusetts plan, and now alternately blasts it and brags about it according to the crowd he's speaking to?  Yes?

holmantx topcommenter

 @Myrna.Minkoff-Katz that presupposes I give a shit about what Romney says regarding universal healthcare.  It's like blaming the total eocnomic destruction of America on Bush.


Who cares?


See if you can get your head around this:  A succession of Congresses, both Repub and Dem acting in concert, passed spending legislation that borrowed on Entitlement collections thus blowing up the existing government healthcare system.  So they cooked up another goofy plan to replace the one they blew up through malfeasance.  But we still owe on the last one.  So they fold the debt into the new one then keep spending money they cannot collect.  This one only prolongs the day of reckoning long enough so our statesmen can retire and slip away into their retirement that doesn't rely upon the system they cooked up for the rest of us.  And you bit hook line and sinker.


But it doesn't matter any more.  This plan is no better than the plan they blew up.  





Myrna.Minkoff-Katz topcommenter

 @Scruffygeist  Wrong.  On two counts.  "Pray" and "Pray tell" are both correct.  Secondly, you spelled "pray" wrong.


Dear, sweet Scruffy.  I'm afraid you're not quite ready to parry with Myrna.


 @ScottsMerkin  @cynicaloldbastard Myrna is :


A) Jim Schutze in drag

B) one of Anna Merlan's multiple schizoid personalities.

C) Eric Nicholson's shrewish mother-in-law

D) Barbara Boxer's nom de plume

E) just another tiresome yenta

F) All of the above

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