March 7, 2014

Contact: Eric W. Boyer, Esq.
Managing Partner/Operations
305-670-1101 Ext. 1023




Medical Malpractice – Negligence – Wrongful Death

Scott Sankey

Robert Cousins

FORT MYERS, Florida ― Quintairos, Prieto, Wood & Boyer, P.A., trial attorneys Robert J. Cousins, managing partner of the Fort Myers office and Scott C. Sankey, a partner in the Fort Lauderdale office, achieved a defense verdict in a medical malpractice claim on behalf of a Board Certified family practice specialist.  The plaintiff, 64 years old, became a patient of the defendant in July 2006.  He had undergone replacement of his aortic valve in 1993 and had been regularly taking Coumadin to prevent the formation of clots on the artificial valve.  Coumadin is monitored by regularly obtaining a laboratory value called the INR which shows the anti-coagulation properties in the blood.
The treating cardiologist and the previous primary care doctor, who had been following the plaintiff since 1993, documented in their records that they wanted to maintain the patient with an INR level of 2.5 to 3.5.  The risk of Coumadin administration when the INR level gets too high is bleeding, including bleeding in the brain.  The risk when the INR level gets too low is a higher risk of forming a clot.  The clot can then travel to the brain and cause a stroke.  The defendant decided to maintain the patient at a level of 2.0 to 3.0, to lessen the risk of bleeding.  The defense argued this was the evolving trend in medicine for Medtronic-Hall aortic valves.
The plaintiff suffered a significant stroke in January 2007 which left him with a right sided hemiparesis and difficulty speaking and communicating.  The plaintiffs also claimed that his death, three years later, was related to the deficits which remained following the stroke.  The plaintiffs alleged that the stroke was caused by a low INR which at the time of the stroke was shown to be 1.8.  The plaintiff claimed that the level was too low and that when the previous doctors had kept the plaintiff at the higher levels he never had a problem.
During the trial, the defense demonstrated that the specific type of valve used in the case, a Medtronic-Hall valve, when placed in the aortic position has the lowest risk of clot formation of any type of mechanical valve.  The defense was also able to demonstrate that several physicians who treated the plaintiff after the stroke agreed that a level of 2.0 to 3.0 was appropriate.  The defense contended that the risk of a bleed with the particular valve was many times higher than the risk of a clot formation, and therefore, the defendant’s decision to use the lower level was appropriate and consistent with this particular artificial valve.
The defense also argued that the location of the actual stroke was not consistent with a stroke that would come from a clot in the heart and therefore, that the plaintiff was unable to prove that the stroke, and the plaintiff’s ultimate death was as a result of a clot from the mechanical valve.
The jury returned a complete defense verdict in favor of the family practice physician.

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