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Radiologist Blamed In Trial, Not Named In Suit

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In a strange medical malpractice lawsuit in Kentucky, everybody blamed the radiologist—except, apparently, the family that filed the suit.

Central Kentucky News, the joint website of four small newspapers, reported on key testimony here and on the trial verdict here. The tragic case began on April 9, 2010, when Doug Smith, a farmer from Preachersville in central Kentucky, was admitted to Ephraim McDowell Regional Medical Center in nearby Danville. Smith, 75, was vomiting and complaining of severe stomach pain.

Doctors discovered an intestinal blockage. Barry Spoonamore, MD, performed gastric bypass surgery on April 17. Smith developed a gastric leak and on April 25 was transferred to the University of Kentucky Medical Center in Lexington. He died there on April 29.

Much of the lawsuit revolved around a CT scan performed on April 24 by board-certified radiologist Joshua Phelps, MD. The scan showed “free air,” a sign of a leak, but Dr. Phelps did not mention that in his report. Smith’s wife and children sued Dr. Spoonamore, saying he should have looked at the scan himself.

The family also sued Tariq Muhammad, MD, Smith’s attending physician, saying he should have looked at the CT scan as well. And the family sued Ephraim McDowell, although the judge dismissed the medical center as a defendant during the trial.

The lawsuit did not name Dr. Phelps as a defendant.

Dr. Spoonamore defended himself in trial testimony:

I saw no reason not to believe a board-certified radiologist’s report. He saw [the free air] but didn’t mention it. I think that’s a mistake.

Asked whether he would have noticed the free air had he seen the scan, Dr. Spoonamore replied, “It was obvious.”

In her closing argument, Barbara McGuire, one of Dr. Muhammad’s attorneys, blamed Dr. Phelps. “If you see free air, you pick up the phone,” she said. “Why isn’t Dr. Phelps here? I can’t answer that question.”

The trial concluded in late February. The Boyle County Circuit Court jury took only an hour and 20 minutes to clear both Dr. Spoonamore and Dr. Muhammad.

An autopsy revealed that Smith had advanced pancreatic cancer. He likely would have lived only a few more weeks no matter what the outcome of the abdominal surgery.

Related CME seminar (up to 11.25 AMA PRA Category 1 credits™): UCSF Abdominal & Pelvic Imaging: CT/MR/US


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