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Missent Biopsy Might Have Lessened Tragedy

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A biopsy ordered by a radiologist might have lessened tragic brain damage and affected a multimillion-dollar lawsuit—if only the results had gotten to the right people.

Late last month, a jury in Erie County, Pennsylvania, awarded $3.5 million to a classical pianist and his wife for damage the man suffered after doctors at Hamot Medical Center in the city of Erie failed to diagnose and properly treat a brain infection. In fact, some of the treatment allegedly made the infection worse.

Martin Billey, 50, of Erie, now speaks with difficulty and has trouble comprehending words, math, entertainment—and music. He carries a card to inform people that he is neither drunk nor developmentally disabled. After the verdict, reported Lisa Thompson of the Erie Times-News, he spoke in halting, fragmentary sentences, saying he wished he’d never gone to Hamot. He did manage one final complete sentence: “They robbed me.”

The radiologist was not a defendant, but several other doctors were. However, the jury decided that the hospital, and not any individual doctors, was to blame and must pay.

Billey came to the emergency department on December 31, 2007, saying he was having trouble finding words and speaking. A brain scan revealed three 9 mm lesions, and a chest X-ray showed a mass in his lung that was consistent with the pneumonia for which he had been treated about two weeks earlier, according to court records. He had a slightly elevated temperature.

The plaintiffs said the doctors who treated Billey acknowledged from the beginning that his symptoms fit either cancer that had spread from his lung to his brain or a brain infection. However, the lawsuit said, the doctors treated Billey for cancer without confirming the diagnosis.

The neurologist on call ordered high doses of a steroid to reduce brain swelling, which, the plaintiffs said, worsened the infection. A pulmonologist called in to consult ordered a biopsy of the lung mass on January 2, 2008, but signed off on the case before reviewing the results of the biopsy, according to the lawsuit.

The biopsy failed to retrieve matter from the targeted area, so radiologist Joshua Rosenberg ordered a second biopsy on January 8. The results showed no lung cancer, but they were sent only to the head of radiology. No one else saw them.

On January 12, Billey complained that his head felt “full.” He vomited and could not speak coherently. He was rushed to Hamot, where a scan showed the brain lesions had quadrupled in size. An infectious-disease specialist and a neurosurgeon, both consulted for the first time, determined that an infection had destroyed large parts of Billey’s brain, according to court records.

The infection responded to antibiotics. Therefore, the lawsuit said, it could have easily been treated if Billey had been properly diagnosed during the first Hamot visit on December 31.

Lawyers for Hamot declined to comment.

Related seminar: Emergency Radiology

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