John J. Snyder and Mary Ann Capriotti of Rawle and Henderson LLP recently obtained a defense verdict in a medical malpractice action in the Philadelphia County Court of Common Pleas. The decedent Donna Williams, age 51, reported to Frankford Hospital complaining of occasional right posterior flank pain for one month which had worsened within the last few days. She was admitted with a diagnosis of ureter calculus and renal insufficiency. The following day, Dr. Marc A. Lavine performed a cystoscopy and stone extraction with stent placement. Following the procedure the patient developed sepsis complications and died approximately 19 days later.

Plaintiff, Ms. Williams’ widow, alleged in his Complaint that Dr. Lavine was negligent for failing to properly diagnose and treat sepsis; for failing to properly diagnose and treat obstructive kidney stones, failure to diagnose and treat the cause of the debris in the kidney, delay in surgical intervention to treat, failure to recognize pus in the kidney, failure to obtain timely specialists consults and failure to admit her to intensive care.

The Honorable Marlene Lachman of Philadelphia County presided over the seven day trial. During the trial, Plaintiff’s urology expert Dr. Thomas Kasper testified that Dr. Lavine should have performed a less manipulative procedure, either a cystocopy and stent placement or a percutaneous nephrostomy, instead of removing the stone. Dr. Kasper testified there was undue delay in performing the operation and that an immediate infectious disease consult should have been ordered after the procedure was complete. He opined that the stone manipulation performed by Dr. Lavine caused the patient to become septic and eventually die.

On behalf of Dr. Lavine, the defense presented treating physicians Dr. Milt Coll and Dr. David Kraman as fact witnesses. The defense also presented Dr. Keith VanArsdalen, an urology expert from the Hospital of the University of Pennsylvania and Dr. Roger Nieman, an infectious disease expert from Abington Hospital. Dr. VanArsdalen testified that the surgery performed by Dr. Lavine was timely and within the standard of care. Dr. VanArsdalen specifically stated that stone removal was the proper procedure due to the stone’s size and location. Dr. Nieman, testified that an infectious disease physician would not have provided any different or additional treatment than was administered by Dr. Lavine and the other treating doctors.

During the trial the defense witnesses explained the pros and cons of a cystocopy and stent placement, percutaneous nephrostomy and the stone removal using computer generated animations which illustrated each procedure. The jury was also shown the actual instruments used during each procedure. By showing the jury the computer generated animations, in addition to the actual instruments, the defense was able to clearly demonstrate that the least manipulative procedure was to remove the stone.

After jury deliberation of approximately one day a defense verdict was rendered.