10/1/2010 - Arasin vs. Mehlman, M.D.Verdict: $475,000
Case: Arasin vs. Mehlman, M.D.
Case No: 017377/2004
Court: Queens County
Judge: Phyllis Orlikoff Flug
Date: 10/1/2007
Plaintiff Attorney(s): Gregory D. Bellantone, Esq. Trial Counsel for the Law Firm of Targum, Britton & Tolud, LLP
Defense Attorney(s): The Law Firm of Velella, Basso & Calandra and The Law Firm of Shaub & Amity
Facts and Allegations: In this medical malpractice case, the female plaintiff contended that the defendant doctor failed to take into consideration her history of post delivery episiotomy and rectal reconstruction before performing a colonoscopy on her. As a result, the defendant performed a colonoscopy on the plaintiff that ultimately failed and subsequently required and additional surgery and extended hospital stay. The plaintiff claimed that during her hospital stay, she experienced irreparable pain and a drain in her rectum. She maintained that after her discharge she was unable to resume her household duties and required the assistance of family members. Furthermore, the plaintiff claimed that she missed approximately three weeks of work and that when she did return to work, she was forced to limit her activities. The defendant argued that the plaintiff failed to make him aware of the fact that she had an episiotomy and rectal repair following the birth of her second child until after he performed a colonoscopy on her. Furthermore, the defendant argued that he did not depart from accepted medical practices.
The evidence revealed that the famale plaintiff was 45 years old and employed as a paraprofessional with the Board of Education when the incident occurred. The plaintiff contended that she first consulted with the defendant on January 28, 2002. The plaintiff testified that she presented to the defendant doctor with complaints of rectal bleeding, blood in her stool and intermittent diarrhea, which allegedly persisted for approximately three months. The plaintiff additionally complained that she had six to eight bowl movements per day, which were small in volume. The plaintiff maintained that the defendant advised her to undergo a colonoscopy, which was to take place at Peninsula hospital. The plaintiff's medical records indicated that following the colonoscopy, she was taken to the recovery room and that the defendant's post-operative discharge notes indicated that the plaintiff had been stable and was able to be discharged. The plaintiff testified that following the colonoscopy, she felt extremely nauseous and had pain in her buttocks. She further testified that she had vomited and had dry heaves. The plaintiff testified that another surgeon examined her after the surgery and that examination revealed that she had sustained a rectal tear during surgery and that was forced to undergo a subsequent same-day additional surgery, which required a five day hospital stay. The plaintiff maintained that she was very apprehensive that she required additional surgery and an extended hospital stay for repair of her rectal laceration.
The defendant doctor testified that he performed a digital rectal examination, which revealed that there had been no mass lesions palpitated. The defendant opined that the plaintiff's rectal bleeding was most likely secondary to local irritation, rather than hemorrhoids. The defendant testified, and entered into evidence, medical documentation from Peninsula hospital which revealed that he performed a physical exam and a pre-operative history prior to the colonoscopy. The defendant maintained that the plaintiff's physical preoperative physical exam included an evaluation of the plaintiff's heart, abdomen and lungs. Plaintiff's counsel argued that the defendant did not make an entry in the chart next to the genitalia / rectal portion of the post operative examination record. Furthermore, plaintiff's counsel argued that the defendant signed the post-operative examination report, but failed to mention in the record any indication that a digital rectal exam had been conducted on the plaintiff on February 21, 2002, prior to the colonoscopy.
The defendant testified that he scheduled a colonoscopy for the plaintiff that took place on February 21, 2002, at Peninsula Hospital, to further evaluate the firmness felt on the digital rectal exam. The defendant maintained that after he inserted the scope into the plaintiff's rectum, through the sigmoid colon, the descending colon, around the splenic fluxure, down the hepatic flexure and the ascending colon to the cecum. The defendant then maintained that he withdrew the scope and attempted to perform retroflexion, but was unable to complete the maneuver. The defendant claimed he reversed the attempted retroflexion and observed what he termed as an "outpocket" in the rectum. The evidence revealed that a note, signed by the defendant on February 21, 2002, stated that the defendant's post-colonoscopy attempt at retroflex had been unsuccessful, but their had been a large outpocket just inside the rectum. The defendant maintained that upon questioning the plaintiff after the procedure, the plaintiff stated that she had rectal reconstruction post-delivery, bud did not think it was important to mention this during the post-surgical history and physical examination.
The plaintiff testified that during her office visit with the defendant on January 28, 2007, she told the defendant that she had experienced an extensive laceration and episiotomy after the delivery of her second child in 1990. Plaintiff's counsel entered into evidence the defendant's notes from the office visit specified by the plaintiff. Plaintiff's counsel argued that the defendant doctor failed to record the fact that the plaintiff had a history of an episiotomy in 1990. The defendant testified, on direct examination, that he did not have an independent recollection of the events of the case beyond what was written in his office notes and hospital charts. Also admitted into evidence were the plaintiff's medical records from Mercy Hospital, dated February 23 to February 26 of 1990, and attested to by the plaintiff's attending ob/gyn. The medical records ultimately supported the fact that plaintiff delivered her second child vaginally, during which she sustained a fourth degree laceration with an episiotomy and repair of the laceration of the rectum and anus.
Following the completion of the colonoscopy, the plaintiff was declared as stable and ready for discharge, as per the defendant's discharge summary. However, that same day, a colo-rectal surgeon, who examined the plaintiff, testified that per his post-operative consolation, the plaintiff had a history of a grade IV laceration of the vagina with episiotmy, which required rectal repair. The surgeon ordered a CT-scan for the plaintiff, which revealed that the plaintiff had a perforated rectum, which was subsequently repaired under general anesthesia. The surgeon's discharge notes, entered into evidence, stated that "status post-colonoscopy with rectal defect noted at attempt at retroflex, most likely related to history of prior rectal repair with prior laceration." As a result of the required additional surgery that was performed on the plaintiff, she was forced to remain in the hospital for five days. |
