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Mayes v. Bryan, M.D. et al.

Dr. Fagel achieved a verdict of $4.3 million on behalf of the surviving family of a 39 year-old woman who died from septic shock after undergoing gastric bypass and cholecystectomy surgery. The surgery was initially successful and the decedent was scheduled to be discharged the next day. However, the decedent began to complain of nausea and vomiting, and then chest pains with a rapid heart rate and rapid breathing. Two surgical residents and the surgeon saw the patient and thought she had a pulmonary embolus. A lung scan was ordered and then sent to a radiologist, Dr. Bryan, who also interpreted the scan as showing pulmonary embolus and then informed the surgeon and a pulmonary specialist about the results. The decedent was then treated for a pulmonary embolus and her blood pressure immediately began to drop.

A nuclear medicine specialist, Dr. Wang, then viewed the lung scan and determined that the decedent had a low probability for a pulmonary embolus. However, he did not know that Dr. Bryan had misinformed the staff about the scan’s results hours earlier so he did not inform the staff of his diagnosis. A few hours later, the patient’s condition worsened with hypotension, an elevated white blood cell count and a 103 degree fever. Two hours later, five hours after Dr. Wang first saw the scan, Dr. Wang discussed the scan with the pulmonary specialist who then decided to take the patient back to surgery. During surgery, a gastric leak was found at the site of the bypassed stomach with 2-3 liters of bile in the abdomen. A blood clot was also found to be obstructing the decedent’s small bowel. After surgery, the decedent remained in critical condition and died of multi-system organ failure two months later. 

The defendants contended that the decedent’s scan and symptoms showed a moderate to high likelihood of a pulmonary embolus. The symptoms, when considered on their own, they argued, showed a high likelihood of a pulmonary embolus so the misinterpreted scan was not a factor in the management of the patient. However, Dr. Fagel proved that the negligent interpretation of the lung scan directly lead to the decedent's death. The misinterpretation of the scan resulted in the surgeon and pulmonary specialist treating the patient for a pulmonary embolus, which delayed the diagnosis and treatment of the true problem and eventual cause of death- a bowel obstruction from a blood clot that formed after surgery, resulting in a gastric leak that caused septic shock from peritonitis.