By Damian D. Capozzola, Esq., and Jamie Terrence, RN
News
On Nov. 22, 2024, a Philadelphia County jury awarded $6.8 million in a medical malpractice case to the estate of a patient who died after experiencing complications from a procedure to treat liver cancer. The lawsuit alleged negligence on the part of the hospital and its medical staff for failing to identify a stomach perforation that occurred during the procedure.
The case centered around a March 2020 procedure in which the patient underwent a radiofrequency ablation (RFA) to treat a liver tumor. The complaint alleged that, during the procedure, the equipment was improperly placed, causing thermal injury that perforated the patient’s stomach. Despite worsening symptoms in subsequent hospital visits, the patient was misdiagnosed and discharged multiple times before eventually developing sepsis. She remained hospitalized for weeks before succumbing to her injuries in April 2020.
The lawsuit, brought by the patient’s family, asserted negligence, wrongful death, and a survival action against the hospital and its medical staff. The jury found in favor of the family and awarded the woman’s estate $6.8 million in damages.
Background
The case arose from a series of events following a medical procedure performed in March 2020. The patient, a woman being treated for liver cancer and cirrhosis, underwent RFA — a procedure designed to destroy cancerous tissue in the liver using heat. The procedure was performed by a doctor at the defendant hospital, but, according to the complaint, the RFA equipment was negligently placed, resulting in thermal injury and perforation of the patient’s stomach.
The plaintiff’s complaint alleged that, after the procedure, she was discharged prematurely without appropriate evaluation, even though the injury had already occurred. The patient returned to the hospital days after the procedure, complaining of shortness of breath and chest pain. She was misdiagnosed with heartburn and discharged again. A few days later, the patient sought care a third time for worsening abdominal pain. Her estate alleged that her condition was not adequately investigated this time either, and she was once again sent home without a proper diagnosis.
In March 2020, the patient presented at the emergency department with significant right upper quadrant abdominal pain and was found to be septic. A subsequent computed tomography (CT) scan revealed a large perihepatic abscess, fluid collections, and pneumoperitoneum (free air in the abdominal cavity). The estate alleged that these signs all indicated a gastrointestinal perforation and infection. The patient was admitted and underwent multiple interventions, including the placement of a drain and an exploratory laparotomy. Surgeons discovered a perforation in the stomach caused by thermal injury from the RFA procedure.
Despite aggressive treatment, the patient’s condition continued to deteriorate. She developed complications, including abdominal sepsis, organ failure, and a high-output gastrointestinal fistula. By April 2020, further endoscopic intervention was planned, but the patient experienced respiratory arrest. She was critically ill, and by April 13, 2020, she experienced septic shock, respiratory failure, and cardiac arrest. After failed resuscitation efforts, she was pronounced dead.
The lawsuit, filed by the patient’s family, alleged that the defendants’ failure to timely diagnose and treat the patient’s injuries caused her condition to worsen and led to her death. The complaint emphasized the multiple missed opportunities to recognize the perforation and prevent further harm. The estate’s claims included professional negligence, wrongful death, and a survival action against the treating physician and the hospital.
At trial, the plaintiffs argued that the defendant doctor’s failure to properly address the misplaced probe during the liver ablation procedure constituted clear negligence. They presented evidence, including CT scan images, to demonstrate that the thermal injury and resulting perforation occurred during the operation. The plaintiffs also emphasized that the defendant doctor knew the probe had migrated but failed to act appropriately, discharging the patient without further evaluation or informing her family of the complication.
The defense acknowledged that the probe had moved during the procedure but claimed that the defendant doctor had adjusted it correctly and that the patient met all discharge criteria. The defense further argued that the patient’s preexisting medical conditions, including liver cancer, cirrhosis, and hepatitis C, affected her surgical outcome and reduced her life expectancy, which they claimed diminished the damages.
The jury ultimately found the evidence of negligence compelling and awarded $6.8 million in damages, reflecting both the conscious pain and suffering experienced by the patient and the loss sustained by her family.
What This Means for You
A key argument by the defense was that the patient’s preexisting medical conditions — liver cancer, cirrhosis, and hepatitis C — affected her surgical outcome and reduced her life expectancy, which they argued should limit any amount of damages she was awarded. However, the jury awarded $6.8 million despite these ailments, signaling that juries will not necessarily discount damages when there is sufficient evidence of negligence. The plaintiffs showed that the patient’s conditions were manageable and that her treatment, including the RFA, was intended to clear the way for a life-saving liver transplant. The jury’s decision shows that preexisting conditions can be extensive, but they do not excuse negligent care and that evidence of these preexisting conditions at trial may have a questionable impact on a jury, particularly when those conditions are actively being treated.
The $6.8 million award was divided into two categories: wrongful death damages and survival damages. Wrongful death damages are intended to compensate the patient’s family for the loss of their loved one. These damages account for the financial and emotional losses experienced because of a plaintiff’s death, including loss of companionship, guidance, and support. In this case, the jury’s significant award likely reflects their recognition of the impact the patient’s death had on her family, including the loss of her role as a mother, family member, and source of emotional support.
For the family, these damages acknowledge the emotional toll of her preventable death and provide a form of restitution for the life that was lost. Survival damages compensate the estate for the suffering endured by the patient before her death. This includes conscious pain and suffering, medical expenses, and the emotional toll of enduring an injury that was preventable. The jury likely considered the prolonged suffering caused by the misdiagnosed condition, repeated discharges, and sepsis. The award acknowledges the patient’s emotional distress and physical agony, as well as the financial burden of the treatments she underwent in an attempt to save her life.
While jury deliberations are confidential, the substantial award suggests that the evidence of repeated missed opportunities to recognize and address the patient’s injury strongly influenced the outcome. The plaintiffs presented compelling evidence, including CT scans, showing that the thermal injury and perforation occurred during the procedure. The jury likely found the failure to address the known equipment migration, coupled with the repeated misdiagnoses and premature discharges, as particularly egregious.
From a practical treatment perspective, also keep in mind that when a patient complains of unexpected symptoms following a procedure, care must be taken to thoroughly investigate the source of these symptoms. The fact that this patient had multiple visits to the hospital with worsening symptoms presents a challenge because of her comorbitities. However, rather than assume that these symptoms are caused by her general medical condition, the practitioner must instead realize that her general condition requires an even more rapid evaluation because this type of patient will be more likely to succumb to an injury, if one exists.
A general rule to manage risk is this that if the patient experiences symptoms that are not expected or are more severe than what the average patient experiences following the same intervention or with a similar diagnosis, further investigation and/or expert consultation is required. Physicians and surgeons have heavy patient loads, and the easy path often is chosen because it often is the only way the load can be managed. Contrast that with the individual patient who has nothing but time to suffer with the pain of a misdiagnosed or undiagnosed illness or an undetected or untreated injury. This can be very compelling to a jury. From a legal perspective, multiple failures to act often strengthen a plaintiff’s claim by showing a pattern of negligence rather than a single, isolated mistake. While the jury’s role is not to punish defendants (as punitive damages are separate and typically not awarded in negligence claims), large compensatory awards can reflect a jury’s frustration with clear evidence of preventable harm.
Juries also can be unpredictable. The defense’s evidence in this case that the patient’s preexisting conditions could have contributed to her condition and should have contributed to her damages could have been strong. When presented with persuasive evidence of preventable harm, juries may surprise defendants with large damages awards, even when plaintiffs have significant preexisting conditions. For whatever reason, the jury here appeared to give little weight to the defendant’s arguments in rendering their verdict.
It remains uncertain whether the defendants in this case will appeal the jury’s decision, but appealing a jury verdict is an uphill battle in most circumstances. Appellate courts often apply a deferential standard of review to the findings of a jury, particularly when it comes to factual determinations such as negligence, causation, and the extent of damages. Unless the defense can demonstrate a clear legal error — such as improper jury instructions, the admission of inadmissible evidence, or an incorrect application of the law — appellate courts often refuse to disturb a jury’s verdict. This deference stems from the principle that juries, having observed the live testimony and evidence firsthand, are best equipped to evaluate credibility and resolve conflicting accounts.
For the defendants, this poses a significant challenge. Once a jury awards damages, overturning that decision on appeal is rare unless there are compelling procedural or legal grounds. While an appeal may delay the ultimate resolution of the case, it also prolongs the uncertainty and may carry additional financial and reputational costs for the defendants. This reinforces the importance for healthcare providers and their defense teams to present the strongest possible case at trial, as the jury’s verdict often is the final word. Being forced to appeal a substantial damages award is far from an ideal position, as it places the outcome squarely in the hands of an appellate court that may be likely to defer to the jury’s findings.
Reference
- Verdict on Nov. 22, 2024, in the Philadelphia County Court of Common Pleas, Case No. 220400891.
Damian D. Capozzola, Esq., The Law Offices of Damian D. Capozzola, Los Angeles
Jamie Terrence, RN, President and Founder, Healthcare Risk Services, Former Director of Risk Management Services (2004-2013), California Hospital Medical Center, Los Angeles
On Nov. 22, 2024, a Philadelphia County jury awarded $6.8 million in a medical malpractice case to the estate of a patient who died after experiencing complications from a procedure to treat liver cancer. The lawsuit alleged negligence on the part of the hospital and its medical staff for failing to identify a stomach perforation that occurred during the procedure.
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