|
|
|
Medical Malpractice: Overdose of Chemotherapy
Family claims patient's death caused by overdose of 5-FU
| Disposition:
(Settlement/Arbitration/Trial) |
Settlement |
Date: |
2/23/2005 |
Type of Case: |
Medical Malpractice |
Allegation(s): |
Chemotherapy overdose causes patient's death |
Result: |
$1,358,000 |
Case Name: |
Charney & Bernstein v. UC Regents, et al. |
Facts: |
In February 2002, following a dental checkup, plaintiffs' decedent David Bernstein, 54, was diagnosed with Stage IV N2c MO squamous cell carcinoma at the base of his tongue. His cancer was then treated at the University of California Medical Center in San Diego by oncologist Vicky Jones, an associate professor of medicine at UCSD's Cancer Center, and otolaryngologist Robert Weisman, the director of head and neck oncology at UCSD Medical Group, as well as other healthcare providers at UCSD's Cancer Center. Because the primary tumor was relatively small and exophytic, the doctors at UCSD felt it would be amenable to radiation and chemotherapy.
Subsequently, Bernstein underwent bilateral dissection of his neck and concurrent radiation therapy with Cisplatin chemotherapy. In mid-June 2002, he completed his chemotherapy. At a follow-up appointment, Weisman's impression was that Bernstein was actually doing better than the average patient with base of tongue cancer.
Because Bernstein had N2 disease (nodal involvement), the UCSD doctors recommended a follow-up round of chemotherapy with Cisplatin and 5-fluorouracil (5-FU). Starting on August 12th, Bernstein began adjuvant chemotherapy. Because he did not want a peripherally inserted central catheter (PICC) line, the 5-FU was given by bolus rather than a continuous infusion. When switching from continuous infusion to bolus route, the dose of 5-FU needs to be significantly reduced. Bone marrow suppression (myelosuppresion) is greatest when 5-FU is administered as an intravenous bolus, whereas it is insignificant when it is administered via PICC line. Unfortunately, the dosage of 5-FU was never decreased. Mr. Bernstein received 800 mg/mm or 1500 mg of 5-FU, and this overdose occurred daily over the course of five days.
On August 25th, Mr. Bernstein was admitted to the UCSD Medical Center suffering from hypoxia. His white blood cell count was 0.1 and his red blood cell count, hemoglobin and hematocrit were all low. His platelet count was very low. Mr. Bernstein was intubated, became septic and finally succumbed to hypoxia, metabolic acidosis and leukopenia/thrombocytopenia on August 29th.
|
| Injury/Injuries: |
Plaintiffs claimed damages for the wrongful death of their husband and father. They claimed that David Bernstein, who at the time he was diagnosed and being treated for his tongue cancer, was shifting his career focus from an attorney to the custom home building industry. The plaintiff asserted that he was actively involved in the design of high-end custom homes and was beginning to realize a profit from his business when his life was cut short. The plaintiff claimed past economic damages of approximately $800,000; future economic damages of approximately $5.3 million; and $250,000 in general damages (per MICRA cap on medical malpractice cases in California).
|
| Contentions: |
Bernstein's wife, Anita Charney, and their two adults children, Justin and Ariel Bernstein, sued the Regents of the University of California, Jones and Weisman, alleging wrongful death and medical malpractice. They contended that the defendants were negligent in the route and dosage of their administration of 5-FU, and that it was the overdose of 5-FU that directly caused the decedent's death. They argued that but for the neglignece of the defendants, decedent had a statistical probability of five-year survival and cure.
The defendants admitted their negligence for purposes of settlement discussion only, but contended that their liability was limited based on their position that the decedent's life expectancy was less than five years. They also disputed the decedent's projected income losses.
|
| Special Notes: |
Plaintiffs demanded $1,800,000. Defendants offered $1,000,000 and then raised it to $1,258,000 by a CCP §998 offer.
|
|  |
|
|
|
