News
4/6/2007 - Doctor Wins Wrongful Death Case in Birmingham
BIRMINGHAM--After five days of trial, a Jefferson County jury returned a defense verdict in favor of Chivers Woodruff, M.D., and his professional corporation, Chivers Woodruff, M.D., P.C. Thomas H. Keene and Frank J. Stakely of Rushton, Stakely, Johnston & Garrett, P.A. represented the defendants.
The decedent was a 19-year-old sophomore at the University of Alabama. One year earlier, he had graduated from Mountain Brook High School as a football star and honor student. He attended the University of Alabama on a full academic scholarship as both a Presidential Scholar and formerly a National Merit Scholar. Throughout his year and a half in college, the patient suffered from recurrent upper respiratory/sinus infections for which he sought treatment at the Russell Student Health Center, a local ENT’s office, and on a couple of occasions, with the defendant, Dr. Chivers Woodruff, a family practice physician in private practice in Birmingham. At no time was the patient diagnosed with mononucleosis during any of those office visits.
The decedent’s family testified that he became ill sometime in early November 2001. He was seen at the ENT’s office on November 8th at which time he was diagnosed with a questionable sinus infection. When his condition did not improve, he was seen again in the ENT’s office on November 15th. He was again diagnosed with an upper respiratory infection and was given antibiotics and a steroid injection. The family testified that the patient never really recovered from this November illness and that he was not well while at home for the Thanksgiving holidays. They testified that he appeared to be pale, tired and run down. Following the Thanksgiving holidays, he returned to the University of Alabama and took final examinations, and after completion of finals, he returned home for the Christmas holidays.
On December 17, 2001, this young man went to work at his father’s contracting business. That morning, he called Dr. Woodruff’s office and made an appointment to be seen on December 19. He worked a full day on December 18th, and on the 19th, he was unable to make the previously scheduled doctor’s appointment because a pierce of heavy machinery broke down at work and he could not leave the job site until it was repaired. He consequently missed his doctor’s appointment. Early the next morning, his mother phoned Dr. Woodruff’s office and rescheduled the appointment for later that day, December 20th.
On Thursday, December 20, 2001, the patient presented to Dr. Woodruff’s office for evaluation. The history taken by the nurse revealed that he had been sick since over the weekend. Dr. Woodruff examined him but did not document the physical examination of his abdomen. Furthermore, he ordered no testing or lab work whatsoever. His diagnosis was bacterial pharyngitis, i.e. strep throat, and the patient was given a shot of Rocephin and a prescription for oral Augmentin. Prior to leaving the office, he was advised to call Dr. Woodruff if he did not get better, or, if he got any worse.
The patient remained home from work on Friday, and on Saturday, he developed severe abdominal pain. His mother called the on-call physician for Dr. Woodruff who changed the antibiotic. By the next morning, he was improved and the pain had resolved. He was now afebrile. Late that morning, he drove to Tuscaloosa to pick up his sister’s Christmas present, and he also visited his girlfriend who was living in Tuscaloosa. Sometime early that afternoon, the young man developed nausea, vomiting and severe abdominal pain. Because he felt so bad, he was unable to immediately return home. When he returned home late that night, his parents took him to the emergency room at Brookwood Medical Center. Fifty minutes after arriving at Brookwood Medical Center, he arrested and resuscitative efforts were unsuccessful. He was pronounced dead during the early morning hours of December 24, 2001.
Following the patient’s death, an autopsy was performed which revealed a massively enlarged spleen which contained a 15 cm. rupture. Lab testing done during the ER admission led to a diagnosis of infectious mononucleosis. The infectious mononucleosis had caused massive enlargement of the spleen as well as the ultimate rupture of the spleen. He died due to massive internal bleeding secondary to the splenic rupture.
Plaintiff’s expert, Dr. Patrick Guiteras, a 62-year-old family practice physician from Chapel Hill, North Carolina, testified that Dr. Woodruff breached the standard of care in many respects. He said that Dr. Woodruff should have performed an abdominal examination at which time he would have detected a massively enlarged spleen. Dr. Guiteras testified that the patient’s spleen was enlarged ten times its normal size and that it should have been easy to palpate had Dr. Woodruff done the required abdominal examination. He was further critical of Dr. Woodruff for failing to order diagnostic testing. He said that a CBC or Mono Spot test would have led to the diagnosis of infectious mononucleosis. Furthermore, had Dr. Woodruff made the diagnosis of infectious mononucleosis, he would have known to advise the patient that if he developed abdominal pain, nausea or vomiting, he should immediately go to the nearest emergency room. Had the patient presented to the emergency room that afternoon when his symptoms began, the diagnosis of splenomegaly would have been made in time to perform a life saving splenectomy. It was Dr. Guiteras’ ultimate opinion that had Dr. Woodruff properly diagnosed this patient, he would not have died at the young age of 19 years.
Defendant’s expert, Dr. Marshall Boone, testified that this was an acute onset of infectious mononucleosis and that mononucleosis is rarely diagnosed in the acute phase of the illness. Bacterial pharyngitis was a very reasonable diagnosis under the circumstances. He further testified that because the illness was less than a week old, a mono spot test would not have been positive nor would a CBC have led to the diagnosis. Dr. Boone said that the patient died of a very rare complication of mononucleosis and earlier intervention would not have been successful.
Stephen Shay Samples, S. Hughston Nichols of Hare, Wynn, Newell & Newton represented the plaintiffs.
Louis Franklin Pierce, Jr., Administrator of the Estate of Nicholas Franklin Pierce, Deceased, v. Chivers R. Woodruff, M.D.; Chivers R. Woodruff, M.D., P.C. Jefferson County Circuit Court, CV-03-7133.