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DCH Healthcare Authority v. Duckworth12/19/2003
ng room pretty much expeditiously after finding out what was going on with him.
"Q. Well, now, prior to that, though, would it have made any difference if you had gotten there any earlier?
"A. No. No.
"Q. In your opinion, in your medical opinion, doctor, to a reasonable degree of certainty, would Mr. Duckworth's outcome have been what it was?
"A. Certainly. I see nothing about this course of events that tells me we could have corrected anything here by a time factor. You can always go back and say, well, is there some other management approach you could have taken, and it's a second guess. But, then, every time you try one of these other things, you can find other complications that could have or might have ar[isen]. So, sure, I don't see anything different to change."
(Emphasis added.)
Mrs. Duckworth refers to other portions of Dr. Jones's testimony in support of her argument that a more expeditious "diagnosis and treatment" would have placed her husband in a "better position than was in as a result," Shanes, 729 So. 2d at 321, of the two- or three-hour diagnostic period of which she complains. Specifically, she states:
"Dr. Jones said it would be reasonable to expect that this patient's hematoma was smaller at the time he was being left in the hallway two (2) hours earlier than he saw him. Dr. Jones recognized that the timing of diagnosis and evacuation of this bleed has an effect on outcome. He also agreed with Dr. Nelson that a delay in diagnosis would 'adversely affect' the patient's condition."
Mrs. Duckworth's brief, at 23 (citations to the record omitted). Dr. Jones's actual testimony in that connection is as follows:
"Q. [Mrs. Duckworth's counsel:] The timing within which a surgeon can evacuate a hematoma like Mr. Duckworth had has some effect on the likelihood of a good outcome, doesn't it?
"A. [Dr. Jones:] Certainly.
"Q. You want to get to it as soon as possible?
"A. That's always the ideal, yes.
"Q. Regardless of whether it's an elderly patient or an adolescent?
"A. That's correct.
"Q. When you say that subdural hematomas like Mr. Duckworth suffered from are known to have an 80% mortality rate, timing of surgical intervention and relieving the pressure has an effect on improving the likelihood of a better outcome?
"A. That's correct. Certainly, if you operate on it next week as opposed to today, that makes a big, big difference.
"Q. Well, and hours can make a difference, can't it.
"A. All the studies show -- well, I shouldn't say all the studies, but the standard of -- by head-injury studies, put it that way, have shown that you basically have a major change in mortality based on an eight-hour window after discovery of the subdural. Now that's not necessarily after the injury.
"....
"A. Because you don't have a precise time when the bleeding started ....
"....
"Q. Doctor, with this patient, taking in consideration specifically with a history of this fall and injury to his head on the escalator and his resulting course, can you tell us, in your opinion, when his hematoma began to form in the subdural region?
"A. I have no clue. I can't ---- I can only tell you where it was at the time when we did the CT [scan].
"Q. Would you expect that the subdural hematoma that you encountered and which you described as being large would have been smaller or less involved with bleeding two hours earlier?
"A. I would expect so, but I have no way of knowing that.
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