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Murphy v. Bernice Community Rehabilitation Hospital10/26/2005
reated Ms. Murphy on March 25, 2002, he obtained and reviewed copies of the carotid ultrasound ordered by Dr. Harris on March 13, 2002, and the CT scan done at Lincoln General Hospital. The Tri-Ward Clinic records indicate that Ms. Murphy's daughter accompanied her and reported symptoms of left-sided weakness, mouth drooping, and changes in mental status. Based on all the information he had, Dr. Shaw determined that there was no reason to repeat the CT scan or treat Ms. Murphy as a stroke victim. Instead, he agreed with her family that she might benefit from a stay in a rehabilitation hospital, and he arranged for her admission to BCRH. He testified that Ms. Murphy's ability to perform her ADL's had dramatically decreased from 1999 to 2002.
Plaintiff's expert, Dr. Richard Smith, testified that Dr. Shaw should have repeated the CT scan on March 25, 2002, to determine whether Ms. Murphy had suffered a stroke. He testified that left-sided weakness, slurred speech, and disorientation are indicative of stroke rather than of Bell's palsy. He believed that Ms. Murphy should have been admitted to an acute care hospital until her condition stabilized before beginning rehabilitation. However, Dr. Smith knew of no treatment that would have prevented the stroke, and he had no opinion as to whether her outcome would have differed if she had been hospitalized for observation on March 25, 2002. Dr. Smith was the only expert witness to testify that Dr. Shaw breached the standard of care in failing to diagnose or properly treat Ms. Murphy as a stroke patient.
Dr. Thomas L. Morris is an internist who began treating Ms. Murphy in April 2002. He believed that Dr. Shaw met the standard of care in diagnosing Bell's palsy and in referring Ms. Murphy to BCRH for rehabilitation. He testified that considering her test results, he would have made the same diagnosis and decision. Moreover, he did not believe that any delay in treating Ms. Murphy as a stroke patient affected her outcome. Dr. Morris disagreed with the assertion that a physician has duty to review the nurse's notes. He testified that physicians will generally talk to the nurses to get up-to-date on a patient's condition and will read the progress notes taken by the physicians.
Dr. Chris Earnhardt, a family physician who treated Ms. Murphy while at MMC, also testified that Dr. Shaw did not breach the standard of care in not ordering a repeat CT scan or diagnosing the stroke on March 25, 2002. He explained that Ms. Murphy's daughter reported subjective complaints but that Dr. Shaw's objective findings did not include left-sided weakness. He noted that no other physician, including Dr. Mays, had then detected any left-sided weakness, and he testified that he would rely on his own findings or another physician's findings over a nursing assessment of left-sided weakness.
Finally, Dr. Don K. Joffrion, an orthopaedic surgeon who was a member of the medical review panel, also testified that Dr. Shaw met the standard of care in treating Ms. Murphy on March 25, 2002. He believed that Bell's palsy was an appropriate diagnosis at the time, though in hindsight and with the benefit of all the medical information, it appeared that she began having symptoms of an evolving stroke as early as March 13, 2002. However, he concluded that even if her stroke symptoms had been diagnosed earlier, there was nothing to be done to prevent it.
The parties presented conflicting testimony as to whether Dr. Shaw should have ordered a repeat CT scan on March 25, 2002, before referring Ms. Murphy for rehab. However, the experts were in agreement that an earlier diagnosis would have had no effect on her outcome and would not have prevented the stroke. It
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