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Date: 08-01-2003

Case Style: ANTHONY DOWNS -v- MUHAMMAD NASSERUDDIN, NATIONAL EMERGENCY SERVICES, INC., an Illinois Corporation, HIGHLAND HOSPITAL CORPORATION, a Delaware Corporation d/b/a HIGHLAND COMMUNITY HOSPITAL, NORTHWEST SUBURBAN COMMUNITY HOSPITAL, INC., a Delaware Corporation d/b/a HIGHLAND COMMUNITY HOSPITAL, INDEPENDENT PHYSICIAN ASSOCIATES, L.L.C. an Illinois Limited Liability Corporation d/b/a HIGHLAND COMMUNITY HOSPITAL; FOREST HEALTH SERVICES CORPORATION a Delaware Corporation doing business in Illinois.

Case Number: 2000 L 24

Judge: Gerald Grubb

Court: Boone County (17th Judicial Circuit, IL)

Plaintiff's Attorney: Mark Rouleau, Rockford, Illinois 61108

Defendant's Attorney: Douglas Pomatto of Heyle Royster Voelker & Allen, Rockford, Illinois for Muhammad Naseerrudin and National Emergency Services

David P. Faulkner of Faulkner & Jensen(formerly of Lord, Bissell & Brook), Rockford, Illinois and Jon Papin of roderick, Steiger & Maisel (St. Paul Captive Law Firm in Chicago), Chicago, Illinois for Highland Hospital Corporation

Amy Kane of Anderson, Bennett & Partners, Chicago, Illinois for Forest Health Services Corporation

Description: MEDICAL MALPRACTICE -FAILURE TO DIAGNOSE (Delayed Diagnosis) - SLIPPED CAPITAL FEMORAL EPIPHYSIS (SCFE)

The plaintiff age 13 presented to the walk in clinic at Highland Community hospital complaining of pain in his left groin and hip. The clinic was closing for the day and the plaintiff was transferred to the emergency room at the Hospital. The defendant Dr. MUHAMMAD NASEERUDDIN was working in both the walk in clinic and the ER. He was a contract employer of the Defendant NATIONAL EMERGENCY SERVICES (NES). Dr. NASEERUDDIN diagnosed the plaintiff as suffering a pulled groin muscle and told him to work it out and that he needed to do more exercise. The plaintiff was morbidly obese for his age. X-Rays (radiographs) were taken at the time. The x-rays were read by a radiologist who reported his findings that the plaintiff suffered a SCFE. The findings were reported the day after the visit. Those x-rays were later determined to show a 20% slip of the growth plate in the upper end of the femur. Although such a finding required immediate non-weight bearing and surgical intervention to prevent further slippage and permanent injury to the effected limb, no contact was initiated with the plaintiff's parents or his family physician. The radiology report indicated that it had been sent to the defendant Dr. MUHAMMAD NASEERUDDIN he denied ever having received it. The report was placed in the plaintiff's medical chart which consisted of a total of 13 pages.

Approximately one month later after school had resumed from the summer break the plaintiff again appeared at the walk in clinic. The plaintiff had been told that he would have to participate in physical education (gym class) unless he obtained a doctor's written excuse. When he returned to the defendant Hospital they immediately placed him on crutches and sent him to see his family physician. The plaintiff's family physician immediately referred the plaintiff to see Orthopedic Surgeon Mark Barba who diagnosed a 50% slippage of the SCFE and performed an immediate pinning of the affected femur.

The defendant FOREST HEALTH SERVICES CORPORATION acquired the hospital between the time that the plaintiff initially presented himself to the ER to the time that his SCFE condition was actually communicated to his parents and family physician.

Several months later the plaintiff developed a similar situation with his right hip which was immediately pinned leaving the plaintiff with no residual in the right lower extremity. Because of the degree of slippage to the left femoral growth plate the plaintiff was at a greatly increased risk of traumatic arthritis in that hip. As a result in the failure to promptly diagnose and treat the left SCFE the plaintiff walked with a limp, had a shortened left leg (aprox. 1") and his left foot was rotated outward to a non-anatomical position causing the plaintiff difficulty with tasks such as pedaling a bicycle. The pin that was placed in the plaintiff's left hip worked loose requiring its removal. At the time of settlement the plaintiff (then 18) had been diagnosed as suffering asymptomatic arthritis in his left hip.

The defendants contended that the delay was not the cause of the plaintiff's arthritis. Medical literature shows that with a 20% slip there is little or no chance of arthritis due to the slip however once the slip becomes more than 40% the likelihood of premature arthritis is almost a certainty. SCFE is a condition that emergency room doctors are taught to look for in adolescent males (especially those who are obese) presenting with the plaintiff's symptoms. The treating orthopedic surgeon stated that the defendant ER physician should have been able to easily recognize the SCFE from examining the initial x-rays taken in the ER.

The defendant hospital (St. Paul Insurance) paid $350,000. The defendant doctor (CNA Insurance) and his employer paid $150,000 and the subsequent purchaser of the hospital paid $25,000. TOTAL $475,000

Outcome: SETTLEMENT - $475,000.00

Plaintiff's Experts: Unavailable

Defendant's Experts: Unavailable

Comments: Reported by Mark Rouleau



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