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Jury sides with doctor over infected appendix

A Greene County jury ruled that a doctor is not responsible for injuries to a patient who alleged that he should have discovered an infected appendix.

“The allegation was that there was either an inflamed appendix or a ruptured appendix that went undiagnosed,” said Randy R. Cowherd of Haden, Cowherd & Bullock, which represented the defendant Dr. Patrick Brooks.

Jerry D. Skaggs visited Mercy Hospital in November 2012 with chest and abdominal pain and was diagnosed with gallbladder problems, according to the plaintiff’s court filings. The organ was surgically removed, and Skaggs was discharged only to arrive back at the hospital four days later with shortness of breath. Abdominal scans revealed a ruptured appendix and an abscess.

The plaintiff’s petition alleged that a white blood-cell count on the initial visit should have pointed to something other than a gallbladder issue.

“The contention was that with that elevated white count and no indication of an infected gallbladder, you should have looked for something else and if you would have you would have caught this ruptured appendix,” Cowherd said. “That was the essence of it.”

Cowherd said he countered that the appendix had ruptured weeks before Skaggs ever came to the hospital and hadn’t given a comprehensive history of his troubles when he arrived.

“He came in with just chest pain and didn’t tell us that 30 days before he had been doubled over with pain in the lower abdomen to the extent that he couldn’t even work for several days,” he said.

The plaintiff’s expert contended the rupture could have happened while he was under medical care, Cowherd said.

“He said that he looked at a sample taken of the abscess that was found a week later and he said this looks like it was about seven to 10 days old which would mean it formed while he was in the hospital,” Cowherd said.

However, Cowherd said his own expert, a pathologist from Harvard, disagreed and found evidence of cells that react to an infection that indicated the rupture had happened weeks previous to Skaggs’ admission.

Doctors made an appropriate diagnosis based on the available information, Cowherd said.

“The signs and symptoms were classic for gallbladder and he had no signs or symptoms that would lead us to think there was anything else going on,” he said.

There wasn’t much dispute over the extent of the injury, Cowherd said.

“He had to have sections of the bowel removed,” he said. “They had to reconnect it and that connection failed, which can happen. He had to have another surgery to fix that and a lot of rehab.”

He said it was mostly a battle of experts though other testimony played a role as well.

“One of the things that we thought helped us was that we got the wife to testify that the husband had in fact had this episode 30 days before hospitalization where he was bent over in pain,” Cowherd said. “She felt he should have gone to the hospital and didn’t.”

He also said his client made a good impression on the stand.

“My doctor did an exceptional job testifying,” he said. “I think the jury liked him and felt he was competent.”

Brian Johnston of Johnson, Vorhees & Martucci, which represented the plaintiff, did not return a request for comment.

Defense verdict

Medical malpractice

Venue: Greene County Circuit Court

Case Number/Date: 1431-CC00135/April 24, 2015

Judge: Michael Cordonnier

Plaintiff’s Experts: Jordan Goodstein, Culver City, California (general surgeon); Paul Cohen, New Haven, Connecticut (pathologist)

Defendant’s Experts: Scott Hockenberry, Columbus, Ohio (general surgery); Robert Odze, Boston (pathologist)

Last Pretrial Demand: $500,000

Last Pretrial Offer: $0

Caption: Jerry and Shirley Skaggs v. Mercy Clinic Springfield Communities and J. Patrick Brooks, M.D.

Plaintiff’s Attorney: Brian D. Johnston, Johnson, Vorhees & Martucci, Springfield

Defendant’s Attorney: Randy R. Cowherd, Haden, Cowherd & Bullock, Springfield

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