Three physicians accused of failing to promptly treat a patient's heart condition agreed on March 6 to a $2.35 million settlement in an Ocean County wrongful death suit by the patient's family, Rabkin v. Varma.

Jonathan Rabkin, 53, went to the emergency room at Community Medical Center in Toms River on Oct. 18, 2013, for sudden-onset upper abdominal pain radiating to the back with associated nausea and vomiting. The attending emergency room doctor, Vikram Varma, ordered a CT angiogram of the chest with contrast, but then cancelled the contrast administration due to concerns about elevated creatinine in Rabkin's system, according to plaintiff attorney Daryl Zaslow of Eichen Crutchlow Zaslow in Edison.

Radiologist Paul Shieh, who interpreted the CT scans, noted a 5-centimeter aortic aneurysm. Shieh's report noted that the results were relayed to the emergency room, but Varma testified that Shieh told him there was “no acute process,” and Varma also said he was never told that a 5-centimeter aortic aneurysm was found, Zaslow said.

Three hours after Rabkin arrived at the hospital, Varma admitted him for observation, turning him over to on-duty hospitalist Luzminda Anama. Later the same day, Rabkin had a CT scan with contrast, revealing an extensive tear in the aorta and blood in the pericardial sac of the heart. Plans were then made to transfer Rabkin to Pennsylvania Hospital, in Philadelphia, for surgical repair of the torn aorta. But Rabkin soon became unstable and could not be resuscitated. He was pronounced dead 10 hours after his arrival.

The medical malpractice suit named Varma, Shieh and Anama. If a timely diagnosis had been made, Rabkin could have easily been transferred to another hospital for heart surgery, the suit claimed. The suit also challenged the decision to transfer to a Philadelphia hospital rather than much-closer Jersey Shore University Medical Center, which was capable of performing the procedure, Zaslow said.

The suit claimed Varma's decision to call off the contrast CT test deviated from the standard of care because a non-contrast test could not reliably diagnose or rule out the existence of aortic dissection. And the suit claimed Shieh's failure to promptly contact Varma and notify him of the test results were a deviation from the standard of care. Anama deviated from the standard of care by not promptly ordering the CT scan with contrast, the suit claimed.

According to Zaslow, defense experts opined that even if Rabkin were diagnosed with an aortic dissection within three hours of his arrival at the emergency room, it still would have taken him six to 10 hours to transfer him to another institution capable of performing the surgery, and therefore he would not have been saved.

The settlement was reached during a settlement conference with Superior Court Judge Craig Wellerson. The terms call for Varma to pay $1.25 million, Shieh to pay $750,000, and Anama to pay $350,000.

Varma's lawyer was Paul Schaaf of Orlovsky Moody Schaaf & Conlon in Long Branch. Shieh was represented by Michael Halpin of Grossman Heavey & Halpin in Brick. Anama's lawyer was Michael Riccardulli of Ruprecht Hart Weeks & Riccardulli in Westfield.

None returned calls about the case.

— Charles Toutant

$1.75M Auto Settlement in Monmouth

Verdiglione v. Ellenberg: A Marlboro Township man who suffered concussions from a vehicle accident, and ultimately dropped out of a college engineering program, entered a $1.75 million settlement in Monmouth County Superior Court on March 6, less than a week before the case was to go to trial.

The case was mediated on Feb. 1 before retired Monmouth County Superior Court Judge Bette Uhrmacher. It was settled five days before it was scheduled for trial on March 11.

Plaintiff Thomas Verdiglione claimed that on Jan. 28, 2014, when he was an 18-year-old high school senior, he was rear-ended while driving westbound on County Road 520 in Marlboro Township. The vehicle that struck Verdiglione from behind was driven by defendant Marc Ellenberg, who was also traveling westbound along the same route.

After the accident, plaintiff attorney Erroll J. Haythorn, of Gill & Chamas in Woodbridge, said Verdiglione attempted to exit his vehicle but stumbled to the ground.

Haythorn said his client sustained permanent injuries from the 2014 accident, including a concussion and residual post-concussion symptoms, vestibular injury, and convergence insufficiency. He said Verdiglione suffered three concussions within a two-year period, with each progressively worse than the previous one.

Defendant Ellenberg, who was represented by attorney Lewis K. Jackson of Styliades & Jackson of Mount Laurel, maintained that any residual cognitive issues that Verdiglione was having were either pre-existing or an aggravation of the pre-existing concussive symptoms, according to Haythorn.

Jackson did not return a call.

Prior to the collision, Verdiglione was accepted to the engineering program at the University of Rhode Island, according to Haythorn. Because of the cognitive injuries he sustained, he said his client dropped out of the university less than a semester after enrolling and selected a less physical and mentally challenging field, which the suit claimed resulted in a reduction in wages.

Verdiglione, now 23, recently obtained a real estate license. He alleges in the suit that the prior concussions rendered him more vulnerable to significant neuro-cognitive deficits with the third concussion due to successive concussion syndrome.

“Each successive concussion became more severe,” Haythorn said. “The third one was the tipping point as symptoms became more severe, pervasive and more permanent.”

Two medical experts testified on Verdiglione's behalf: neurologist Dr. Alan Pertchik of Tinton Falls, and neuro-phsychologist Dr. Joely Esposito, PSY.D. of Philadelphia.

— Suzette Parmley

$1.5M for Warehouse Injury

Correa v. Clifton Fidelco Associates: A warehouse worker who sustained head and spinal injuries when he was struck by wood falling from the facility's ceiling was paid a $1.5 million settlement in his Essex County suit on Jan. 3.

On June 22, 2013, plaintiff Jesus Correa, then 42, was working at NJ Cash and Carry at 791 Paulison Ave. in Clifton, owned by Clifton Fidelco Associates, where he had worked for several years. As he gathered orders for a pallet, he heard a noise from above, looked up, and was struck in the head by a falling piece of wood from a roof truss and knocked unconscious, the suit claimed.

Correa was hospitalized and discharged with a head contusion and concussion, but had subsequent medical consults because of neck pain and restricted motion, dizziness, memory issues, headaches, and other symptoms, according to his lawyer, Damon Vespi of the Vespi Law Firm in Totowa.

The suit claimed Correa was diagnosed with disc bulges, herniations and radiculopathy at the cervical spine, hernations at the thoracic spine, and injuries to the nasal passages. He underwent a cervical fusion surgery as well as rounds of epidural injections, but now walks with a cane, takes medication for ongoing pain and is limited in his activities, according to Vespi, who noted that Correa was terminated from his position and has applied for Social Security disability benefits.

Correa is a single father caring for a special-needs son, Vespi noted.

The suit alleged that Clifton Fidelco failed to keep the warehouse roof in good condition. It claimed $220,878 in medical expenses, a $62,173 workers' compensation lien, and a $3,074 Medicaid lien.

The parties were approaching the trial date when the matter settled during mediation with Eugene Codey, a retired Superior Court judge with Connell Foley in Roseland.

The settlement was memorialized in an Oct. 22, 2018, order, according to documents from the judiciary's online database of civil cases.

The settlement sum was disbursed to Correa on Jan. 3, Vespi said.

Michael Schwartz of Kirmser, Lamastra, Cunningham & Skinner represented Clifton Fidelco. Schwartz declined to comment through an assistant.

— David Gialanella