Kopycinski v. Itskowitz

$700,000 Verdict

Date of Verdict: Jan. 16.

Court and Case No.: C.P. Allegheny No. GD-17-004492.

Judge: Philip A. Ignelzi.

Type of Action: Medical malpractice.

Injuries: Hysterectomy, colostomy.

Plaintiffs Counsel: Timothy G. Wojton, Scanlon & Wojton Attorneys at Law.

Plaintiffs Expert: Jan C. Seski, gynecologic oncology, Murrysville.

Defense Counsel: Jennifer M. Kirschler and Lauren M. Kelly, Gordon Rees Scully Mansukhani, Pittsburgh.

Defense Experts: Donald A. Walters, gastroenterology; Butler; Ernest F. Gillan, general practice, Paoli; Robert L. Bell, general surgery; Berkeley Heights, New  Jersey.

Comment:

On March 31, 2015, plaintiff Rose Marie Kopycinski, 79, presented to the emergency room at Allegheny General Hospital in Pittsburgh with complaints of abdominal discomfort and pain. She was diagnosed with sepsis, systolic blood pressure, ruptured abscesses throughout her digestive tract, necrosis, perforations of the intestines and uterus, and severe peritonitis.

Kopycinski sued Allegheny General Hospital; its owner, Allegheny Health Network; her primary care physician, Mark Itskowitz; and Itskowitz's practice, Pittsburgh General Medicine Associates. Kopycinski alleged that the defendants failed in their standard of care toward her. She further alleged that their failure constituted malpractice.

On March 18, 2015, Kopycinski visited Itskowitz. She complained of back pain and abdominal pain. The physician ordered a back X-ray and a renal ultrasonography, both of which were negative.

Kopycinski's counsel contended that, despite Kopycinski's 20-year history of diverticulitis, Itskowitz failed to order a CT scan of her abdomen. Between March 18 and March 31, Kopycinski's daughter contacted Itskowitz's office three or four times and spoke to nurse Barbara Doscher to suggest that Kopycinski undergo an abdominal CT scan, given her diverticulitis history. A scan was not performed. By March 31, 2015, Kopycinski's diverticulitis had reaggravated and her condition had deteriorated severely. Kopycinski's counsel suggested that Doscher did not inform Itskowitz of Kopycinski's complaints and telephone calls.

Upon presenting to Allegheny General Hospital, Kopycinski underwent surgery by Nii-Daako Darko. Darko performed an exploratory laparotomy and drainage of an intraabdominal abscess.

Kopycinski's expert gynecologic oncologist, who also treated Kopycinski, testified that Itskowitz was negligent for failing to timely diagnose Kopycinski's urgent diverticulitis and abscess condition. Had the diagnosis been made closer to the March 18 visit, Kopycinski would have undergone treatment that would have prevented the bursting of one or more abscesses or staved the flow of infected fluid in and around her pelvic activity, thereby averting the need for invasive surgery that included a total hysterectomy and insertion of a colostomy bag, the expert contended.

Kopycinski's expert also testified that Darko was negligent in his management of Kopycinski's condition. Preoperatively, the abdominal CT scan established diagnoses of diverticulitis, a perforated sigmoid colon, peritonitis, free air in the abdomen and a pelvic abscess, the expert contended. According to the expert, Darko, during the surgery, erroneously ascribed these findings to a tubo-ovarian abscess of gynecological origin. Darko neglected to address the findings of a perforated sigmoid colon and the presence of free air in the abdomen, which could have been caused by only a perforation originating from the intestinal tract and not by a tub-ovarian abscess, the expert contended. Additionally, since Darko ascribed Kopycinski's condition as being gynecologic in origin, he was negligent as he did not obtain an emergency intraoperative consultation with a gynecologist, the expert opined.

The defense maintained that Kopycinski was treated within the standard of care. Itskowitz testified that Kopycinski made no mention of having abdominal complaints during her March 18 visit. Doscher testified neither Kopycinski nor her daughter ever made a request for a CT scan.

The defense's expert in general practice testified that Itskowitz could not have predicted the eventual diverticular perforation, as Kopycinski had no abdominal complaints March 18, and none related to Itskowitz's office until March 31, when she was referred for a CT scan of her abdomen. The expert concluded that Itskowitz acted appropriately in his care of Kopycinski. The defense's expert in gastroenterology testified that there was no evidence in the history or physical exam performed by Itskowitz that would have indicated Kopycinski was at risk for developing severe diverticulitis with colonic perforation, leading to colon resection and colostomy formation.

The defense's expert in general surgery testified that the complaints against Darko were without merit, since Darko's surgery saved Kopycinski's life.

On April 1, 2015, a day after she presented to an emergency room, Kopycinski underwent a radical hysterectomy, bilateral salpingo-oophorectomy and a colostomy. Following the surgery, Kopycinski remained hospitalized. On April 10, she underwent a primary closure of her abdominal wall. On April 14, her nasogastric tube was removed and she was started on a liquid diet. On April 24, Kopycinski was transferred to a skilled nursing facility. She underwent treatment for a few months and then was discharged home.

In the ensuing years, Kopycinski treated with a gastroenterologist; the doctor determined that Kopycinski's colostomy was permanent.

Kopycinski testified that her quality of life has diminished greatly; that is due to her colostomy bag, which has caused her embarrassment. She also had to alter her diet significantly, and she no longer engages in social activities. Her husband and daughter testified as to Kopycinski's condition. Kopycinski' sought damages for past and future pain and suffering.

The jury found Doscher 100% liable. No liability was found against Itskowitz, Nii-Daako, Allegheny General Hospital and Kopycinski. Kopycinski was determined to receive $700,000.

This report is based on information that was provided by plaintiffs and defense counsel.

—This report first appeared in VerdictSearch, an ALM publication