A Madison County jury returned a defense verdict in a medical malpractice lawsuit on Friday, concluding that Drs. Tibor Kopjas and Michael Mandis did not violate standards of care in treating a patient’s MRSA infection from an IV site.
The jury, consisting of eight women and four men, reached their decision after deliberating just over an hour on the fifth day of trial in Circuit Judge William Mudge’s court.
Plaintiff Fred Simon’s daughter Stacey Luber sued Kopjas, Mandis, Anderson Hospital and others in 2006 claiming the defendants failed to timely and properly diagnose and treat Simon for bacterial sepsis. Simon later died on Aug. 17, 2005. According to the court record, cause of death was pneumonia.
Only Kopjas and Mandis remained as defendants at trial. Kopjas was Simon’s primary care physician. Mandis made rounds at the hospital for Kopjas during the decedent’s hospitalization.
Plaintiff attorney Colleen Jones of St. Louis began closing arguments on Friday morning. She established that while Simon, 76, did suffer “some underlying problems,” such as diabetes and kidney failure, he was a relatively active man. She added that experts suspected he had roughly 10 more years in life expectancy.
“He was retired now, this was his time,” she said.
Attorney Ted Dennis of Belleville, counsel for Mandis, countered during his closing arguments that 10 years is just the average life expectancy for any 76-year-old man without taking into consideration his medical condition and situation.
According to testimony, Simon was hospitalized at Anderson Hospital in Maryville for blood transfusions as treatment for internal bleeding in mid-March 2005.
Jones said that while there, Simon developed a 101.4 degree fever on March 16, 2005. Kopjas allegedly ordered a chest X-ray and a urinalysis. After taking a dose of Tylenol and an antibiotic, Simon’s temperature allegedly returned to normal and didn’t spike again during his stay.
Jones accused Kopjas and Mandis of violating standard protocol for treating a patient with a fever. She argues the standard is to order a blood culture with the X-ray and urinalysis to check for infection, which they failed to do right away.
However, attorney James Neville of Belleville, counsel for Kopjas, countered the argument and told the jury that even the plaintiff’s experts testified that doctors don’t always order blood cultures, especially when a patient already has a large number of open wounds and needle punctures.
In response, Jones told the jury that when a doctor notices a certain symptom, the most life-threatening diagnoses must be ruled out first. If the tests come back negative, then “no harm, no foul, he gets to go home.” But it’s better to be safe than to let a dangerous situation worsen, she said.
In fact, Simon returned to Anderson’s ER two days later and was eventually re-admitted around March 21, 2005, when a blood test taken at the ER came back positive with methicillin-resistant staphylococcus aureus (MERSA), which was the result of an infection at the IV site in his left wrist.
As a result of the diagnosis, Kopjas wrote Simon a prescription for Levaquin – an antibiotic designed to treat MRSA that Simon had previously responded well to. However, Neville said in his closing arguments that the medication was never picked up from the pharmacy.
Jones argued that Kopjas negligently sent Simon home for the weekend and told him to return to the hospital the following Monday. She said the delay “set up a deadly situation” by allowing the infection to invade the rest of his body.
However, because Simon needed a special hospital room due to his condition and diagnosis, Neville said it took time to arrange a proper treatment facility.
Simon was treated for MRSA with a strong antibiotic for two weeks until he showed no more signs of infection.
Jones said the treatment was not long enough and the antibiotic was not strong enough, but Neville said other stronger medications are known to have adverse effects on the kidneys. Because Simon already suffered from kidney failure, Neville said the defendants appropriately settled with treating Simon with Levaquin, which is gentler on the kidneys.
Simon was treated for MRSA again at St. Mary’s Hospital in Richmond Heights.
Neville argued that while Simon was at St. Mary’s the doctors there took all the same tests and prescribed the same medication.
“He was on a course that, despite the best care, the damage could not be altered,” Neville said.
Jones had asked the jury to award the plaintiff $2 million.
Madison County Circuit Court case number 06-L-661