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Case of the Month

West's® Jury Verdicts - Nevada Reports

Hematologist Not Liable for Patient's Stroke after Blood Coagulant Use

McLoughlin v. Shopnick

Type of Case:
Medical Malpractice-Procedures & Treatment - Medication
Medical Malpractice-Procedures & Treatment - Brain
Medical Malpractice-Procedures & Treatment - Informed Consent
Medical Malpractice-Physicians & Health Professionals - Other Physicians & Health Professionals
Medical Malpractice-Facility - Hospital
Medical Malpractice-Facility - Clinic/Center/Group

Specific Liability:
Hematologist used synthetic coagulation factor prior a total shoulder replacement surgery that caused patient's ischemic stroke

General Injury:
Ischemic stroke; medical expenses

Jurisdiction:
State: Nevada
Court: District Court of Nevada, Eighth Judicial District, Clark County.

Related Court Documents:
Plaintiff's complaint: 2006 WL 6854662
Defendants' civil trial memorandum: 2011 WL 5855303
Joint pretrial memorandum: 2011 WL 5855298
Jury instructions: 2011 WL 5855300
Verdict form: 2011 WL 5834946

Case Name:
Sharon McLoughlin and Edward McLoughlin v. Rinah Shopnick, DO, Rinah Shopnick Inc., University of Nevada School of Medicine Multi-Specialty Group Practice South Inc., Hemophilia and Thrombosis Center of Nevada Inc., University of Nevada School of Medicine, Does I through XX and/or Roe Corporations I through XX, inclusive

Docket/File Number:
A530576

Verdict:
Defendant Shopnick, $0

Verdict Date:
Oct. 31, 2011

Judge:
James Bixler

Attorneys:
Plaintiff: Leonard H. Stone and Brett I. Johnson, Shook & Stone, Las Vegas, Nev.

Defendants (Shopnick, Rinah Shopnick Inc and Hemophilia and Thrombosis Center of Nevada): Robert C. McBride and Heather S. Hall, Mandelbaum, Ellerton & McBride, Las Vegas, Nev.; Robert C. McBride, Kim Irene Mandelbaum and Heather S. Hall, Mandelbaum, Schwarz, Ellerton & McBride, Las Vegas, Nev.

Trial Type:
Jury

Experts:
Plaintiff: Charles Abrams, MD, hematologist, Philadelphia, Pa.; Russell J. Shah, MD, neurologist, Russell J. Shah MD Ltd., Henderson, Nev.; Stan V. Smith, PhD, forensic economist, Smith Economics Group Ltd., Chicago, Ill.

Defendant (Shopnick, Rinah Shopnick Inc and Hemophilia and Thrombosis Center of Nevada): Alice De-Ling Ma, MD, hematologist, University of North Carolina, Chapel Hill, N.C.; Geoffrey A. Allen, MD, pediatric hematologist, Forcier/Allen SC, Barrington, R.I.

Breakdown of Award:
$0

Summary of Facts:
Sharon McLoughlin, 51, reportedly underwent a shoulder replacement surgery Oct. 28, 2004. The surgery was reportedly her seventh in nine years following a work-related injuries in 1994. McLoughlin had a condition known as Factor XI deficiency, Hemophilia C, at the time of the surgery, which had caused her to bleed excessively during prior surgeries.

According to Shopnick's counsel, during her pre-operative visit with her surgeon, Robert Tait, MD, McLoughlin expressed her frustration that her prior surgeries had failed, and Tait explained the extreme nature of the proposed reconstructive surgery, which might require amputation of her arm if it failed. Tait also explained the risk of bleeding, infection and stroke to McLoughlin, Shopnick's counsel said. Tait referred McLoughlin to hematologist Rinah Shopnick, DO.

According to Shopnick, she met with McLoughlin, who told her about the failed surgeries despite the use of extensive transfusions with fresh frozen plasma. Because the surgery was McLoughlin's last chance for a successful outcome, Shopnick recommended an off-label use of a new recombinant clotting agent, NovoSeven, which Shopnick believed would give McLoughlin the best chance to avoid bleeding into the joint and compromising the surgery.

Shopnick claimed she had a lengthy discussion with McLoughlin about the medication and its expense.

After the surgery, McLoughlin suffered an ischemic stroke, resulting in disabilities on her left side. She said she suffered from numbness, difficulty speaking, foot drop and incontinence after the surgery. According to Shopnick's counsel, NovoSeven was discontinued and anticoagulants were administered to reverse the effects of the surgery.

McLoughlin and her husband, Edward McLoughlin, sued Shopnick and her practice, Rinah Shopnick Inc.; the University of Nevada School of Medicine Multi-Specialty Group Practice South Inc.; Hemophilia and Thrombosis Center of Nevada; and the University of Nevada School of Medicine. The plaintiffs claimed the doctor was negligent in failing to adequately inform Sharon about the risks of stroke or blood clot related to NovoSeven, failing to inform Sharon that giving her NovoSeven was an off-label use of the drug and failing to adequately assess the risks of giving NovoSeven rather than a single donor blood product. Shopnick's counsel said the plaintiffs claimed the medication was unsafe and untested for this use and there was a known risk of stroke from using NovoSeven.

The plaintiffs claimed fresh frozen plasma had not failed during her previous surgeries and it remained the standard of care.

The plaintiffs further alleged Shopnick acted as an employee or agent of the other defendants, making them vicariously liable for her negligence. According to the defense, the plaintiffs alleged the non-profit Hemophilia & Thrombosis Center of Nevada obtained around $12,000 in educational grants and benefits, which unduly influenced Shopnick's decision to prescribe NovoSeven.

According to defense counsel, the plaintiffs sought $2.5 million to $4 million to compensate for pain and suffering, past and future medical expenses and hedonic damages.

Edward brought a claim for loss of consortium.

The defendants denied they were negligent but acknowledged NovoSeven likely caused or contributed to Sharon's stroke. However, the defense claimed, there was no known risk of thrombus reported in the medical literature at the time, and Shopnick immediately reported the adverse incident to the manufacturer and the FDA. According to defense counsel, it was not until two years later that the medical community became aware of the possible correlation between NovoSeven and thrombus in Factor XI deficient patients through an article in JAMA.

The defense said the plaintiff served an Offer of Judgment on all of the defendants for $699,999.99 in June 2011.

In October 2011 a jury determined Shopnick was not negligent.

Court: District Court of Nevada, Eighth Judicial District, Clark County.

Westlaw Citation:
2011 WL 6062931

West's Jury Verdicts - Nevada Reports Citation:
West's J.V. Nev. Rep., Vol. 7, Iss. 10, p. 7 (2012)