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Blood Clot Filter Imbedded in Vein; No Standard of Care Evidence


A man was injured when the man fell from a roof, fracturing both heels and a vertebra. The man’s injuries required several surgeries, a 17-day stay in the hospital, and a subsequent period of immobilization. Prior to surgery, the hospital’s orthopedic surgeon ordered that a retrievable blood clot filter be placed in the man’s inferior vena cava (IVC), a large vein leading to the heart. The purpose of installing the filter was to trap blood clots that might arise from the period of physical inactivity during the man’s recuperation after surgery. A radiologist implanted a filter.

 

After the filter had been in place for approximately 120 days and the man had regained some mobility, the hospital’s orthopedic surgeon ordered that it be removed. A surgeon attempted to remove the filter, but discovered that it was embedded in the wall of the man’s IVC and could not be retrieved.

 

After the failed filter retrieval, the man returned to the hospital’s emergency room (ER) several times with severe abdominal, pelvic, and groin pains. The man was treated for a bladder or kidney infection. The man returned to the ER with a swollen right leg. The man was transported to another medical center and remained there for four days. Doctors at the medical center treated the man for a blood clot and hematoma, and inserted a stent in the man’s left iliac vein.

 

The doctors at the medical center determined that removal of the blood clot filter was too complicated to attempt and referred the man to another medical center. Doctors at the second medical center unsuccessfully attempted to remove the embedded filter. In the process of doing so, the tip of a catheter broke off in the vein and could not be retrieved.

 

Doctors at the second medical center referred the man to a third medical center where doctors used a unique laser procedure to remove the blood clot filter. The third medical center’s doctors were unable to remove the fragment of catheter because it was embedded in the wall of the man’s IVC.

 

The man brought a medical negligence action against the hospital where the blood clot filter was installed.

 

At trial, the man presented testimony of treating doctors as well as two expert medical witnesses. The only express reference to standard of care from any of the man’s experts came during cross-examination. One of the man’s experts was asked whether the standard of care would vary depending upon where the medical professional practiced.

 

When the man rested, the hospital moved for judgment as a matter of law. The motion contended that the man had failed to prove that the hospital departed from the applicable standard of care. The First Judicial District Court, Lewis and Clark County, denied the motion and the case proceeded.

 

The hospital’s expert testified that the decision to use the IVC filter was within acceptable medical practice and met the applicable standard of care.

 

The jury returned a verdict in favor of the man. The jury awarded the man damages for medical expenses, lost wages, pain and suffering, and mental and emotional distress. The trial court entered judgment in the man’s favor for $492,268.39.

 

The hospital then renewed its motion for judgment as a matter of law. Again, the motion contended that the man had failed to prove that the hospital departed from the applicable standard of care. The trial court entered an order overturning the jury’s verdict and granting judgment in favor of the hospital. The trial court concluded that the man’s experts provided no opinion regarding the applicable standard of care or whether it was breached.

 

The Supreme Court of Montana affirmed. The court held that the trial court did not err in granting judgment as a matter of law in favor of the hospital following a jury verdict in favor of the man.

 

The trial court did not err in granting judgment as a matter of law in favor of the hospital following a jury verdict in favor of the man. The man failed to provide sufficient evidence concerning the applicable standard of care. The court noted that one of the man’s experts did not identify any medical standard of care that would have been applicable to the man’s situation, neither as to the hospital nor the individual doctors. The man’s other expert failed to provide any testimony as to the standard of care applicable to the hospital. Information from the manufacturer of the filter did not provide a description of the standard of care that a jury could comprehend.

 

The Supreme Court of Montana affirmed the trial court’s entry of post-jury-trial orders overturning the verdict and granting judgment in favor of the hospital.

 

See: Horn v. St. Peter’s Hospital, 2017 WL 6028371 (Mont., December 5, 2017) (not designated for publication).

 

See also Medical Law Perspectives Report: Thicker Than Water: Liability When Blood Clots Cause Injury or Death

 

See also Medical Law Perspectives Report: Spinal Cord Injury Malpractice: Back to Back Problems

 

 

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