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ED doc and group owe $13.5M after patient’s serious brain injury


A doctor and one of Idaho’s premier emergency medicine groups must pay millions of dollars to a stroke patient and his wife in what is being called the second-largest medical malpractice award in the state’s history, according to a report in the Idaho Capital Sun.

The suit, which took nearly 5 years after filing to wend its way through the courts, stems from an incident that took place in the early morning of March 29, 2016. An Ada County resident peered into the family bathroom and discovered that her husband, Carl B. Stiefel, lay on the floor confused and vomiting and complaining of a severe headache. Recently, the man had experienced several of these same symptoms, plus sinus congestion, dizziness, and tinnitus.

As Mr. Stiefel’s confusion worsened, his wife called for an ambulance, which arrived at the local hospital emergency department (ED) at 4:12 AM. Within approximately 11 minutes, the patient was examined by a doctor and later underwent a cranial CT scan, which a second doctor said showed “no intracranial process.”

Mr. Stiefel’s condition improved somewhat, although his dizziness persisted, leaving him still unable to walk. At this point, his primary ED doctor admitted him to the hospital for “benign positional vertigo.” The doctor also joined colleagues in suggesting that the patient might well be a candidate for an MRI, just in case his condition failed to improve over the next few hours.

But the transfer from the ED to the main hospital reportedly took at least 3 hours, during which time Mr. Stiefel’s condition deteriorated. Once admitted, he was observed by a healthcare provider — the news report doesn’t indicate precisely who — to be “delirious without meaningful interaction.” At least 4 hours would pass before the patient was seen by still another doctor, as the plaintiffs later claimed.

The patient remained disoriented and restless as the day unfolded. The MRI contemplated earlier was finally ordered, but the scan wasn’t available for several hours, according to nursing notes cited by the plaintiffs in their lawsuit.

Finally, the scan was administered at about 5:50 PM, almost 12 hours since Mr. Stiefel had first arrived at the ED. It showed that he had a torn artery in his neck and was experiencing a stroke. This was, clearly, a very different diagnosis from the one that his admitting doctor had entered into his notes.

A surgeon operated to repair the arterial tear, but the patient’s condition continued to worsen. Over the next 3 weeks, Mr. Stiefel went from the hospital to a local rehab facility, and back to the hospital with bacterial meningitis. Ultimately, he was diagnosed with “an irreparable brain injury,” which ultimately left him disabled and unable to work.

At this point, he and his wife sued a broad range of defendants — a radiology group, individual healthcare providers employed by the hospital, the primary ED physician, and that doctor’s emergency medicine group. In the nearly 5 intervening years, each of the named defendants settled, except the ED doctor and the emergency medicine group.

The two remaining defendants vigorously contested the claims against them, denying “any and all allegations of responsibility and liability” and contending that the patient’s injuries resulted from unforeseen complications rather than the care that had been administered.

The Ada County jury disagreed, however. It found that the primary ED doctor — and by extension the group to which the doctor belonged — did in fact negligently and recklessly fail to meet the proper standard of care, leading directly to the patient’s life-altering injuries.

For this failure, the jury awarded the plaintiffs $13.5 million, well over the state’s current inflation-adjusted cap of $400,000. (To date, Idaho’s largest med-mal award is nearly $30 million, handed down more than 20 years ago.)

At press time, there was no word of an appeal.


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