June 12, 2019

The Maine Supreme Judicial Court (“Maine Appellate Court”), in its decision filed on May 30, 2019, affirmed the trial court’s granting summary judgment in favor of the defendant radiologist in a Maine medical malpractice case where the plaintiff claimed the radiologist negligently failed to properly read a CT scan which allegedly resulted in a delay in treatment and the plaintiff suffering injuries he claimed he would not have sustained had a timely and accurate reading of his CT scan been made by the defendant radiologist.

The Underlying Facts

The plaintiff had a noncancerous polyp removed from his colon on August 14, 2012, and was discharged from the hospital four days later. Two days later, he went to the hospital’s emergency room complaining of abdominal pain. A CT scan was ordered to rule out active bleeding or an anastomotic leak (i.e., a leak of the contents of the bowel at the junction of the two portions of the bowel that were surgically reconnected during the surgery to remove the polyp). The CT scan was performed about two-and-a-half hours later and was read about an hour after the CT scan was completed. The radiologist reported evidence of moderate to severe abdominal ascites (i.e., an accumulation of serous fluid in the peritoneal cavity).

The defendant radiologist reviewed the CT scan the following morning, identified the ascites, and further stated “[t]here were no findings to suggest an anastomotic leak.” Nonetheless, exploratory surgery that evening found a small anastomotic leak that the surgeon believed had infected the fluid and blood in the plaintiff’s abdomen that caused his “septic state.”

After the second surgery, the plaintiff was hospitalized for an extended period, was intubated and later had a tracheostomy, and suffered a stroke from deep venous thrombosis.

The plaintiff’s general surgeon expert testified during his deposition that it was more likely than not that the plaintiff would have had fewer postoperative complications had the second surgery occurred 24 hours earlier. The plaintiff’s neurologist expert testified during his deposition that had the second surgery occurred earlier, it was more likely than not that the plaintiff could have avoided the stroke.

The trial judge granted the defendant radiologist’s motion for summary judgment, concluding that his involvement “is too removed in the space and time, well after a period plaintiffs’ expert testified was a critical juncture, such that it is unreasonable to allow a jury to make the requisite finding of proximate cause.”

The Maine Appellate Court stated, “Here, the trial court correctly determined that, based on the undisputed facts, the [plaintiffs] failed to establish a prima facie case for negligence against [the defendant radiologist]. [The plaintiff’s] anastomotic leak began before he arrived at [the] emergency room on August 20, 2012. [The defendant radiologist] did not review the CT scan of [the plaintiff’s] abdomen until 8:00 a.m. on August 21, 2012; this was approximately fifteen hours after [the plaintiff] arrived at [the hospital] and approximately twelve hours after the time identified by the [plaintiffs’] surgical expert—8:00 p.m. on August 20, 2012—when the surgery needed to have been completed in order to avoid [the plaintiff’s] postoperative complications.”

The Maine Appellate Court held: “the [plaintiffs] do not cite to any record evidence showing that these experts explained what role, if any, [the defendant radiologist’s] allegedly negligent reading of the CT scan played in the development of [the plaintiff’s] postoperative complications. Although the [plaintiffs] are correct that “absolute certainty” is not required, some evidence is, and the record presented is insufficient to provide any basis for a determination that [the defendant radiologist’s] conduct played a role in [the plaintiff’s] injuries … it would be “conjecture or speculation” to say that any negligence attributable to [the defendant radiologist] was the proximate cause of [the plaintiff’s] injuries.”

Source Holmes v. Eastern Maine Medical Center, 2019 ME 84.

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