View Full Version : Three is Company's Actor, John Ritter's Family Files Medical Malpractice Suit Against Hospital
Ritter family files suit against hospital
From Matt Carey
CNN
Thursday, September 9, 2004 Posted: 9:30 PM EDT (0130 GMT)
Actor John Ritter
LOS ANGELES, California (CNN) -- The family of the late TV sitcom star John Ritter has filed a wrongful death lawsuit against a Burbank hospital, alleging that a misdiagnosis of his condition contributed to his unexpected death last year.
Ritter, 54, was taken by ambulance to Providence Saint Joseph Medical Center last September 11 after complaining of chest pain on the set of the ABC series "8 Simple Rules for Dating My Teenage Daughter." He died on the operating table as surgeons tried to repair a tear in his aorta.
The suit, brought by Ritter's widow, actress Amy Yasbeck, and his four children, alleges that doctors initially misdiagnosed Ritter's condition as a heart attack. It seeks unspecified damages against the hospital and its medical staff.
"Mr. Ritter's doctors, failed to properly and timely diagnose and treat an aortic aneurysm, which would have prevented his death," said Yasbeck's spokeswoman, Lisa Kasteler, in a statement.
Source (http://www.cnn.com/2004/SHOWBIZ/TV/09/09/ritter.lawsuit/index.html)
"We have a chance to take a giant stride forward for the good of all humanity" in the next election. "We can choose between the future and the past, between reason and ignorance, between true compassion and mere ideology."- Ron Reagan Jr.
[This message was edited by Faye on 09-12-04 at 06:18 PM.]
Kaprikorn1
09-12-2004, 04:46 PM
Christ....they'll probably get John Edwards to sue for them.
"It's not easy being green"
cheesecake
09-12-2004, 05:01 PM
I don't believe you can try a case while serving as an acting Vice President. Let me check the consttutiona law book and get back to you on that...... http://sci.rutgers.edu/forum/images/smilies/biggrin.gif
"A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles"....C. Reeve 1998
The point is that with all the accurate diagnostic equipment available, there are so many missed diagnoses of obvious conditions. In emergency situations where time is of the essence this could easily cost you your life.
And that is what happened to John Ritter.
John Ritter's death may have been easily prevented with accurate and timely diagnosis, much like Jason's paralysis could have been prevented with timely thrombolytic treatment.
A blood clot is easily visualized on an MRA.
But of course Kap would be totally understanding of such a mistake, if it happened to one of his children. Oh well....
"We have a chance to take a giant stride forward for the good of all humanity" in the next election. "We can choose between the future and the past, between reason and ignorance, between true compassion and mere ideology."- Ron Reagan Jr.
Chris Chappell
09-12-2004, 05:31 PM
Yeah Kap and he'd probably win.
Lshall82978@yahoo.com
09-12-2004, 06:09 PM
Sadly, whatever happens, it won't bring him back.
marmalady
09-12-2004, 07:25 PM
Faye, with all due respect here, and I'm not saying that a lawsuit isn't the right thing. But the first thing in 'triage' ER situations is to get the patient stabilized; people don't get admitted to the ER and then immediately go for sophisticated testing like CAT scans, MRI or MRA. Re your comment 'if they had only taken him for an MRA', may very well be true; we don't know, however, if they were setting up for this test. There just isn't enough information in the article you linked to give enough factual information.
I was saddened to hear of John Ritter's death; he was always one of those actors I would have loved to have dinner with.
_____________
If we have no peace, it is because we have forgotten that we belong to each other. - Mother Teresa
i think marm is right once again.
as they say, hindsight is 20/20. wouldn't it be nice if we had foresight.
i doubt ritter's family is in financial need. i doubt his is a cause of med mal. one more data point for lawsuits in this country going nuts.
btw, let's not forget that not too many yrs ago ppl didn't have the option of open heart surgery, nor did they survive sci.
Lizbv
09-13-2004, 02:13 AM
They'll never win as long as Bush is in office.
TAKE YOUR HANDS OFF MY MOJO
Rollwithit
09-13-2004, 06:51 AM
Wow! How'd his aorta get torn in the first place?
My husband's aorta was torn in our accident. They knew there was blood in his chest but didn't know what was causing it. Why? Because the hospital we were in was so small they had no way to find out. He lasted through the night and an ambulance ride the next morning to a much larger hospital where they diagnosed the torn aorta.
Lots of would-have's, should-have's, could-have's...people are still human and make mistakes and lawsuits for millions of dollars will never fix that or bring people back.
Originally posted by cass:
btw, let's not forget that not too many yrs ago ppl didn't have the option of open heart surgery, nor did they survive sci.
Well I guess you all should arrive in the ER with a sign on you saying to the Dr.: Oh well....if you are incompetent, slow, that's ok., I understand...., that's only human....
I really don't expect to get standard practice of care......
A stat sonography of the heart and surrounding area, would have easily detected the problem.
"We have a chance to take a giant stride forward for the good of all humanity" in the next election. "We can choose between the future and the past, between reason and ignorance, between true compassion and mere ideology."- Ron Reagan Jr.
marmalady
09-13-2004, 07:26 AM
Patient risk stratification, using a variety of prognostic markers, is a crucial part of the management of unstable coronary artery disease (UCAD, encompassing the syndromes of both UA and NQMI). The general practitioner will most likely be responsible for early recognition of acute coronary syndromes (ACSs), hence some degree of risk assessment will be involved in reaching a decision on whether to send a patient to hospital. Risk assessment and stratification will certainly be a consideration for the emergency room or casualty doctor and could be imperative to identify a life-threatening myocardial infarction (MI) or episode of UA. At this point, the question will be whether to send the patient to a coronary care unit (CCU), or whether treatment in the emergency room and an early discharge home would be more appropriate. The patient will also need to be risk stratified to facilitate decisions regarding whether intensive antithrombotic treatment is appropriate or whether immediate early or elective revascularization by percutaneous techniques is required.
There is no universally accepted system for risk stratification, and a variety of methods has been employed. Among the approaches most commonly encountered are clinical evaluation based on history and symptoms at presentation, electrocardiography (ECG) on admission, continuous ECG monitoring, biochemical marker measurements, exercise or stress-induced ischemia testing; and angiography. The overall goal of risk stratification is to assess the likelihood of a patient suffering a fatal MI or sudden arrhythmia, progression of the condition to MI, or a recurrence of symptoms after the initial episode has subsided.2 Symptom recurrence, which is frequently the main risk, is related to ongoing and continued inflammatory activity and limitation of coronary arterial flow at the lesion site. Approaches to the prevention of this phenomenon usually comprise either prolonged intense antithrombotic treatment or the undertaking of invasive procedures.
link (http://www.clinicalcardiology.org/supplements/CC23S1/cc23s1.husted.html)
If we have no peace, it is because we have forgotten that we belong to each other. - Mother Teresa
Things YOU need to know!
Aortic dissection is the most common catastrophe of the aorta, 2-3 times more common than rupture of the abdominal aorta. When left untreated, about 33% of patients die within the first 24 hours, and 50% die within 48 hours. The 2-week mortality rate approaches 75% in patients with undiagnosed ascending aortic dissection. For a great "overview" and "pictures" read this now! Click Here!
The essential feature of aortic dissection is a tear in the intimal layer, followed by formation and propagation of a subintimal hematoma. The dissecting hematoma commonly occupies about half and occasionally the entire circumference of the aorta. This produces a false lumen or double-barreled aorta, which can reduce blood flow to the major arteries arising from the aorta. If the dissection involves the pericardial space, cardiac tamponade may result.
The most common site of dissection is the first few centimeters of the ascending aorta, with 90% occurring within 10 centimeters of the aortic valve. The second most common site is just distal to the left subclavian artery. Between 5% and 10% of dissections do not have an obvious intimal tear. These often are attributed to rupture of the aortic vasa vasorum as first described by Krukenberg in 1920.
In the US: The true incidence of dissection is difficult to estimate. Most estimates are based on autopsy studies. One population-based study estimated the incidence at roughly 6 new aneurysms per 100,000 person years. Evidence of dissection is found in 1-3% of all autopsies.
From 1-2% die per hour for the first 24-48 hours.
Aortopathy may be present in heritable diseases such as Marfan syndrome, Ehlers-Danlos syndrome, annuloaortic ectasia, familial aortic dissections, adult polycystic kidney disease, Turner syndrome, Noonan syndrome, osteogenesis imperfecta, bicuspid aortic valve, coarctation of the aorta, and connective-tissue disorders. It is also seen in heritable metabolic disorders such as homocystinuria and familial hypercholesterolemia.
Incidence is increased in pregnancy and syphilis. Thoracic aortic dissection also is associated with crack cocaine use and iatrogenic causes, such as cardiac catheterization.
Race: Aortic dissection is more common in blacks than in whites and less common in Asians than in whites.
Sex: Male-to-female ratio is 3:1.
Age: Approximately 75% of dissections occur in those aged 40-70 years, with a peak in the range of 50-65 years. (courtesy of emedicine)
Summary
I hope that this website will help educate you about what an aortic dissection really is and how to get help and when you are in the ER room, to know what tests to demand if you feel that you are not getting adequate care. It's up to you to know the signs and be the best prepared you can.
http://www.aorticdissection.com/
Stirring Echoes
The T-surgeon's scrub nurse calls you back and tells you that he is tied up in surgery and can't see the patient now. You tell the nurse that you think you have a patient with a dissecting ascending thoracic aneurysm but they don't seem too impressed. He relays a message that he wants cardiology to see her first. The cardiologist calls about the same time. You again relate the story but the cardiologist thinks this is a surgical case and suggests more testing and - you guessed it - a T-surgeon (the loop begins!).....
He cannot break away from his clinic to see the patient right now. The patient is more stable, albeit hypotensive. You order a stat transthoracic echocardiogram. Fortunately, the Echo tech is not busy like your consultants. The EMT is curious as to what type of dissection you think this might be?
Answer: Tell him there are two classification schemes. In the DeBakey classification, type I dissections occur when the ascending and descending thoracic aorta is involved. The extent of involvement of the descending thoracic aorta can vary. Type II aortic dissections occur when only the ascending aorta is involved. When the dissection begins in the descending thoracic aorta it is described as a type III dissection.
The dissection is type IIIa if only the thoracic aorta is involved and type IIIb if the thoracic and abdominal aorta are involved. More recently the Stanford classification has been used; this classification reflects treatment options. In Stanford Type A the dissections involve the ascending aorta, while all others are type B. If symptoms have been present for less than 2 weeks the dissection is described as acute, otherwise, it is chronic. You tell him this patient probably has a DeBakey II or a Stanford Type A. (1)
"We have a chance to take a giant stride forward for the good of all humanity" in the next election. "We can choose between the future and the past, between reason and ignorance, between true compassion and mere ideology."- Ron Reagan Jr.
[This message was edited by Faye on 09-13-04 at 10:53 AM.]
What can our Emergency Room Doctors do to be able to quickly diagnose an aortic dissection?
The diagnosis of aortic dissection is a particularly difficult one, since it is still relatively rare, yet the consequences of a delay in diagnosis can be disastrous. The frequency of heart attack is still much higher than the frequency of aortic dissection, so thinking of a heart attack in someone with chest pain is still the first instinct. I think the most important thing for the treating physician and what I teach all my residents is to always consider the 3 diagnoses that can kill the patient suddenly which present with chest pain, myocardial infarction, aortic dissection and pulmonary embolus. The physician should, consciously, go over why he/she would exclude each of those diagnoses.
The things that point toward an aortic dissection would be:
1. Very abrupt onset of pain
2. Loss of pulses/perfusion in any extremity
3. Family history of dissection/Marfan syndrome
4. Lack of evidence of the other diagnoses on initial examination in a patient who appears ill.
Unfortunately, these features are far from universally present, which leads to frequent delays in diagnosis of aortic dissection. A CT scan or a transesophageal echocardiogram would certainly have made the diagnosis in John Ritter's case, however doing a scan in every patient with chest pain would not be appropriate for reasons of procedural morbidity, patient discomfort and cost.
One step I would propose would be to increase the use of transthoracic echocardiography in the emergency room. Although, the transthoracic echo is far from definitive in ruling in or ruling out an aortic dissection, it probably does a better job than any of the other available inexpensive noninvasive tests. A transtoracic echocardiogram can also help to confirm one of the others of the 3 diagnosis allowing the physician to be more effective in using CT and TEE in evaluating the remaining patients without firm diagnoses.
With this there will still be missed or delayed diagnoses of aortic dissection. Perhaps a day will come when we can do a 3 minute MRI scan from head to toe. That may be what will be necessary to reach 100% accuracy in the diagnosis of aortic dissection. In the meantime keeping aortic dissection in the minds of emergency physicians is probably the most important step. The important message is that not all chest pain is either a heart attack or it is nothing, the two acutely life threatening diagnoses should always be considered,
David
Source (http://www.aorticdissection.com/Helping%20our%20ER%20Doctors.htm)
"We have a chance to take a giant stride forward for the good of all humanity" in the next election. "We can choose between the future and the past, between reason and ignorance, between true compassion and mere ideology."- Ron Reagan Jr.
marmalady
09-13-2004, 08:53 AM
Faye, perhaps you could write to the appropriate agencies, and suggest a rewrite on the guidelines for emergeny cardiac care. http://sci.rutgers.edu/forum/images/smilies/smile.gif
_____________
If we have no peace, it is because we have forgotten that we belong to each other. - Mother Teresa
Cappy
09-13-2004, 08:55 AM
Great pissing contest. http://sci.rutgers.edu/forum/images/smilies/smile.gif
Off the wall, through the hole, and into the bottle. http://sci.rutgers.edu/forum/images/smilies/smile.gif
Yes Marmalady, as a trained sonographer I have advocated for: the use of transthoracic echocardiography in the emergency room as well as ER use of transcranial doppler which would have instantly visualized the high velocity flow in my son Jason's basilar artery.
These procedures are inexpensive and can be administered stat.
"We have a chance to take a giant stride forward for the good of all humanity" in the next election. "We can choose between the future and the past, between reason and ignorance, between true compassion and mere ideology."- Ron Reagan Jr.
marmalady
09-13-2004, 09:04 AM
You're right, Cappy - I'm done. I've obviously been outstripped by the knowledge of a sonographer. See ya!
_____________
If we have no peace, it is because we have forgotten that we belong to each other. - Mother Teresa
Marmalady, with all due respect, I am just making the point as does the physician quoted that when arriving at an ER, time is of the essence.
When a differential diagnosis is made one should try to rule out the killers first, and not jump to conclusions and/or treat most common conditions only.
In the ER, it shouldn't be the luck of the draw whether the killers are ruled out.
As David the physician teaches: always consider the 3 diagnoses that can kill the patient suddenly which present with chest pain, myocardial infarction, aortic dissection and pulmonary embolus.
"We have a chance to take a giant stride forward for the good of all humanity" in the next election. "We can choose between the future and the past, between reason and ignorance, between true compassion and mere ideology."- Ron Reagan Jr.
Originally posted by Faye:
Originally posted by cass:
btw, let's not forget that not too many yrs ago ppl didn't have the option of open heart surgery, nor did they survive sci.
Well I guess you all should arrive in the ER with a sign on you saying to the Dr.: Oh well....if you are incompetent, slow, that's ok., I understand...., that's only human....
actually, it is human. but, of course, i do expect ER doctors to be competent and i think most are. even competent people make mistakes.
btw, i also know several engineers who design and test the ultrasound machines.
you know, i just happen to think most doctors do their best. i've had my share of incompetent doctors, nurses, etc. but MOST did their best.
perhaps you should direct your concerns to the health insurance industry which causes many diagnostic decisions to be made. then, consider the business aspects of med mal for those same providers.
i'm not saying it's right, but pointing out cause and effect.
this country needs good national health insurance. to put it into the hands of pure businesspeople is not in the best interests of the patient or the medical provider.
Originally posted by cass:
this country needs good national health insurance. to put it into the hands of pure businesspeople is not in the best interests of the patient or the medical provider.
I'm totally with you on this. I have advocated Universal Health Care for a long time. But we still need to hold the approx. 4% poorly performing doctors accountable for lost and devastated lives which with less negligence could have been saved.ie.:
1. This is the business decision that cost Jason his freedom and independence:
The first hospital I took him to had decided four weeks earlier to not have MRI facilities available over the weekend
2. This is the doctor/hospital mistake which caused a delay in diagnosis and may have led to a misdiagnosis:
Instead of treating Jason's severe neurological symptoms as the emergency it was, all he got was some bloodwork, Ct scan and hours of valuable time wasted. What should have happened as with any business decision:
There should have been a back-up plan for severe ER patients who needed immediate MRI, to transfer him STAT to a tertiary center with MRI facilities.
Elsewhere there ARE protocols in place that require certain conditions to bypass the nearest hospital to go to designated tertiary centers, ESPECIALLY WHEN IT IS KNOWN the proper diagnostic equipment is not available at that nearest hospital.
It is against the standard of care to "Just watch a person got paralyzed without applying proper diagnostic procedures, and treatment based on diagnosis in a timely fashion"
There is no excuse for wasting hours upon hours in an ER without any significant treatment at all. That would be ok for a cold, but is egregious neglect in life threatening emergencies.
"We have a chance to take a giant stride forward for the good of all humanity" in the next election. "We can choose between the future and the past, between reason and ignorance, between true compassion and mere ideology."- Ron Reagan Jr.
[This message was edited by Faye on 09-15-04 at 02:08 PM.]