Stahl v. United States of America
Feb 13, 2010OUTCOME: Settlement before trial
Robert Stahl fell at his home, injuring his back. He was taken to the local hospital emergency room for evaluation. X-rays were taken that were inconclusive, and the doctor ordered that Mr. Stahl be ... admitted for further evaluation of his severe back pain. As the patient was a veteran, he was transferred to the VA Hospital in Milwaukee. Upon arrival, despite the fact that severe back pain was the reason for the trip to the emergency room, the examining doctor ordered that Mr. Stahl be admitted to the cardiology team for a determination of whether it may have been a heart issue that caused the initial fall to the ground. After admission, over the course of the next four days, Mr. Stahl's back was never examined or evaluated. During this time, his complaints of pain were noted to be intractable, even while receiving narcotic medication. He would yell out in pain with the slightest movement. He could not lay flat. He was noted as having characterized his pain as a "22" on a scale of 1 to 10. Despite all of this, no back evaluation was done. On the fourth day, after having been made to lie flat under general anesthesia on a table for a heart examination, Mr. Stahl was found to have lost feeling in both legs, and he no longer had control of his bowels and bladder. He was paralyzed below the waist. A CT scan revealed that there was a severe distraction fracture in his lower back, which had displaced, causing injury to the spinal cord. Mr. Stahl never regained the use of his legs, or the control of his bowels and bladder, and spent the next year in a wheelchair while living in a long-term care facility over 150 miles away from his wife and family. After that year's time, he ultimately died, never having returned to his home. A lawsuit was started against the United States, for the failure to address the back issues that were evident at the V.A. Hospital. Among the plaintiff's witnesses was the former Chair of the Department of Neurosurgery at the Medical College of Wisconsin, Dr. Sanford Larson, a physician who also previously oversaw the neurosurgical procedures done at the V.A. He testified that the fracture occurred when Mr. Stahl fell; that the hospital was required to have a proper evaluation done of his back; and that, had one been done, it would have revealed the fracture in time to repair it and prevent paralysis. The United States retained an Illinois neurologist who testified that the fracture occurred spontaneously during the hospitalization, and it was impossible for anyone to foresee it happening, or to prevent it. He went on to say that it was just as likely to have occurred while simply lying in bed, as at any other time. This witness tragically died prior to trial, and the government retained a new expert, a neurosurgeon, also from Illinois. He testified that there could be no standard of care to apply to Mr. Stahl, as his situation was too unique. The doctor's basis for saying so was that this was a man with a myriad of health problems that existed before his admission to the V.A. For a doctor to determine a standard of care, he/she must have treated many similar patients in the past, which this witness said he had not. Dr. Larson, however, explained that he had seen and treated dozens and dozens of similar patients, that there clearly is a standard that must apply to doctors overseeing such a patient's care, and that the standard required an immediate evaluation of the severe back complaints, to protect the patient from possible paralysis. The case settled just weeks before trial was set to begin.
