Barr v. Beck

21 Pa. D. & C.5th 311
CourtPennsylvania Court of Common Pleas, Montgomery County
DecidedFebruary 3, 2011
Docketno. 1095 EDA 2009
StatusPublished

This text of 21 Pa. D. & C.5th 311 (Barr v. Beck) is published on Counsel Stack Legal Research, covering Pennsylvania Court of Common Pleas, Montgomery County primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Barr v. Beck, 21 Pa. D. & C.5th 311 (Pa. Super. Ct. 2011).

Opinion

ROGERS, J.,

T. INTRODUCTION

Appellant Carolyn D. Barr, individually and as administratrix of the Estate of Darren Barr, de[313]*313ceased (“appellant”), appeals to the Superior Court of Pennsylvania (“Superior Court”) from the denial of appellant’s post-trial motion for relief docketed on March 4, 2009. Pursuant to Pa.R.A.P. 1925(b), appellant submitted a concise statement of errors complained of on appeal (“concise statement”). This opinion is filed in accordance with Pa.R.A.P. 1925(a).

II. FACTUAL AND PROCEDURAL FIISTORY

This is a medical malpractice action arising from the death of Darrin Barr (“Mr. Barr” or “decedent”), a 32-year-old man, at North Penn Hospital on November 21, 1998. Mr. Barr was a patient of Lansdale Medical Group since February 1991. Between 1991 and 1998, Mr. Barr was seen by Jonathan E. Beck, D.O. (“Dr. Beck”) for routine visits. On October 20, 1998, Mr. Barr was seen at Lansdale Medical Group by Linda Nadwodny, D.O. (“Dr. Nadwodny”), a partner of Dr. Beck, with complaints of rib cage pain and shortness of breath associated with use of a bench press.

On October 22, 1998, Mr. Barr was diagnosed with mild left lower lobe pneumonia and lower respiratory infection by Dr. Nadwodny. The diagnosis was based on Mr. Barr’s symptoms and on a chest x-ray that showed fluid in the left lower lobe and atelactasis in the right middle lobe (N.T. November 28, 2007, pp. 82-93). Based on the symptoms and chest x-ray, Dr. Nadwodny believed the pneumonia was bacterial and not viral in origin. Dr. Nadwodny prescribed an oral antibiotic called Azithromycin, and Mr. Barrs symptoms improved (N.T. November 28, 2007, pp. 92-93). Mr. Barr was seen by Dr. Nadwodny [314]*314a second time for follow up on November 4, 1998. According to Dr. Nadwodny’s November 4,1998 office note, Mr. Barr’s symptoms had resolved. A second chest x-ray was done which showed resolution of the left lower lobe infiltrate and the right lung atelactasis (N.T. November 28, 2007, pp. 93-95). On November 14, 1998, Mr. Barr’s symptoms returned and he called Dr. Beck’s office. A second course of Azithromycin (Zithromax) was prescribed over the phone (N.T. November 28, 2007, pp. 103-105).

On November 21, 1998, Mr. Barr reported to the emergency room at North Penn Hospital complaining of shortness of breath (N.T. December 5, 2007, p. 11 [Forstater]). Mr. Barr reported to the triage nurse that he just completed a second round of antibiotics for recurrent pneumonia. Id. He told the nurse that he had been treated for left lower lobe pneumonia, which had recurred on the right side approximately one week before he came to the emergency room (N.T. November 29, 2007, pp. 34-41; N.T. November 30, 2007, pp. 26-32).

Dr. Derby, the attending emergency room doctor, ordered chest x-ray, blood tests and an arterial blood gas study (N.T. December 5, 2007, pp. 12-13 [Forstater]). Dr. Derby found the tests inconclusive. At approximately 6:55 p.m., he consulted with Dr. Driver, the pulmonologist on call that evening (N.T. December 5,2007, pp. 9-10 [Driver]). Dr. Derby called Dr. Driver and explained Mr. Barr’s history noting that Mr. Barr’s chest x-ray was unremarkable. He told Dr. Driver that Mr. Barr was hypoxemic (N.T. December 5, 2007, p. 10 [Driver]). Drs. Derby and Driver briefly discussed possible causes for Mr. Barr’s condition, including pneumonia and pulmonary embolism [315]*315(N.T. December 5, 2007, p. 11 [Driver]). Dr. Derby told Dr. Driver that he was going to speak with Mr. Barr about leaving the hospital and receiving treatment for his shortness of breath on an out-patient basis (N.T. December 5, 2007, pp. 14-15 [Driver]). Dr. Derby also indicated that he would ask Mr. Barr if he wanted to see a pulmonary specialist before leaving the hospital (N.T. December 5, 2007, p. 14 [Driver]).

Dr. Derby paged Dr. Driver again to advise him that Mr. Barr had requested to see a pulmonary specialist (N.T. December 5, 2007, p. 18 [Driver]). Dr. Driver arrived at North Penn Hospital at approximately 8:00 p.m. (N.T. December 5, 2007, p. 19 [Driver]). Dr. Driver reviewed Mr. Barr’s chart, including the lab results and chest x-ray, and then met with Mr. Barr (N.T. December 5, 2007, pp. 20-23 [Driver]). Dr. Driver examined Mr. Barr, observed Mr. Barr’s demeanor, and concluded that Mr. Barr appeared comfortable; did not have difficulty speaking; and did not appear to be short of breath or cyanotic (N.T. December 5,2007, p. 24 [Driver]). Dr. Driver observed that Mi'. Barr did not show signs of impending respiratory failure despite the fact that his oxygen levels appeared to be below normal1. Mr. Barr had no difficulty communicating and did not appear to be in distress. Mr. Barr responded in the negative to having any chest pain (N.T. December 5, 2007, p. 27 [Driver]).

Dr. Driver concluded his examination of Mr. Barr at approximately 8:45 p.m. He found no evidence of deep [316]*316vein thrombosis, no edema, and no tenderness on examination. However, upon completion of his examination of Mr. Barr, Dr. Driver suspected that Mr. Barr might have a pulmonary embolism (N.T. December 5, 2007, p. 33 [Driver]). Dr. Driver also believed that Mr. Barr could be exhibiting abnormal symptoms of pneumonia or suffering from some form of cardiac distress (N.T. December 5, 2007, pp. 34-35 [Driver]).

Dr. Driver admitted Mr. Bair to the hospital. He prescribed heparin, started a course of antibiotics, and requested a cardiology consult for Mr. Barr in the morning (N.T. December 5, 2007, p. 34 [Driver]). Dr. Driver ordered the testing to confirm or rule out the suspected pulmonary embolism (N.T. December 5, 2007, p. 36 [Driver]).

Dr. Driver ordered the “standard” dose of heparin for Mr. Ban; which was generally accepted in 1998 (N.T. December 5, 2007, p. 38 [Driver]). Dr. Driver testified that he was aware that in 1998 certain physicians were utilizing a weight-based protocol for administering heparin to patients but that he believed that the standard dose was appropriate at the time (N.T. December 5,2007, p. 52 [Driver]). Mr. Barr was transferred from the emergency room to a patient floor of the hospital (N.T. December 5,2007, pp. 34,37 [Driver]). Shortly thereafter, he began seizing (N.T. December 5, 2007, pp. 40-41 [Driver]). At approximately 10:00 p.m., Dr. Driver was paged and, upon being informed of the seizure, ordered valium. Dr. Driver contacted a neurologist for consultation about Mr. Bair’s condition but was inteirupted by an emergency page from the hospital. Dr. Driver contacted the hospital and was informed that Mr. Barr was in cardio-respiratory arrest (N.T. December [317]*3175, 2007, pp. 41-42 [Driver]). Dr. Driver returned to the hospital to supervise the treatment of Mr. Barr until 10:56 p.m., when Mr. Barr was pronounced dead (N.T. December 5, 2007, pp. 43-45 [Driver]). The autopsy revealed a massive bilateral pulmonary embolism.

Appellant commenced a medical malpractice action by filing a writ of summons on September 7, 1999. The complaint was filed on January 24, 2000. The trial commenced on November 27,2007 and concluded on December 10, 2007. The jury rendered a verdict in favor of all defendants.

On December 19, 2007, appellant filed her motion for post-trial relief. After consideration of appellant’s motion, appellees’ responses thereto, and oral argument on May 16, 2008, this court denied the post-trial motion by order dated March 2,2009 and docketed on March 4,2009.

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21 Pa. D. & C.5th 311, Counsel Stack Legal Research, https://law.counselstack.com/opinion/barr-v-beck-pactcomplmontgo-2011.