Thomas C. Dufreche v. Jeffrey Wayne Coco, Md and Internal Medicine Specialists, Inc.

Louisiana Court of Appeal·Decided April 15, 2020·No. 2020-CA-0030·Published

Opinion

THOMAS C. DUFRECHE * NO. 2020-CA-0030

VERSUS * COURT OF APPEAL

JEFFREY WAYNE COCO, MD * AND INTERNAL MEDICINE FOURTH CIRCUIT SPECIALISTS, INC. * STATE OF LOUISIANA

*******

APPEAL FROM

CIVIL DISTRICT COURT, ORLEANS PARISH NO. 2017-03960, DIVISION “L”

Honorable Kern A. Reese, Judge ******

Judge Dale N. Atkins

******

(Court composed of Chief Judge James F. McKay, III, Judge Terri F. Love, Judge Dale N. Atkins)

T. Carey Wicker, III James Alexander Watkins Vincent E. Odom CAPETELLI & WICKER 1100 Poydras Street, Suite 2950 New Orleans, LA 70163-2950

COUNSEL FOR PLAINTIFF/APPELLEE

Kathryn M. Caraway Ann Marie LeBlanc Erica L. Andrews CARAWAY LEBLANC, L.L.C. 3936 Bienville Street New Orleans, LA 70119

COUNSEL FOR DEFENDANT/APPELLANT

AFFIRMED

APRIL 15, 2020

DNA JFM TFL This is a medical malpractice case. Appellants, Dr. Jeffrey Wayne Coco and

Internal Medicine Specialists, Inc. (“IMS”), appeal the trial court’s judgment finding that they breached the applicable standard of care in their treatment of Appellee, Thomas C. Dufreche, and awarding Mr. Dufreche $45,000 in damages for negligent infliction of emotional distress. For the reasons that follow, we affirm.

FACTUAL AND PROCEDURAL BACKGROUND Prior to 2012, Mr. Dufreche underwent periodic testing for human immunodeficiency virus (“HIV”). In June 2012, Mr. Dufreche sought HIV testing from Dr. Coco, a physician in New Orleans who specializes in infectious diseases.

At the time when Dr. Coco treated Mr. Dufreche, Dr. Coco was practicing in the area of infectious diseases at IMS in New Orleans.

In May 2012, prior to Mr. Dufreche seeing Dr. Coco, Mr. Dufreche sought treatment from his primary care physician, Dr. Alan Bowers. Dr. Bowers administered a rapid HIV anti-body blood test1 for Mr. Dufreche. The test was negative. A few weeks later, on June 9, 2012, Mr. Dufreche went to the emergency

1 This test picks up the anti-bodies that a patient develops in response to the antigens that are on the cell wall of the HIV virus. Usually, results are reported in less than an hour.

room at Touro Infirmary Hospital (“Touro”) in New Orleans for general malaise, and another rapid HIV anti-body blood test was performed, which was also negative. The medical providers at Touro performed several other diagnostic tests, yet were unable to diagnose the cause of Mr. Dufreche’s symptoms.

After his symptoms persisted, Mr. Dufreche’s friend and neighbor Kevin Adams, who was a nurse at Touro, suggested that Mr. Dufreche seek follow-up treatment from Dr. Coco at IMS. Mr. Adams helped Mr. Dufreche get an appointment with Dr. Coco on June 12, 2012. Mr. Dufreche’s appointment with Dr. Coco lasted about forty-five minutes. According to Mr. Dufreche, Dr. Coco told Mr. Dufreche that he believed Mr. Dufreche’s malaise symptoms were likely the result of a virus that would run its course and about which Mr. Dufreche need not worry. Nevertheless, at Mr. Dufreche’s request, Dr. Coco ordered an HIV viral load blood test for Mr. Dufreche, also called the HIV-RNA quantitative test, which measures active viruses in the body. The results took a few weeks to come back. According to Mr. Dufreche, at the conclusion of his appointment, Dr. Coco informed him that Dr. Coco would notify him of the results of the test when they came in.

Dr. Coco received the results of Mr. Dufreche’s HIV test at IMS on June 19, 2012, and he reviewed them on June 21, 2012. The test showed Mr. Dufreche had HIV and a high viral load.2 Dr. Coco did not notify Mr. Dufreche when he received the results of Mr. Dufreche’s HIV test, nor did anyone else at IMS. Consequently, Mr. Dufreche never had a follow-up appointment with Dr. Coco. According to the record, Dr. Coco reviewed Mr. Dufreche’s test results again several months later so

2 Viral load is used to determine the amount of HIV in the blood. The higher the load, the more susceptible the patient is to becoming ill because of HIV.

he could sign Mr. Dufreche’s medical chart. Again, Mr. Dufreche was not notified of the test results.

According to Dr. Coco, it is and always has been his practice to have his office staff request that patients schedule follow-up appointments when ordering HIV tests so that the results of the test could be discussed with the patient in person. Dr. Coco maintained that he never discusses the results of HIV tests with patients via telephone because of the sensitive nature of communicating such test results and the need to provide some counseling and treatment options to the patient. Nevertheless, Dr. Coco, nor anyone from his staff, could recall or definitively show through Mr. Dufreche’s medical records or otherwise whether Mr. Dufreche was ever informed of this policy or asked to schedule a follow-up appointment. Mr. Dufreche maintains that he was never told that a follow-up appointment needed to be scheduled, and he heard nothing further from Dr. Coco. When he received no communication from Dr. Coco or IMS and his symptoms subsided, Mr. Dufreche assumed that, as Dr. Coco had said, his symptoms were the result of a virus that had run its course and the results of the HIV test were negative.

Fifteen months passed, during which Mr. Dufreche was unaware that he was HIV positive. In September 2013, after he could not get an appointment with Dr. Bowers, Mr. Dufreche sought treatment from another primary care physician, Dr. Kenneth Combs, for small spots on his left leg, sinus issues, and a flu shot. At Mr. Dufreche’s request, Dr. Combs ordered an HIV anti-body western blot test. The test was positive. Before Dr. Combs could notify Mr. Dufreche of his positive HIV test, a social worker with the Louisiana State Department of Health (“LDH”) contacted Mr. Dufreche and offered him help in finding medical care due to a

blood test that had been reported to the LDH. When Mr. Dufreche met with the social worker from the LDH in person a few days later, he learned the positive blood test in the LDH’s possession was the one from Dr. Coco’s office that was performed in June 2012. This was the first time Mr. Dufreche was notified he was HIV positive, and he immediately sought treatment from Dr. Bowers.

Mr. Dufreche filed a request for a medical review panel on September 27, 2014. The panel unanimously concluded that there was a material issue of fact bearing on Dr. Coco’s and IMS’s liability for the court’s consideration on the following issues:

1. Whether or not the patient was notified of Dr. Coco’s office policy to make a follow-up appointment in reporting HIV test results.

2. Whether CDC guidelines indicate that the communication of positive HIV test results should not be communicated by telephone or mail and follow-up appointments are recommended.

3. Whether Mr. Dufreche was offered a follow-up appointment by Dr. Coco or his staff, as Dr. Coco’s medical records do not reflect a written policy to indicate how HIV test results are communicated or whether the patient was offered a follow-up appointment, nor do they reflect whether the patient attempted to obtain his results.

On April 26, 2017, Mr. Dufreche filed a petition for damages in Orleans Parish Civil District Court, naming Dr. Coco and IMS as defendants. He alleged that Dr. Coco and IMS deviated from the applicable standard of care of a physician and a physician’s clinic by mismanaging Mr. Dufreche’s medical care, failing to advise Mr. Dufreche of his positive HIV status, and failing to follow-up on medical tests ordered and sent from IMS. Mr. Dufreche further alleged that, because of Dr. Coco’s and IMS’s negligence, he went unaware that he was HIV positive for

approximately fifteen months, suffered a delay in treatment for his medical condition, and suffered from the psychological shock of learning that he had HIV by the LDH via telephone. He also alleged emotional distress from worry over his prognosis in treating HIV due to the delay in treatment and from not knowing whom he may have infected during the fifteen-month period in which he was unaware he was HIV positive.

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Thomas C. Dufreche v. Jeffrey Wayne Coco, Md and Internal Medicine Specialists, Inc., (La. Ct. App. 2020).

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