Toal v. United States

306 F. Supp. 1063, 1969 U.S. Dist. LEXIS 8852
CourtDistrict Court, D. Connecticut
DecidedDecember 4, 1969
DocketCiv. No. 11052
StatusPublished
Cited by5 cases

This text of 306 F. Supp. 1063 (Toal v. United States) is published on Counsel Stack Legal Research, covering District Court, D. Connecticut primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Toal v. United States, 306 F. Supp. 1063, 1969 U.S. Dist. LEXIS 8852 (D. Conn. 1969).

Opinion

MEMORANDUM OF DECISION

ZAMPANO, District Judge.

This is an action brought by the plaintiff under the provisions of the Federal Tort Claims Act, 28 U.S.C. § 1346(b), seeking to recover for injuries allegedly caused by the negligence of the defendant’s doctors who treated the plaintiff at the Veterans Administration Hospital in West Haven, Connecticut.

The plaintiff, James F. Toal, now 52 years old, suffered a back injury while serving in the Navy during World War II. This injury entitled him to receive medical treatment for his back at Veterans Administration Hospitals in the future. After his discharge from the service in 1946, he rejoined the New York City Police Department.

Toal’s back pains persisted and in October, 1951, he was admitted to the Columbia Presbyterian Hospital in New York City for a laminectomy and spinal fusion of the L-4 through S-l. Because his back condition was found to be service connected, he received a 60% disability compensation award from the Veterans Administration. In 1952 he retired on disability from the police department and entered the insurance business. Two years later the plaintiff was hospitalized for six weeks for a condition diagnosed as “arteriosclerotic heart disease with coronary insufficiency and anginal syndrome.” He made a satisfactory recovery and this condition has not been a source of difficulty since that time.

During the period 1956-1960, Toal was earning an average of approximately $28,000 per year. In 1956 he was named “Man of the Year for the Mutual Benefit Life Insurance Company,” and later became the head of the estate and pension planning department for Financial Planning Corporation.

In June, 1961, the plaintiff traveled to Austria where his back condition took a severe turn for the worse. He was treated by several doctors recommended by the American Consulate, and in January, 1962, he was admitted to the Federal Public Hospital for Neurosurgery in Bad Ischl, Austria. A myelogram was performed with a watersoluble dye; the findings indicated the necessity for renewed surgical intervention in the area of the third intervertebral space. During this period of time he was considered 100% disabled and unemployable.

In April, 1962, Toal returned to the United States in order to receive treatment at the Veterans Administration Hospital, West Haven, Connecticut. The Hospital has a professional working relationship with the Yale University Medical School which supervises a residency training system there. Graduation from a medical school, an internship, and a residency in general surgery are prerequisites for admission to the three-year residency in orthopedic surgery at the Hospital.

Toal entered the Hospital on May 1st, and became the patient of Dr. John Elliott who was in the eleventh month of his first year of a residency in orthopedic surgery. On May 2, 1962, Toal was evaluated by the Neurosurgery Service and a myelogram was recommended to evaluate his back problems.

Myelography involves the introduction of an iodized radio-opaque contrast material into the patient’s spinal cord by means of a lumbar puncture, usually at the interspace between L2 and L3, with an 18 gauge needle. First the spinal fluid is measured and manometric tests are performed. If there is a free flow of spinal fluid, a small amount of it is removed for protein examination, a cell count and other tests. Then usually about 10 to 15 cc.’s of pantopaque are inserted into the spinal column with the patient in a lateral recumbent position. He is then turned over to a prone position on a flat table that can be tilted. The entire spine is scanned by X ray as the patient is placed at different angles. If the cervical region is to be viewed, the head is lowered with the chin slightly [1066]*1066extended, and the pantopaque is allowed to run into the cervical area. Films are taken throughout this period. After the X rays are taken, the usual and customary procedure in the United States is to tilt the patient to allow the pantopaque to collect again in the lumbar sac and then to aspirate as much of the pantopaque as possible. The dye is removed with the needle positioned in the same pathway formed when the substance was inserted.

On May 23rd, Dr. Elliott and a radiologist performed the myelogram on Toal. Dr. Elliott operated the needle and the radiologist did the scanning and took the X rays. According to the plaintiff, the procedure caused him a great deal of pain and his legs were jerking as if they had “electric shocks in them.” He testified that he heard Dr. Elliott exclaim, “I’m getting nothing but blood out,” and that thereafter Dr. Elliott left the room for a few minutes. Upon Dr. Elliott’s return, Toal claims he stated, “I can’t find him,” and then said, “I’ll have to leave * * * the (pantopaque) in.”

On or about June 1st, Dr. Elliott made the following entry in the hospital record:

Myelogram today. Ten cc.’s of pantopaque injected Ll-2 without difficulty. Good myelography attained. However, dye could not be removed, except for a few cc.’s, despite all efforts to do so. Finally, because trauma seemed to be outweighing the possible advantages of dye removal, it was decided to withdraw the needle.

Although at trial Dr. Elliott recalled very little of the circumstances surrounding the myelographic procedure on Toal, he was adamant that it was not his decision to remove the needle allowing the pantopaque to remain in Toal’s body but that the radiologist instructed him to stop the procedure. Since he “was learning at the time,” Dr. Elliott testified, he would not “have dared to voice an opinion” on the subject.

During the remainder of Toal’s stay in the Hospital, there was no further attempt to remove the pantopaque from his spinal column. No operation was performed. Toal testified that prior to his release from the Hospital on May 31st, Dr. Elliott admitted to him that the pantopaque was not removed but that it was “standard procedure” to leave it in, that “it would eventually absorb,” and that there was “nothing to worry about.”

Four days later the plaintiff was involved in an automobile accident as a result of which he was hospitalized for a month suffering from head, neck, and back injuries.

In February, 1963, the plaintiff returned to Austria. Because of his severe headaches, Dr. Eric Strasser took a series of skull X rays on March 7, 1964, which revealed the presence of globules of pantopaque in the cranial area in the sub-arachnoid spaces, the sylvian fissure, the sylvian cistern, and on the pia, a membrane covering the brain. It was on this date that the plaintiff first learned that the dye was lodged within his skull and that the presence of this material in that area might be harmful. After receiving several medical opinions that his symptoms were causally related to the retained pantopaque, the plaintiff instituted this action on July 27, 1965.

The plaintiff's primary claims of malpractice and negligence are (1) that Dr. Elliott was not qualified or competent to perform the myelogram, and (2) that the failure to remove the pantopaque at the completion of the myelogram was contrary to the standards of reasonable medical care required under the circumstances. The defendant denies these allegations and affirmatively contends the plaintiff’s action is barred by the statute of limitations.

Statute of Limitations

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Cite This Page — Counsel Stack

Bluebook (online)
306 F. Supp. 1063, 1969 U.S. Dist. LEXIS 8852, Counsel Stack Legal Research, https://law.counselstack.com/opinion/toal-v-united-states-ctd-1969.