Whether a jury in Maine will believe that Dr. Larry Labul committed medical malpractice while caring for 84-year-old Maxine Turner will likely depend upon how they evaluate the testimony given by competing medical experts. Their differences of opinion could not be more sharply drawn.
A wrongful death lawsuit filed by Maxine Turner’s estate alleges that Dr. Labul committed several medical errors before discharging Ms. Turner from Franklin Memorial Hospital in Franklin, Maine. Ms. Turner died three hours after the discharge.
Ms. Turner suffered from a number of health conditions that are common to a person of her age, including congestive heart failure, diabetes, and restless leg syndrome. She was on oxygen therapy to help her with her breathing.
Ms. Turner was admitted to the emergency room after she fell out of a chair. A doctor advised her to breathe deeply several times a day to clear her lungs so that she would not contract pneumonia. He also recommended that she wear a rib belt.
Ms. Turner’s family made sure that Ms. Turner followed that advice. They also arranged for 24-hour care as the doctor advised.
Five days later, Ms. Turner’s granddaughter observed that Ms. Turner was no longer breathing as deeply as she should. She was also falling asleep continually. The granddaughter called Ms. Turner’s doctor, who suggested that Ms. Turner might have pneumonia and that her medications might need to be adjusted if they were making her too sleepy. He advised the granddaughter to take Ms. Turner to Dr. Labul for treatment.
Dr. Labul read Ms. Turner’s records, administered some tests, and decided to treat her for chronic obstructive pulmonary disease after noting a deterioration of her oxygen saturation. The granddaughter testified that she asked about pneumonia but Dr. Lubal did not answer. Dr. Labul noted that Ms. Turner was hallucinating and prescribed a psychotropic medication.
Over the next three days, Dr. Labul gradually increased Ms. Turner’s oxygen intake from 2 to 6 liters per minute. He discharged Ms. Turner from the hospital when her oxygen saturation reached an acceptable level. Ms. Turner was still hallucinating at that time. Dr. Labul recommended that Ms. Turner should enter a nursing home or an assisted living center. She was released to a skilled nursing facility, where she died within hours.
Ms. Turner’s granddaughter was told that a medical review of Ms. Turner’s death would be held within 45 days and that she would be invited to participate. She did not hear back from the hospital and her requests for information went unheeded. She eventually received a letter stating that the investigation had been completed and that the hospital was not at fault.
The lawsuit faults Dr. Labul for failing to stabilize his patient’s breathing before discharging her to a nursing care facility. It also alleges that Dr. Lubal or the hospital made medication errors and that Dr. Lubal failed to diagnose Ms. Turner’s pneumonia.
Dr. Labul contends that he considered and ruled out pneumonia. No autopsy was performed to establish the cause of Ms. Turner’s death. That omission might be a difficult barrier for the estate to overcome.
Dr. Thomas Masterson testified as an expert witness for Ms. Turner’s estate. He questioned whether Ms. Turner actually suffered from chronic obstructive pulmonary disease, based on negative test results in her medical records some years earlier.
Dr. Masterson also noted that the dosage of Requip prescribed to treat Ms. Turner’s restless leg syndrome doubled after her admission to the hospital. Dr. Masterson testified that the dosage was excessive and that the medication error probably contributed to Ms. Turner’s hallucinations.
Finally, Dr. Masterson noted that Dr. Labul ordered an echocardiogram but discharged Ms. Turner before it was performed. Dr. Masterson testified that the combination of medical errors were causative factors in Ms. Turner’s death.
The defense countered with the expert testimony of Dr. Joseph Zibrak, a pulmonologist. Dr. Zibrak denied that Dr. Lubal’s treatment contributed to Ms. Turner’s death. He noted that Ms. Turner’s medical records showed that she had a history of chronic bronchitis and emphysema, and expressed the opinion that both diseases are a form of chronic obstructive pulmonary disease.
Dr. Zibrak thought it was unlikely that Ms. Turner died from untreated pneumonia, given the suddenness of her death. He also saw no connection between the death and the failure to perform the echocardiogram.
Another witness who testified on behalf of the defense, Dr. Howard Sachs, testified that Dr. Labul met and sometimes exceeded the standard of care that was appropriate for Ms. Turner’s treatment. After it considers the competing views of the plaintiff and defense experts, the jury will be asked to decide whether Dr. Labul and the hospital were responsible for Ms. Turner’s wrongful death.