OTHER USEFUL INFORMATION:
The plaintiff, a then 25 year-old-man, experienced the sudden onset of severe testicular pain while lying in bed. That same night, he presented to the emergency department of a Boston-area hospital for evaluation of his symptoms. The emergency room physician who performed the examination of the plaintiff ordered a testicular ultrasound for what the physician believed to be a hernia.
The radiologist who interpreted the ultrasound reported findings consistent with a hernia. The emergency room physician discharged the plaintiff with instructions to follow up with the surgical service for repair of his presumed hernia.
Less than two days later, the plaintiff returned to the same emergency department with increased pain. He was initially thought to have an incarcerated hernia – given the previous diagnosis just two days earlier – but an examination performed by a physician at that time revealed the spermatic cord could be palpated above the scrotum – a finding that seemed to contradict the diagnosis of a hernia.
The plaintiff was taken to the operating room and during the procedure it was revealed that his left testicle had twisted 720 degrees and was necrotic. The testicle could not be saved and had to be surgically removed.
The plaintiff filed a claim against both the attending emergency room physician and the radiologist for failing to properly diagnose and timely treat torsion. A review conducted by plaintiff’s radiology expert revealed that the testicular ultrasound performed did in fact demonstrate absent blood flow to the left testicle – a strong indication of torsion – yet no further testing or intervention was ordered or performed by the plaintiff’s attending E.R. physician.
A key development in the case was the deposition testimony of the defendant E.R. physician – who testified that he personally viewed “video tape” of the plaintiff’s testicular ultrasound shortly after the ultrasound was performed by the hospital’s radiology department. Curiously, a subsequent deposition of the hospital’s chief technology officer revealed that the hospital did not own or operate equipment which would have permitted the ultrasound to be recorded on tape – or any other media – when the defendant claimed to have reviewed the “recorded” results.
The plaintiff’s medical experts were prepared to testify that had surgery been performed then, it was likely that the plaintiff’s left testicle would have been saved.
The defendants claimed that the plaintiff did not present to the emergency department at that time with a classic presentation of torsion. Also, the defendants argued that the testicular torsion was ruled-out by way of ultrasound, which they maintained revealed a hernia-like mass.
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