NATIONAL POST
Farmer wins $1.5M in lawsuit
Shaughn Butts, Postmedia News
Wayne Forsberg had both legs and one arm amputated after an Alberta doctor waited three hours before treating him for meningitis.
Tom Blackwell, National Post · Aug. 4, 2011 |
Wayne Forsberg had a suspicion he might be suffering from meningitis when he arrived at the local emergency department: the dairy farmer's neck was stiff, his skin was covered in telltale spots and authorities had warned of a local outbreak of the perilous disease.
The rural Alberta physician who saw him was not so sure of what to do, though, and for more than three hours simply conducted tests. By the time Mr. Forsberg - who later would play a central role in Canada's mad-cow-disease crisis - finally got the antibiotics he desperately needed, it was too late.
Clots created by the meningitis bacteria had spread widely and choked off blood flow to his limbs, killing tissue. Surgeons had to amputate large parts of both legs and one arm.
Now, a decade later, Mr. Forsberg has been awarded $1.5-million in a malpractice suit that dramatically highlights the life-and-death time pressures of emergency medicine - and an illness one expert says can advance with frightening rapidity. That treatment delay was unacceptable and caused most of the patient's injuries, Justice Dennis Thomas concluded in ruling against Dr. Dadi Naidoo.
"When faced with a 'very ill man,' Dr. Naidoo knew that a probable cause was bacterial infection, and that there was literally nothing to lose by a very prompt attempt to treat that possible infection with antibiotics," the Court of Queen's Bench judge wrote. "Any medical professional should clearly have known that was the case."
Though he was equipped with prostheses, Mr. Forsberg's mobility was severely restricted and he ended up selling off his cattle herd. (He, his lawyer, and Dr. Naidoo's lawyer all declined to comment on the ruling.)
This is not the first time Mr. Forsberg has made headlines around brain-related illness. Four years after his own 2000 medical crisis, it emerged that an animal from his farm had been diagnosed with mad-cow disease in the United States, contributing to trade restrictions that eventually cost the Canadian cattle industry millions of dollars. The farmer noted at the time that he had raised the infected cow according to government regulations, and called for more extensive testing of cattle. The affair caused "a terrific amount of stress," he told a news conference in early 2004.
The meningococcal bacteria that infected the farmer in October, 2000, can cause both meningitis - an inflammation of the membranes around the brain and spinal cord - or blood infection, or both at the same time, said Dr. Andrew Morris, an infectiousdisease specialist at Toronto's Mount Sinai Hospital. Meningitis can also be caused by a virus, but that illness is relatively benign.
Dr. Morris said he could not comment on the ruling, but noted that most emergency doctors are acutely aware that patients with certain symptoms, like fever and a headache, might have the infection, and that it is crucial to act fast.
"I won't forget the first time I saw it when I was training and a young patient basically died in front of my eyes, within hours," he said. "It humbles most physicians when we see patients come in and deteriorate so rapidly."
In October 2000, Mr. Forsberg, then 61, arrived at the emergency ward of Leduc (POPN:23,000)Hospital,(36 ACUTE BEDS) just south of Edmonton, complaining of fever, a stiff neck and an array of spots. Public health officials had been warning of a spike in cases of bacterial meningitis in the Edmonton area and his wife, Shirley, immediately raised the possibility her husband had been infected.
Joanne Ward, the nurse who first saw him, recognized the spots as signs of bleeding under the skin and a likely blood infection and quickly alerted Dr. Naidoo. Ms. Ward testified in the mal-practice trial that she twice asked the physician if she should start Mr. Forsberg on antibiotics, and twice was told to wait.
A family physician who does shifts in the hospital's emergency department, Dr. Naidoo testified that he realized the farmer probably had a blood infection, or septicemia, but felt he needed to be treated at a larger hospital, and wanted to consult an infectious-disease expert before proceeding. That other doctor suggested by phone conducting a spinal tap that would help narrow the diagnosis. Dr. Naidoo twice tried to carry out the procedure, without success.
More than three hours after the patient arrived, a transfer to Edmonton's Royal Alexandra Hospital was finally arranged. Mr. Forsberg was started on antibiotics there almost immediately.
Judge Thomas concluded that, if the drugs had been started immediately, the farmer would have lost most of his toes and needed some skin grafts but would have been spared the major amputations.
The damages he awarded included over $1-million to cover business losses, about $270,000 for pain and suffering and other sums to compensate his wife and other family members.
The rural Alberta physician who saw him was not so sure of what to do, though, and for more than three hours simply conducted tests. By the time Mr. Forsberg - who later would play a central role in Canada's mad-cow-disease crisis - finally got the antibiotics he desperately needed, it was too late.
Clots created by the meningitis bacteria had spread widely and choked off blood flow to his limbs, killing tissue. Surgeons had to amputate large parts of both legs and one arm.
Now, a decade later, Mr. Forsberg has been awarded $1.5-million in a malpractice suit that dramatically highlights the life-and-death time pressures of emergency medicine - and an illness one expert says can advance with frightening rapidity. That treatment delay was unacceptable and caused most of the patient's injuries, Justice Dennis Thomas concluded in ruling against Dr. Dadi Naidoo.
"When faced with a 'very ill man,' Dr. Naidoo knew that a probable cause was bacterial infection, and that there was literally nothing to lose by a very prompt attempt to treat that possible infection with antibiotics," the Court of Queen's Bench judge wrote. "Any medical professional should clearly have known that was the case."
Though he was equipped with prostheses, Mr. Forsberg's mobility was severely restricted and he ended up selling off his cattle herd. (He, his lawyer, and Dr. Naidoo's lawyer all declined to comment on the ruling.)
This is not the first time Mr. Forsberg has made headlines around brain-related illness. Four years after his own 2000 medical crisis, it emerged that an animal from his farm had been diagnosed with mad-cow disease in the United States, contributing to trade restrictions that eventually cost the Canadian cattle industry millions of dollars. The farmer noted at the time that he had raised the infected cow according to government regulations, and called for more extensive testing of cattle. The affair caused "a terrific amount of stress," he told a news conference in early 2004.
The meningococcal bacteria that infected the farmer in October, 2000, can cause both meningitis - an inflammation of the membranes around the brain and spinal cord - or blood infection, or both at the same time, said Dr. Andrew Morris, an infectiousdisease specialist at Toronto's Mount Sinai Hospital. Meningitis can also be caused by a virus, but that illness is relatively benign.
Dr. Morris said he could not comment on the ruling, but noted that most emergency doctors are acutely aware that patients with certain symptoms, like fever and a headache, might have the infection, and that it is crucial to act fast.
"I won't forget the first time I saw it when I was training and a young patient basically died in front of my eyes, within hours," he said. "It humbles most physicians when we see patients come in and deteriorate so rapidly."
In October 2000, Mr. Forsberg, then 61, arrived at the emergency ward of Leduc (POPN:23,000)Hospital,(36 ACUTE BEDS) just south of Edmonton, complaining of fever, a stiff neck and an array of spots. Public health officials had been warning of a spike in cases of bacterial meningitis in the Edmonton area and his wife, Shirley, immediately raised the possibility her husband had been infected.
Joanne Ward, the nurse who first saw him, recognized the spots as signs of bleeding under the skin and a likely blood infection and quickly alerted Dr. Naidoo. Ms. Ward testified in the mal-practice trial that she twice asked the physician if she should start Mr. Forsberg on antibiotics, and twice was told to wait.
A family physician who does shifts in the hospital's emergency department, Dr. Naidoo testified that he realized the farmer probably had a blood infection, or septicemia, but felt he needed to be treated at a larger hospital, and wanted to consult an infectious-disease expert before proceeding. That other doctor suggested by phone conducting a spinal tap that would help narrow the diagnosis. Dr. Naidoo twice tried to carry out the procedure, without success.
More than three hours after the patient arrived, a transfer to Edmonton's Royal Alexandra Hospital was finally arranged. Mr. Forsberg was started on antibiotics there almost immediately.
Judge Thomas concluded that, if the drugs had been started immediately, the farmer would have lost most of his toes and needed some skin grafts but would have been spared the major amputations.
The damages he awarded included over $1-million to cover business losses, about $270,000 for pain and suffering and other sums to compensate his wife and other family members.
