Frankford Hospital & Doctors Settle Med Mal “Bleed-Out” Case for $4.5 Million

The parents of a 20-year-old college student who died after hospital doctors removed his spleen settled with their son’s doctors and the hospital Monday for $4.5 million, lawyers involved with the case said.

Joseph Ruzzi’s parents had filed a wrongful death and survival suit against Joseph’s surgeon, two anesthesiologists and Frankford Hospital in Torresdale, alleging the defendants failed to discover post-operative bleeding, resulting in their son bleeding to death, according to court documents.

In an unusually public medical malpractice settlement, the details of the agreement between the parties were released — an exception to regular settlements involving the MCARE fund that typically require confidentiality, according to the lawyers in the case.

Michael Ruzzi, Joseph’s father, had been so upset by the circumstances surrounding his son’s death that he promised not to settle unless the agreement was made public, according to Slade H. McLaughlin of McLaughlin & Lauricella in Philadelphia.

The parties were prepared to go to trial Monday after picking a jury Friday, the lawyers said.  Instead of presenting opening arguments, they spent the morning discussing settlement terms with the help of Philadelphia Common Pleas Judge Arnold L. New.

The Ruzzis will not collect the entire $4.5 million from the defendants because of the 2002 bankruptcy of PHICO Insurance Co., which insured two of the defendants.  But they expect to collect at least $4 million, and their lawyers said they would seek the remaining $500,000 by filling a claim in bankruptcy court as a creditor.

Joseph Ruzzi was a student in the culinary arts program at the Community College of Philadelphia, according to court documents.  The Ruzzis took their son to the emergency room at Frankford Hospital after he became feverish and complained of abdominal pain.

Ruzzi had mononucleosis, which can cause the spleen to swell as it filters excess white blood cells aroused by the infection.

Doctors at the hospital said Ruzzi needed immediate surgery to remove his spleen– a 60-minute procedure performed by Dr. Glenn D. Horowitz. Hours later, while Ruzzi was resting in the recovery room, alarms monitoring his vital signs sounded as his heart began to fail.  Ruzzi was rushed back into surgery.

The two trauma surgeons who re-opened his abdominal cavity were joined by Horowitz, who had left the hospital but was called back for the emergency. What the surgeons found inside Ruzzi while attempting to save him would have been disputed at trial, lawyers for both sides said.

Not only were the facts surrounding Ruzzi’s death in dispute between the plaintiffs and defendants, but also among the defendant doctors, said Dean F. Murtagh of German Gallagher & Murtagh, the lawyer for Horowitz.

“It was an ugly case because no one could figure out what happened,” Murtagh said.

McLaughlin would have argued that Ruzzi was showing symptoms of internal bleeding during the four hours he laid in the recovery room, the lawyers said.  Ruzzi’s surgeon, the anesthesiologists, and the nurses should have recognized the symptoms and treated the post-operative bleeding, McLaughlin said. Because they hadn’t, Ruzzi bled to death.

Murtagh said he would have argued in response that Ruzzi’s “mono” infection caused the ventricles controlling blood flow to his heart to become enlarged, suppressing the amount of blood that reached the organ.

There was no quarrel with the original surgery, Murtagh noted.  When Ruzzi’s abdomen was opened for the second time “there was no surgery to be done– all the sutures were tight,” Murtagh said.  An autopsy report supported this fact, he said.

But there was also a significant amount of fluid in Ruzzi’s belly, Murtagh said.

The plaintiffs contend the fluid was blood and this was evidence of post-operative bleeding.  One of the trauma surgeons said there was blood in the abdomen, Murtagh said.

Horowitz acknowledged that there was fluid, and that that fluid may have been tinged with blood, but he claimed that the fluid itself was not blood. “It could maybe not have been blood,” Murtagh said.  “But [the plaintiffs] had a substantial reason for saying that.  They had a good doctor who had made that statement.”

If the case had gone to trial, Murtagh said, “a deciding factor would have been the discrepancies among the defendant doctors.”

Under the terms of the settlement breakdown, the hospital would pay $1.2 million, Horowitz $1.2 million, anesthesiologist Leighton S. Perrins $1.2 million and anesthesiologist Michel Maria Gunnells $900,000, lawyers said.

The Pennsylvania Property  Insurance and Casualty Guarantee Association was involved with the agreement in regards to Perrins and Gunnells, who were insured by the now bankrupt PHICO Insurance Co.

But PPICGA only provides $300,000 in total coverage for both doctors; the MCARE Fund would pay some of the amount in excess of the doctors’ primary policies, allowing the Ruzzis to recover $1.1 million from Perrins and $500,000 from Gunnells.

As for the remaining $500,000, the Ruzzis’ lawyer said he would attempt to recover the balance from the PHICO Insurance Co. Estate through the bankruptcy proceeding.

The Legal Intelligencer – November 19, 2003
By Melissa Nann

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