LAT: John Ritter's Family Files Lawsuit Against Hospital

[question everything]

http://www.latimes.com/business/la-fi-ritter10sep10,1,5034761.story

John Ritter's Family Files Lawsuit Against Hospital
Robert W. Welkos

September 10, 2004

The family of television star John Ritter has filed a wrongful death lawsuit against the hospital and medical staff who treated the 54-year-old actor after he collapsed on the set of the ABC sitcom "8 Simple Rules for Dating My Teenage Daughter" last year.

The suit, filed Sept. 3 in Los Angeles County Superior Court by Ritter's wife, Amy Yasbeck, and four children, including actor Jason Ritter, claims Ritter's death was caused by "misdiagnosing his condition" and "failing to provide proper treatment in connection with an ascending aortic aneurysm that would have saved his life."

Ritter was stricken Sept. 11, 2003, and taken to the Providence St. Joseph Medical Center emergency room in Burbank. Death was attributed to a tear in his aorta. Rushed to the hospital complaining of chest pain, nausea and vomiting, the suit alleges, Ritter was misdiagnosed as having a heart attack.

[soleft]

1. another frivilous law suit that will prevent hospitals from spreading love

:eyes:

[question everything]

3. Doctors are not gods and medicine is still more an art than science

but once we go through life being assured that every problem can be solved or prevented, and that when bad things happen to us it is always someone's fault - we sue.

The most striking example is the surprise of Clinton's blocked arteries - a lengthy process that was not discovered when he had the best medical care in the world

[redqueen]

4. Wasn't it recently reported that medical errors

result in some ridiculously high number of fatalities? That the costs of dealing with the problems are astronomical?

I'm sorry... but brushing off serious medical errors as just because it's 'more art than science' isn't going to help us address the reasons for these mistakes. If there is negligence, it should be dealt with. And IMNSHO, there's more than enough negligence to go around.

[Warpy]

5. I'd have to know how he was treated

and how treatment options had been explained to him and his family to make too much of a comment on this one.

The fact is that he presented with classic symptoms of a heart attack. Ruptured ascending aortic aneurysms are extremely rare, especially when compared to the numbers for garden variety heart attacks. If any error was made, it was on the side of the statistics.

Negligence would mean that someone hadn't bothered to treat him, which I don't think was the case. Malpractice would involve treating him with a discarded protocol, which might or might not be the case.

Surgery is the treatment of choice for a ruptured aneurysm, and he did die on the operating table. The statistics for ruptured aneurysm are not good, even when surgery is immediate.

I feel very sorry for his family, but I don't think this suit will get very far, just a gut feeling.

[gratuitous]

6. And unfortunately, the best vehicle for determining this is . . .

Yes, the facts of the treatment, the determinations made by the folks involved and on what basis, and an evaluation of what was or wasn't done is absolutely crucial to finding out if malpractice indeed happened.

Unfortunately, the best way to find this out is through a lawsuit. The only alternative to a civil suit at this time is a criminal suit. Should doctors, hospitals and their staff be at risk for jail time for negligence? Or should we simply create a special class for medical practitioners that they are legally proof against any errors of omission or commission?

[patcox2]

9. What is an "error"? There are such things as blameless errors

And there are such things as unavoidable errors. The person above is right, just because something bad happens does not mean its someone's fault.

A bad outcome is not an "error," nor is a misdiagnosis, unless the misdiagnosis was the result of negligence.

If a 50 year old man comes in short of breath, with chest pains and nausea, the odds greatly favor the fact that he is having a heart attack (a common occurrence) as opposed to a rupturing aortic anuerysm (a relatively rare occurence).

You can call it an "error" that they treated him, in an emergency situation, in accordance with the most likely diagnosis. But it is not necessarily negligence. Certainly if they had more time they would have correctly diagnosed, but there were only minutes to work with.

Our society is incredibly punitive, blaming, intolerant of normal human imperfection, it shows in so many aspects of our legal system. We hold children to the culpability level of adults, we pillory anyone who makes a mistake, and we are coming close to criminalizing normal human nature, making any imperfection, any physical or judgment lapse a crime (driving while tired, driving while distracted, driving while irritable, in each case you will find a shrill finger-pointer arguing that its the same as murder).

We lack the capacity to accept the normal random tragedy that makes up human existence.

We don't want to accept that we will all die, sooner or later.

We need scape-goats for every single lapse from the perfection we crave so that we can avoid the discomfort of having to accept the fact that life is random and tragedy happens and that we are all eminently fallible.

[theHandpuppet]

11. THANK YOU!!

God, I've been waiting for the longest time for someone to say what you just expressed so eloquently.

[nothingshocksmeanymore]

13. You would be correct if ruptured anyeurism as rare as you say it is

in that age group, but it really isn't. An ultrasound which is how one is diagnosed takes only minutes.

[LanternWaste]

17. it would appear that a CT Scan, MRI and/or CSF analysis is used

As per http://www.chclibrary.org/micromed/00042010.html


"...based on the clinical symptoms, a doctor will run several tests to confirm an aneurysm or an SAH. A magnetic resonance imaging test (MRI) may be done instead of a CT scan. MRI, however, is not as sensitive as CT for detecting subarachnoid blood. A CT scan can determine whether there has been a hemorrhage and can assist in pinpointing the location of the aneurysm. The scan is most useful when it is done within 72 hours of the rupture. Later scans may miss the signs of hemorrhage."

[Ilsa]

22. But I'd rather have them look at the possibility and treatment for a

heart attack first, as that is more likely, vs not being treated for a heart attack, and they waste precious time on what might be a wild goose chase.

[question everything]

30. Certainly his death raised the level of awareness of this problem

and more, I think, now undergo CT scan to detect it.

[GarySeven]

15. The standard for malpractice is ...

the "standard of care" rule -- not what is the "state of the art" in medicine, but what would OTHER doctors do when presented with the same situation.

In other words, if a person came into a doctor's office suffering from shortness of breath, there could be any number of reasons why. There is among doctors a standard of care -- a protocol they are all supposed to go through to determine whether the guy may have asthma or about to have a heart attack.

The law doesn't expect every doctor to be right all the time; that's a ridiculous standard. But the law does expect for the medical profession to set standards of care and for doctors to uphold it. If they don't, that's negligence and that's actionable.

[gratuitous]

24. Just so

And how is it going to be determined whether the doctor or hospital met the standard of care? Take the doctor's word for it? Hmmm. There may be a problem with that as a solution.

How about, I don't know, we set up a system with rules of evidence, rules of procedure, and a chance for both sides to present their side of the story to an impartial arbiter, elected by the people, whose decisions are reviewable by a panel of other impartial arbiters.

But how would we set such a system up?

[patcox2]

25. I have tried a med mal case, represented the plaintiff, too

So I am pretty well familiar with both the legal system and with the standard of care in a medical malpractice case.

Our legal system is fucked up, but still pretty close to the best there is. I was criticizing not so much the law and the courts as the general societal trend towards blaming, looking for the fault behind every bad thing that happens. I was criticizing the trend towards extending culpability, increasing punishments, in general. I am appalled at the rise in strict liability offenses, in the criminalization of merely negligent actions, and in the extremely judgemental and condemnatory tone and trend in society.

Its present everywhere, here among progressives as much as among conservatives.

Its ugly.

When I was a boy riding in the car with my father, and we saw a bum on the sidewalk, or passed by a prison, my father would make a gentle remark about the "poor souls" who had "lost their way." Its called compassion, the word literally means shared pain, the empathy stemming from the recognition that noone is better than anyone else, we are all just insignificant flawed beings muddling our way through life and we ought not to judge others and we ought to have pity and compassion for others.

Its gone, that message I got from my father, all I hear and see anymore from people all around me is "he was wrong, he was negligent, prosecute, sue, punish to the fullest extent of the law." The arrogant,nit-picking, superior judgmentalism I see here sometimes is disgusting. There isn an arrogance to it, a hint of "I am perfect, I have never made a mistake."

[gratuitous]

27. I would suggest you start a separate thread

In this thread, we appear to be talking about the wrongful death lawsuit brought by John Ritter's estate, which alleges that the doctors and the hospital failed to meet their standard of care which resulted in Mr. Ritter's death. I haven't seen the medical records, I don't know what happened at all. Were the doctors or the hospital negligent? Did they miss something obvious? I don't know. I'll go way out on a limb and suggest that you don't, either. And finding out the truth of what happened hardly means "arrogance" or "perfection" on the part of the person inquiring.

Is our society too litigious? Perhaps. But I would submit that finding out the truth of any particular matter is better handled in a court of law, and the courthouse doors should be open to all citizens. It hasn't been that long in the western tradition that some poor schlub killed by a wealthier or more influential member of society had any recourse whatsoever. But there's definitely a movement afoot to go back to the days when a person injured or killed by a wealthy or influential person's negligence or outright recklessness doesn't have any right to compensation.

[Cocoa]

2. ABC morning news had a touchy-feely Ritter story today

I didn't see the whole thing, but I don't recall any mention of the suit...

[bleedingheart]

7. My assumption is that an echocardiogram would have diagnosed

the real problem versus an electrocardiogram.

Had they seen the problem perhaps he would have had the emergency surgery to repair the defect....If they had diagnosed it correctly and he still would have died (perhaps during surgery) there wouldn't be grounds for a lawsuit.

Look at Bill Clinton...all those physical examinations and he was a ticking time bomb..now that makes one wonder what the hell is going on...

[redqueen]

8. Are echocardiograms more expensive than electrocardiograms?

If so, there's your answer.

[patcox2]

10. No they are not. I have had several.

My doc does them in his office.

[nothingshocksmeanymore]

14. Nope...anyeurism is diagnosed by ultrasound

it's a blood clot.

[rocketdem]

16. No, this is incorrect. I've had this same condition that killed Ritter.

I had the nearly exact same condition two and a half years ago. The only difference was that mine was properly diagnosed and repaired.

It is not a blood clot and it is not caused by a blood clot. It is a bulging and potential tearing and rupture of the aorta.

If your ascending aorta opens up, you're dead.

It can be found with a CAT scan or an angiogram or with a trans-esophageal echocardiogram.

The only way to repair it is open heart surgury and replacement with a synthetic artery.

[Blind Tiresias]

31. an aneurysm

is short stretch of blood vessel that dilates and bursts because of increased pressure from hypertension and occlusion from atherosclerosis has worn out the vessel wall. As a result, the thing bursts and you get hemmorrhage and unless you act fairly quickly death.

[bleedingheart]

19. an echocardiogram is an ultrasound..

I have had many...it would have detected the clot..

I have had mine to monitor the ejection fraction of my heart.

"Transthoracic echocardiogram (TTE); Echocardiogram - transthoracic; Doppler ultrasound of the heart; Surface echo
Definition Return to top

Echocardiogram is a test that uses sound waves to create a moving picture of the heart. The picture is much more detailed than X-ray image and involves no radiation exposure. "

edited: added info..

[mitchtv]

20. not a blood clot, but a weakening on the aortic wall, actually

a clot can cause the rupture when it slows the blood down at the wide spot. I know, my partner was just diagnosed, with Ct and ultra sound.It is pretty scary and we are now getting ready for an operation

[BleedingHeartPatriot]

32. Disecting aneurysms can present in different ways...

Often, when they occur, the patient has excruciating back pain. I've worked in ambulatory clinics for years, and have had first time experiences with several situations of patients presenting at the clinics with evolving ruptured aneurysms...twice the patients complained of back pain. One pt. actually scheduled an appointment for back pain and drove himself in. While in the waiting room, he collapsed and died, after the aneurysm ruptured.

The other back pain pt. had a history of kidney stones and was convinced that was what was causing his back pain. We sent the patient to radiology, for a renal ultrasound, and the sonographer discovered the disecting aneurysm. We sent him by helicopter to the nearest hospital and he survived.

I worked as an ER nurse for a few years, and one quick way to determine if you're dealing with a "triple A" (abdominal aortic aneurysm) is to obtain bilateral BP's. If there is a significant change in pulse pressure (20 points or more) between the two, that could be an indicator.

I would hate to make a judgment at this time about how the treatment progressed on Mr. Ritter, however, I can say during my ER years, an aneurysm was one of the top "rule out" scenarios we focused on for acute onset of severe sx's. They are not a day to day event, but not that unusual either. That said, whenever an acutely ill presents, you sometimes have only minutes or seconds to make a definitive diagnosis and initiate treatment. As I said beforem I can't speak to John Ritter's case, at all, especially knowing how hard it can be to manage a patient who is critical, without immediately knowing the specific cause. MKJ

Edited with more of my very humble opinion

[bleedingheart]

35. I had a high school friend who had an aneurysm

and the thing that saved her live was that she had a car accident as a result. Her's ruptured in her head and the EMT's thought she had a head injury and called lifeflight...she got to the hospital and the tests showed the aneurysm and she got immediate treatment and survived.

[Cush]

12. I thought the condition was hard to detect?

[mitchtv]

21. generally diagnosed by accident

as was partner's . syptoms are subtle- sometimes non existent , till it bursts, like Ritter

[Snivi Yllom]

18. they needed the Threes Company nurse

[Ilsa]

23. My cousin's first and only time to perform CPR

was at a volleyball tournament at college. A young man came down from the jump and collapsed as he hit the floor. She never could get a pulse or spontaneous respirations. Fortunately for her, someone let her know the next day that he had died almost immediately from an anuerysm and rupture in the aortic arch (really bad place for one, certain death), so no amount of perfectly performed CPR was going to save him.

My mother-in-law presented at the ER last night with tremors, tachycardia, nausea, sweating, weakness. Their first guess was cardiac-related problems, so they ran electrocardiograms. Turns out she is hypo-thyroid, but they ruled out cardiac first.

[zanana]

26. The only people I've ever known to file medical lawsuits..

were Republicans.

[BiggJawn]

28. Guess they didn't have enough magic 9-11 Teddy Bears....

If superstition fails, call a lawyer.
An aneurysm is one of those "Could blow at any second" things, right?

Sounds to me like somebody is stuck in the anger/denial stage of grief and needs somebody to blame for John's death. Not yet in the "shit happens" stage.

But what do I know? I'm just a stupid VCR mechanic who's lost a mom and a stepkid...

[BiggJawn]

29. self delete-double post

[leesa]

33. Misdiagnosis happens. Especially in the ED.

That said, error rates are astronomical in hospitals because we are grossly understaffed due to privitization efforts over the last thirty years. With the Pharma costs (usually absorbed by hospitals since insurance won't pay), the uninsured, the underinsured, and continuous staff cuts, it's not a safe place to be.
All of us are handling far too many patients.

[BleedingHeartPatriot]

34. You're so right, and I applaud you for working in the ER

I know that during my stint, I felt, at times, that I was operating by the skin of my teeth...so many patients, a lot of them with the potential to "crump" at any minute, and so little staff. I run an ambulatory clinic now, although it often resembles an ER. Due to the increasing costs of ER visits, patients with serious, and at time life threatening, symptoms come to the clinic now, rather than the ER (where we do our best to stabilize and ambulance or helicopter out). They mistakenly think it will cost less, and of course there is often an element of denial of the seriousness.

I'd love for the insurance companies and politicians who support and subsidize them, to spend a day in our clinic or your ER. It's a scary time to be in medicine. MKJ