Exactly four years to the day after she was admitted to Liberty Regional Medical Center, a civil trial stemming from a wrongful-death lawsuit on behalf of former LRMC chief operating room nurse Barbara Porter started in Liberty County State Court.
Opening arguments were given Wednesday before State Court Judge Leon Braun in the Liberty County Justice Center. By that afternoon, the plaintiffs called their first witness to the stand.
The suit was filed by Porter’s widow, Kenneth, and his attorneys, Craig Stafford and Jeff Arnold, against Dr. Stephen Weiss, Dr. Colin Badea and Dr. Traiana Pacurar.
Stafford showed evidence that Barbara Porter was admitted to LRMC on the evening of Friday, July 29, 2011. Her attending physician, Weiss, admitted documenting her complaints of severe substernal epigastric pain. She died the following evening.
The death certificate noted the cause of death as cardiorespiratory arrest, acute myocardial infarction — commonly called a heart attack — and coronary artery disease.
The suit alleges the physicians were negligent in their care, treatment and diagnoses of Porter. It alleges the physicians focused only on possible gastric, abdominal and pancreatic medical conditions, of which she had a prior 20-year medical history, while ignoring what the plaintiff claims were well-documented and clearly visible signs of a cardiac condition.
“He didn’t check her heart,” Stafford told the jury while pointing to Weiss.
“Four years ago to this day, Dr. Calin Badea, who is seated right here, placed a telephone order to discontinue and continue certain medications that Barbara Porter was on as she was in the hospital. Dr. Badea didn’t check her heart,” Stafford continued.
Stafford then spoke about Pacurar, who had a consultation with Porter the morning of July 30, 2011, explaining that Pacurar also never checked Porter’s heart.
Stafford and Arnold argued that Porter clearly didn’t get the care she should have.
Weiss’ attorney, Chris Ray, said testimony would show that his client correctly diagnosed Porter’s medical condition. He said the defense would prove that Porter and Weiss had discussed her gastric issues six to eight weeks before her death. He added that his client’s intake form shows that the manner in which Porter described her pain matched the gastrointestinal and esophageal disorders she had suffered from for quite some time.
Pacurar’s attorney, Scott Bailey, and Badea’s attorney, Greg Talley, added that their evidence will show that Porter ignored advice two months earlier from Dr. Brian Risgow, a cardiologist, that she should get a stress test because her symptoms then also could indicate coronary artery disease.
Both attorneys added that the physicians requested that an electrocardiogram be performed during Porter’s stay.
When that EKG was performed and what happened to the results are at the heart of the case.
Stafford produced evidence showing that Pacurar, hours before Porter died that Saturday evening, wrote a medical order requesting a cardiac enzyme — blood work to check for heart issues — for the next day and an order, “for a 12 lead EKG to be done today,” Stafford said. The attorney then explained the significance of the statements to the jury verbally and through the use of two witnesses both in the nursing and medical profession.
“You are going to learn that a cardiac enzyme is a test that should be done now,” Stafford told the jury. “You don’t wait to go looking for a heart attack tomorrow. … Heart attacks kill right away. The order for the EKG says today. It does not say stat, it does not say right away, it does not say now.”
The witnesses went on to say that in medical terminology, when a doctor writes up a report for an EKG today, it is understood that the test should be done within that 12-hour work shift. In this case, that shift was from 7 a.m. until 7 p.m. Both went on to testify that when an order is written in that format, it usually indicates a routine EKG test, whereas an order stating a specific time, that says “now” or “stat” requires immediate attention and is typically done within minutes of having the order written.
The attorneys for the defendants argued that Porter’s overall medical history was taken into account during her initial admittance on the evening of Friday, July 29, 2011, by Weiss and up until her consultation with Pacurar the following day around 11 a.m.
They stated that during this timeframe, Porter did not exhibit any signs of acute cardiac conditions.
An EKG was eventually done on Porter at 3:38 p.m. July 30, 2011, roughly 3½ hours before her death. And the results showed abnormalities.
Ray and the other defendants’ attorneys claim the negligent parties were staff nurses and respiratory therapists employed by LRMC.
Ray explained to the jurors that the test results were never placed in Porter’s medical chart. That meant none of the attending physicians were aware of any abnormal results nor had reason to suspect coronary issues.
“The hospital did not get that information to the ordering physician,” Ray said.
Ray said a judgment had already been decided, and the plaintiff settled with LRMC admitting responsibility for the EKG error.
“The evidence will show that Mrs. Porter was not in any acute cardiac distress when Dr. Pacurar saw her,” attorney Bailey said adding that his client is undeserving of the suit against her. “By 3:38, the EKG had be done, the report said it was abnormal, somebody needed to know about that and nobody was told and that is undisputable.”
Eight women and six men make up the jury and alternates. After lunch on Wednesday, however, one of the alternates was released because of a death in the family.
The case is expected to last at least through Friday with a litany of experts from the medical field scheduled to take the stand on behalf of the plaintiffs and defendants.