Manchester VA to Pay $21 Million for Malpractice that Left Vet with ‘Locked-in-Syndrome’

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A 60-year-old Navy veteran has been awarded a $21 million malpractice verdict against the Veterans Administration Medical Center in Manchester, NH, after the facility prescribed the wrong medication and left the patient “medically abandoned.”

What’s the Problem?

The patient, Michael Farley of Bennington, NH, fell into ‘locked-in syndrome’ after having 2 strokes within 2 months in 2010. Farley remains fully conscious, but has almost no voluntary muscle movement aside from a very limited ability to move his eyes and head. The medical malpractice lawsuit contends that Farley’s condition could’ve been avoided if doctors at the Manchester VA had properly diagnosed and treated him after his first stroke.

Farley sought treatment at the facility after having a painful headache and losing his peripheral vision, according to court documents. After tests were performed, doctors determined that he had suffered a stroke.

“It is a basic principle of medicine that a patient who has suffered a stroke is generally at an elevated risk of suffering a second stroke,” said U.S. District Court Judge Landya McCafferty. “Therefore, doctors who are treating stroke patients must be cognizant of this risk, and they must take steps to prevent a second stroke from occurring. Unfortunately, Mr. Farley’s doctors at the Manchester VA did not adhere to this standard of care. They failed to provide him with an adequate diagnostic evaluation, and as a result, they carelessly prescribed him the wrong medication.”

McCafferty’s ruling cited a number of medical nuances, but the core issue centered around the fact that doctors sent Farley home after his first stroke with instructions to take 2 baby aspirins daily. Six weeks later, he was found unresponsive and taken to Elliot Hospital, where it was determined that he had suffered a massive stroke in the same part of his brain where the first occurred.

Patient Given Wrong Prescription

McCafferty referenced medical studies and expert testimony in stating that the doctor should have prescribed Farley the anti-coagulant drug Coumadin (generic: warfarin) after his first stroke.

“The overwhelming weight of the expert testimony, coupled with the scientific studies, established that Coumadin more likely than not would have prevented Mr. Farley’s second stroke from occurring,” she said.

In addition to giving him the wrong prescription, Farley’s doctors ordered an ambulance transfer to a veterans affairs facility in West Roxbury, Mass., where he would have been admitted to a hospital and evaluated by a neurologist; however, the ambulance was ordered to turn back for unknown reasons.

“The evidence suggests that the decision to cancel the transfer was made amidst confusion at the Manchester VA,” McCafferty said.

The judge’s decision cited a number of other allegations related to the VA malpractice lawsuit, such as failure to use proper monitors, failure to perform adequate testing, and failing to refer the patient to qualified specialists.

Hospital Missteps Led to ‘Locked-in-Syndrome’

On Dec. 2, Farley was admitted to Elliot Hospital in Manchester, where doctors initially believed he had slipped into a coma from which he would not recover.

“Mr. Farley lay trapped inside his paralyzed body, lucid and mentally alive, but he could not communicate that to his caregivers and family, who were in his hospital room discussing end-of-life scenarios,” McCafferty wrote. “Mr. Farley’s adult children did not believe he was in a coma; they thought that he was moving his eyes in an effort to communicate with them. The caregivers assured them that they were wrong and that his eye movement was merely a symptom of his comatose state.”

A nurse later noticed Farley’s eyes following her, and his diagnosis was changed to ‘locked-in-syndrome.’

The plaintiff’s award was broken down as follows:

  • $1.3 million for past and current medical expenses;
  • $12 million for future medical care, and
  • $8.1 million to Mrs. Farley for non-economic damages.

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