Injuries Alleged: Wernicke’s encephalopathy, brain damage with cognitive impairment and memory loss, neuro-ophthalmological injuries
Name of Mediator: Judge Joanna Fitzpatrick (Ret.)
Date Resolved: Jan. 27, 2025
Attorneys for Plaintiff: Edward J. McNelis and Ward Marstiller, Richmond, Emroch and Kilduff
Summary: This medical malpractice case involved a healthy 21-year-old woman, who was pregnant with her first child when she sought out the OBGYN services from the defendant doctors and their practice in June 2021. By the time of the plaintiff’s initial clinical visit with the defendants’ practice in mid-June, she had already suffered through several weeks of nausea and vomiting. During her treatment and care by the defendants through early August 2021, her condition deteriorated with intractable, uncontrolled vomiting, severe malnourishment and an estimated 40-pound weight loss from her pre-pregnancy weight.
The plaintiff was diagnosed with hyperemesis gravidarum, which progressively included metabolic derangement as her health declined. The plaintiff eventually developed a rare condition known as Wernicke’s encephalopathy. While uncommon, risk factors for developing this condition during pregnancy include persistent nausea with vomiting, electrolyte or nutrient deficiencies and poor intake or weight loss. The plaintiff’s medical records document all these risk factors.
The plaintiff was seen, evaluated and treated by the defendants on multiple occasions, including six outpatient clinic visits as well as seven separate hospitalizations before being transferred on an emergent basis to a tertiary care center on Aug. 9, 2021, with a diagnosis of Wernicke’s encephalopathy.
The plaintiff was left with permanent brain damage, with significant cognitive and memory impairment as well as neuro-ophthalmologic deficits. The plaintiff’s experts testified at deposition that malnutrition, specifically thiamine deficiency, is a known cause of Wernicke’s encephalopathy which could have been easily treated with supplemental, empiric thiamine — a vitamin that could have been administered at almost no expense.
The plaintiff’s experts further testified that longstanding guidelines from the American College of Obstetricians and Gynecologists called for the administration of empiric thiamine for patients suffering from severe hyperemesis gravidarum. The defendants acknowledged the plaintiff experienced this condition while under their care.
Edward McNelis, counsel for the plaintiff, provided case information.