Injuries Alleged: Damage to thoracic spine from MRSA-caused osteomyelitis/discitis
Name of Mediator: Judge Robert S. Brewbaker Jr. (Ret.)
Date Resolved: Jan. 29, 2025
Attorneys for Plaintiff: Ward Marstiller and Ed McNelis, Richmond, Emroch & Kilduff
Summary: A 62-year-old woman underwent a laparoscopic cholecystectomy in July 2020 for acute gallstone cholecystitis.
She developed respiratory issues during her hospitalization. Her surgeon consulted with the defendant pulmonologist, who ordered thoracentesis after testing confirmed the development of pleural effusion.
After pleural fluid was drained, the defendant pulmonologist sent it out for lab culture testing. Once symptoms improved, the plaintiff was discharged home with a prescription for the antibiotic Augmentin. Lab results available to the defendant confirmed MRSA infection four days after the patient’s July 17 hospital discharge with the culture sensitivity panel listing antibiotics such as vancomycin, clindamycin and tetracycline.
During the plaintiff’s initial follow-up visit with the defendant on Aug. 10, 2020, she presented with body aches, back and flank pain but without a high-grade fever. A prior chest X-ray showed her pleural effusion was resolving.
The defendant prescribed a seven-day supply of the antibiotic doxycycline for the patient’s MRSA despite the defendant’s chart stating the plaintiff would require vancomycin. The defendant’s Aug. 11 addendum noted that additional testing had ruled out pancreatitis with an abdominal CT showing almost complete resolution of pleural effusion.
However, lab results showed elevated white blood cell levels. Doxycycline failed to resolve the MRSA infection.
Subsequent medical providers started the plaintiff on IV vancomycin and later daptomycin infusion due to an allergic rash to the vancomycin. The plaintiff alleged that the delay in prescribing an appropriate and therapeutic IV antibiotic such as vancomycin, eventually caused osteomyelitis, discitis and significant damage to the plaintiff’s thoracic spine as well as recurrent MRSA infections, resulting in multiple surgeries and hospitalizations.
The plaintiff designated a pulmonology standard-of-care expert and multiple ID specialists to address causation and damages.
Among other defenses, the defendant asserted protection of the COVID-19 immunity plea in bar as the defendant claimed that the choice of doxycycline was impacted by the pandemic. The defense was in the process of designating multiple experts on standard-of-care and causation and damage issues at the time of settlement.
Plaintiff’s counsel Ward Marstiller provided case information.