Jury Finds ER Doctor Liable for $1.44 Million

By Barbara Grzincic

A board-certified doctor of emergency medicine should pay $1.44 million to the family of a Rodgers Forge man who died a day after spending six hours waiting to be admitted to the hospital, a Baltimore County jury said.

The widow and daughters of Thomas D. Murphy, 59, argued that his death from septic shock could have been prevented if he had received a broad-spectrum antibiotic and “liters and liters” of fluid when he first went to the emergency room on June 10, 2007.

Monday’s verdict in Baltimore County Circuit Court fell just short of the $1.6 million sought by the plaintiffs’ lawyers, Julia R. Arfaa and Benjamin S. Salsbury of Salsbury Clements Bekman Marder & Adkins LLC.

The difference came out of the widow’s award for her own pain and suffering, which the jury set at $300,000, Arfaa said.

Otherwise, “it was perfect …,” she said. “I tried to be reasonable, and the jury responded.”

The Murphys settled before trial with three other defendants, but Dr. Richard Tempel and his insurer, Medical Mutual Liability Insurance Society of Maryland, made it “a zero-offer case up to the trial,” Arfaa said.

Tempel’s attorney, Ronald U. Shaw, said the Murphy family “forced us to go to trial” by refusing to disclose the amount of the other settlements.

“We needed to know what the other settlement amounts were in order to make a principled decision on whether to go to trial,” said Shaw, of Shaw, Morrow & Joseph P.A. in Hunt Valley.

“It’s like going in to buy a car in a showroom and you ask what the price is, and the dealer says it’s confidential,” he added.

With the release of three fellow defendants, Tempel will pay no more than 25 percent of the jury’s award. If the prior settlements exceed the jury’s award, Tempel will not have to pay anything, Shaw said.

Tempel, who graduated from the University of Maryland School of Medicine and finished his residency at Duke in 2006, now practices in Florida, Shaw said.

Chills and Fever

According to the complaint, Murphy, a property manager for Colliers Pinkard, went to Patient First-Green Spring on June 9, 2007. Generally in good health, he complained of fever, chills, pains and other symptoms that had lasted for two days. He was seen and sent home. (The doctor at Patient First was one of those who settled before trial, Arfaa said.)

The next day, Murphy went to the emergency room at St. Joseph Medical Center around 5:30 p.m.

“He came in with sepsis, probably from bowel bacteria, but whatever the cause he should have been treated with a broad-spectrum antibiotic,” Arfaa said.

Instead, he was given a drug to treat pneumonia and just one liter of fluid, she said.

According to Shaw, the doctor saw Murphy within 45 minutes of his arrival and ordered a CT scan.

He would have had the results, which ruled out pneumonia, by 8:30, Arfaa said.

At 8:40, Shaw said, Tempel paged the floor doctor responsible for admitting patients to the hospital. That doctor phoned him at 9:10.

However, for reasons neither side could say, Murphy remained in the ER until after midnight. (The hospital and the floor doctor were the other two defendants who settled, Arfaa said.)

The defense “argued that once he’d called to have [Murphy] admitted at 9:10 p.m., that it wasn’t his problem anymore,” Arfaa said.

Shaw countered that Tempel was responsible for nine ER rooms that night, and said none of the nurses ever reported Murphy’s condition was worsening.

“Sepsis is the body’s response to a bacterial infection,” he said. “[Murphy’s] own defense mechanisms hit him hard, but not until after he left the ER.”

Both sides agree that after midnight on June 11, 2007, Murphy was transferred to the hospital’s Telemetry Room — a place where vital signs are constantly monitored.

He was sent to the Intensive Care Unit around 3 a.m., Shaw said, and into surgery 11 hours after that to try to determine the source of the infection. The source was never found.

Murphy died about 4:30 that afternoon after suffering several bouts of cardiac arrest, Shaw said.

He had been seen “by seven other doctors” after Tempel and “died of septic shock from an organism nobody knows, because no autopsy was done,” Shaw said.

Below the Cap

After a 10-day trial before Judge John Nagle III, the jurors deliberated about five and a half hours before coming back with the plaintiffs’ verdict.

Elana Murphy, the widow, was awarded economic damages of $840,000, including future lost wages of $600,000. Murphy’s estate and his daughters — Megan, 21, and Carolina, 24 — each were awarded $100,000 in non-economic damages, Arfaa said.

The awards fall below Maryland’s cap on non-economic damages, she noted.

Shaw said an appeal is being considered, with one of the issues being a defendant’s right to know, prior to trial, the amount of the settlement with other defendants.

They were unable to find any cases on that point in Maryland, he said.

“I talked to the jurors afterward,” he said. “They recognized that there were other defendants who were negligent, but since they didn’t know what had happened there, they couldn’t consider it.”

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Jury awards $1.44 Million to family of patient who died of sepsis at St. Joseph