$8 Million med mal verdict issued to disabled woman

October, 2003

A Philadelphia jury issued an $8 million verdict to a Montgomery County woman Tuesday for pain and suffering associated with a string of trips to area emergency rooms where doctors failed to properly diagnose a condition that deprived her of the full use of one hand and arm, her lawyer said.

However, Antonia Mark, the 37-year old plaintiff, will not receive $8 million because the jury’s finding was subject to high-low and joint tortfeasor agreements.

The $8 million verdict was reduced by a confidential high-low agreement between Mark and one of the doctors she sued, Larry Alan Ravetz, according to the woman’s lawyer, Mark W. Tanner.

Tanner could not reveal the range of the agreement. His client had requested $93,000 to compensate for past medical bills and $575,000 to $1.25 million to cover future medical costs, depending on her life expectancy. Tanner could not reveal whether he would file for delay damages, he said.

In deciding Mark v. Ravetz, the 12-member jury deliberated for about three-and-a-half hours and then found Ravetz 68 percent liable and another doctor, Clifford Phillip Catania, 32 percent liable.

But because of a joint tortfeasor agreement between Mark and Catania, Catania was released from paying the specified jury award and instead settled for a confidential amount after the jurors were picked Sept. 19. Catania and his lawyer, Richard S. Margulies of Christie Pabarue Mortensen & Young, did not participate in the trial or offer any evidence, Margulies said.

Mark and a third doctor, L. Gary Gladstone, also entered into a joint tortfeasor agreement and settled for a confidential amount a week into the trial, said Tanner of Feldman Shepherd Wohlgelernter & Tanner, who tried the case with Riki R. Redente. The jury did not find Gladstone was negligent.

Common Pleas Judge Mary D. Colins presided over the seven-day trial. Colins had evaluated the case, coming up with a settlement number of $800,000 that Mark agreed to take, Tanner said. Ravetz’s attorney recommended that the MCARE fund and Pennsylvania Property Casualty Insurance Guaranty Association adjusters take the deal, but they refused, Tanner said.

In 1999 when Mark was 32, she suffered from end-stage renal failure caused by lupus, requiring her to undergo dialysis three times a week. She went to the emergency room at North Penn Hospital in Lansdale (now Central Montgomery Medical Center) with pain and swelling in her right arm, according to court documents. Gladstone prescribed an anticoagulant drug called Lovenox to treat a suspected blood clot in her arm, which was changed over to another anticoagulant, Coumadin.

The next morning, Ravetz took over Mark’s care at the hospital. Mark began to have such severe, unexplained neck pain that Ravetz prescribed morphine, according to court documents. She was still complaining of neck pain when she was discharged five days after checking in to the hospital.

Mark was sent home without a neurological exam, according to court documents.

Counsel for Ravetz, Kenneth S. Fair of Naulty Scaricamazza & McDevitt, did not return calls for comment Wednesday.

When the pain continued the next day, Mark went to the emergency room at Phoenixville Hospital, where she was treated by Catania, according to court documents. Catania performed no neurological exam but examined Mark for other conditions and discharged her with a prescription for Tylenol 3.

Two days later, Mark was lying on the couch when she found she could not move her arms or legs, Tanner said. When her sister returned to the house five hours later, she found Mark had fallen to the floor, and an ambulance was called, according to court documents.

At North Penn Hospital, Mark was diagnosed with an epidural bleed, which required surgery to decompress her spinal cord, according to court documents. But because her condition went untreated, she couldn’t move her arms or legs, Tanner said. After a year of therapy she was able to walk again, he said, but she still cannot use her one hand or extend an arm.

Mark sued Gladstone because he had used Lovenox and Catania and Ravetz for failing to recognize the symptoms of her ailment and treat them, Tanner said.

“The sudden neck pain was the first ... warning sign of this condition,” he said.

A patient is at a high risk for bleeding when on anticoagulants, and neck pain in someone on anticoagulants could signal bleeding around the spinal cord, Tanner explained in his pretrial memo.

The damages awarded Tuesday were for pain and suffering because Mark’s disability prevents her from working and so she lost no wages.

Other defendants named in the original complaint were dismissed, including North Penn Hospital and Phoenixville Hospital.

See article published in Pennsylvania Jury Verdicts and Settlements Review and Analysis about this case.