Estate of Crutcher v. Philip C. Trover, M.D. & Baptist Health Madisonville, Inc.
| Decision Date | 08 January 2016 |
| Docket Number | NO. 2012-CA-001859-MR,NO. 2012-CA-001856-MR,NO. 2012-CA-001842-MR,NO. 2012-CA-001841-MR,2012-CA-001841-MR,2012-CA-001842-MR,2012-CA-001856-MR,2012-CA-001859-MR |
| Parties | ESTATE OF MARY CRUTCHER, BY AND THROUGH HER PERSONAL REPRESENTATIVE, REBA JEAN CRUTCHER QUALLS APPELLANT v. PHILIP C. TROVER, M.D. AND BAPTIST HEALTH MADISONVILLE, INC., F/K/A THE TROVER CLINIC FOUNDATION, INC. APPELLEES AND DAVID POWERS APPELLANT v. PHILIP C. TROVER, M.D. AND BAPTIST HEALTH MADISONVILLE, INC., F/K/A THE TROVER CLINIC FOUNDATION, INC. APPELLEES AND TERRY MITCHELL APPELLANT v. PHILIP C. TROVER, M.D. AND BAPTIST HEALTH MADISONVILLE, INC., F/K/A THE TROVER CLINIC FOUNDATION, INC. APPELLEES AND DAVID BREWER APPELLANT v. PHILIP C. TROVER, M.D. AND BAPTIST HEALTH MADISONVILLE, INC., F/K/A THE TROVER CLINIC FOUNDATION, INC. APPELLEES |
| Court | Kentucky Court of Appeals |
NOT TO BE PUBLISHED
APPEAL FROM HOPKINS CIRCUIT COURT
More than four dozen cases were appealed to this Court related to Dr. Trover and the Foundation. About half of those cases settled prior to briefing.This Court, with the assistance of the parties, divided the remaining twenty-four cases into three groups, with a few outlying cases.
Because Appellants in this group raise common issues in their separate appeals, we have consolidated their cases and resolve each in this opinion. For the following reasons, we affirm as to each appeal.
The Foundation consists primarily of the Regional Medical Center and the Trover Clinic, both located in Madisonville, Kentucky. Dr. Trover began employment with the Foundation in 1980, and quickly assumed the position of Chair of the Medical Center Radiological Department.
In late 2003, Dr. Neil Kluger, an oncologist associated with the Foundation, became concerned over what he considered substandard work habits displayed by Dr. Trover and, specifically, an unacceptable number of misread radiological films. Dr. Kluger addressed his concerns to the Medical Center's Medical Executive Committee, the Foundation's Board of Governors, and the Kentucky Board of Medical Licensure.
The Committee extensively investigated the allegations and, on April 20, 2004, issued a report outlining its findings. The Committee concluded Dr. Trover's rate of error when interpreting mammographic slides was "unacceptable"; his 1.8% call-back rate2 was significantly lower than the national average3 and theaverage of his colleagues; his reports consistently lacked the detail necessary to assist treating physicians in developing and confirming diagnoses; he typically interpreted over 30,000 radiological examinations per year, well in excess of the average workload of a typical full-time radiologist;4 and, his behavior toward employees in the radiological department created an atmosphere of uncertainty and distrust, compromising the overall effectiveness of the radiological department.
Based on its investigation, the Committee recommended that the Board of Governors revoke Dr. Trover's clinical privileges and terminate his membership on the Medical Center's medical staff, subject to reinstatement if certain conditions were met. Dr. Trover resigned from the Medical Center in April 2004 and resumed practice in Michigan.
The Kentucky Board of Medical Licensure also reviewed Dr. Trover's practice, and on July 14, 2005, issued an Emergency Order temporarily suspending his medical license. Dr. Trover contested the suspension, and on April 13, 2006, entered into an agreed order with the Board that reinstated his license with numerous restrictions.5
Based on the allegations, investigations, and the potential number of radiological misreads, the Foundation conducted a review of approximately 10,000 of Dr. Trover's radiological interpretations occurring between 2003 and 2004.That review, according to the Foundation, indicated that the rate of discrepancy between Dr. Trover's interpretations and those of the reviewers was "well within the standard of care." Nevertheless, around this time, media reports began to surface concerning the allegations made by Dr. Kluger. In March 2004, an announcement appeared in the local newspaper, the Madisonville Messenger, encouraging members of the public who had received radiological exams at the Medical Center during the pertinent period to present themselves as potential members of a proposed class action lawsuit against Dr. Trover and the Foundation. All the named Appellants fell within these parameters.
Mary Crutcher6 was in an automobile accident on April 27, 2002. She was seventy-five years old. Crutcher presented to the Medical Center for treatment. Three x-rays were taken and interpreted by Dr. James Esser, and Crutcher was released on the same day. On May 2, 2002, Crutcher stated she woke up and discovered she was bleeding. She was taken to MultiCare Specialists, and it was determined she was suffering from a lacerated kidney and three broken ribs. Crutcher then went back to the Medical Center and was hospitalized from May 3, 2002 until May 12, 2002.
During her stay, Dr. Trover read three CT scans of Crutcher's chest, abdomen, and pelvis. Crutcher alleges that Dr. Trover was negligent in the reading of her chest CT scan because his interpretation stated that her "lungs and pleural spaces are clear ... mediastinum shows no abnormality." A re-read of the scan in October 2004 indicated "small right pleural effusion[,] ... chronic lung changes seen peripherally and in the right lung apex." However, Crutcher had a documented history of chronic lung and breathing problems beginning in the 1970s.
On August 18, 2003, Crutcher presented to the Medical Center emergency room after falling and breaking her hip. Crutcher had a chest x-ray as a part of her evaluation. The film was read by Dr. Trover. Dr. Trover found no abnormalities in his interpretation. This chest x-ray was re-read on May 3, 2004, and noted "mild atherosclerosis of the aorta" and "biapical thickening from old disease" as well as a possible "component of chronic airway obstruction." Crutcher stated in her deposition that she did not seek any treatment after the alleged misinterpretation.
Crutcher believes that the misinterpretations by Dr. Trover, jointly or individually, delayed a proper treatment plan, exposed her to a greater risk of complications, and caused her great emotional harm as well as contributed to her considerable pulmonary pain.
On December 29, 2002, David Powers was in a motorcycle accident in which he sustained multiple severe injuries. Upon Powers' admission to the hospital, several x-rays and CT scans were ordered. Dr. Trover interpreted several of Powers' films; however, only the chest CT scan is at issue. On his report, Dr. Trover noted infiltrates in both perihilar areas, possible aspiration or contusion, no fluid in the pleural spaces, and normal medistinum.
In Powers' follow-up treatment after his accident, he complained to Dr. Donley of neck and rib pain and headaches. As a result, Dr. Donley sent Powers to the Medical Center for a nuclear total body bone scan on March 6, 2003. Dr. Esser found "an abnormal increased uptake in the approximate T8 vertebral body region and suggested compression deformity" on the total body scan. Dr. Donley advised Powers to go to a spinal specialist. Powers went to Dr. Melvin Law in Nashville. Dr. Law informed Powers that he had shattered his T7 vertebrae, sustained damage to the surrounding vertebrae, and had seven broken ribs. Dr. Law subsequently performed surgery on Powers' spine.
On September 14, 2004, Dr. Patterson re-read Powers' December 29, 2002 chest CT scan originally interpreted by Dr. Trover. The re-read provided: Powers claims that because Dr. Trover did not report the fracture in his spine in December 2002, it went undetected and resulted in permanent nerve damage.
Terry Mitchell was diagnosed with benign lung scarring in 1978. Since then, he had been in and out of the hospital due to various problems with his lungs and liver. He was later diagnosed with hepatitis C and cirrhosis of the liver. Mitchell's extensive medical record consists of a myriad of films, scans, and reports detailing his chronic chest pain and liver condition of the last several decades.
On May 15, 2003, Mitchell went to the emergency room at the Medical Center complaining of severe chest pain, intermittent tingling on the left side, diaphoresis, shortness of breath, and nausea. X-rays were taken of Mitchell's chest and lungs. Dr. Trover read Mitchell's x-rays as normal. Despite the normal reading, Mitchell was admitted to the hospital for further testing; however, Mitchell...
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