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Level of care of patient with history of brain injury and stroke questioned. Tica v. Metz, 2024 N.Y. Slip Op. 31497 (N.Y. Sup. Ct. 2024)


In Tica v. Metz, 2024 N.Y. Slip Op. 31497 (N.Y. Sup. Ct. 2024), a case involving allegations of medical malpractice, lack of informed consent, and negligent hiring, plaintiffs claim that the mistakes of doctors at New York Presbyterian Brooklyn Methodist Hospital led to a wrongful death.

Background Facts
Marie Trebilcock, a 68-year-old woman, had a complex medical history including a prior stroke, stenosis of her right internal carotid artery, coronary artery disease, and a traumatic brain injury from a car accident in 1999. On October 30, 2016, she attended a family wedding in Brooklyn. While dancing, she began to feel dizzy and weak. An ambulance was called, and she arrived at New York Presbyterian’s emergency department at 10:02 pm. Her initial vitals were mostly normal except for elevated blood pressure. She complained of severe headache and dizziness.

At the hospital, Dr. Metz and Dr. Ayala took her history and performed a physical examination. Dr. Metz noted her history of coronary artery disease and prior stroke. Despite various symptoms, Trebilcock denied several specific issues like chest pain, visual problems, and neurological issues. A CT scan showed no intracranial hemorrhages. Her blood pressure rose significantly over several hours, reaching dangerous levels. Dr. Metz administered Amlodipine to lower her blood pressure. Her condition improved slightly, and she was discharged with instructions to follow up with her primary care provider.

After being driven home, Trebilcock had difficulty standing and was taken to Orange Regional Medical Center (ORMC). There, her blood pressure remained elevated, and a CT scan later showed evolving acute infarction. Despite ongoing treatment, her condition deteriorated, and she passed away on June 5, 2022.

Whether the defendants deviated from accepted medical practices in treating Trebilcock and whether these deviations proximately caused her injuries and eventual death.

The court denied the defendants’ motion for summary judgment, indicating that there were triable issues of fact regarding the standard of care provided and its impact on Trebilcock’s condition.

The court’s decision was based on several key points:

  1. Lack of Differential Diagnosis: Dr. Metz did not include stroke in his differential diagnosis despite Trebilcock’s history and symptoms. The court found that this omission raised questions about the adequacy of the medical evaluation.
  2. Blood Pressure Management: Trebilcock’s blood pressure was dangerously high for several hours. Dr. Metz administered Amlodipine, but her pressure remained elevated even after some reduction. The timing of her discharge raised concerns, especially since her blood pressure was higher than when she was admitted. Dr. Ayala’s testimony suggested that the peak effect of Amlodipine occurs after several hours, indicating that the patient’s response to the medication was not adequately monitored.
  3. Subsequent Medical Records: The defendants could not have known Trebilcock’s later blood pressure readings and condition at ORMC. This created factual disputes regarding the appropriateness of their actions based on the information they had at the time.
  4. Expert Testimonies: The court found that the experts’ affirmations provided by the defendants did not conclusively establish that Trebilcock received care consistent with accepted medical standards. The experts speculated about the inclusion of stroke in the differential diagnosis, which was not documented.
  5. Stroke Code and Neurological Consultation: The failure to call a stroke code and seek urgent neurological consultation, along with not admitting Trebilcock for further evaluation, raised significant issues regarding the standard of care.

If you or someone you know is dealing with complications from a brain injury that were caused by or exacerbated by medical mistakes, contact an experienced New York brain injury lawyer who can navigate the complexities of medical malpractice claims and work to secure the compensation you deserve. Medical malpractice cases involve intricate details and require thorough investigation and expert testimony. In cases like Tica v. Metz, where multiple medical issues and treatment decisions are involved, having a knowledgeable advocate on your side is crucial. The right lawyer will help you understand your legal options, guide you through the process, and fight for the compensation you need.

Contact Stephen Bilkis & Associates to discuss your case and take the first step toward achieving justice and securing the support you need. Protecting your rights and securing your future starts with having a knowledgeable advocate on your side.

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