Decatur, GA—Attorneys argued whether medical malpractice or rare, unexpected complications led to the death of a Georgia grandmother from a bowel obstruction, as trial began against two doctors who treated her. Scoggins v. Smith, et al., 15A56505E4.
Ann Scoggins, 72, died from a heart attack in January 2014 while being treated at Athens Regional hospital by Dr. Daniel Moldoveanu for a suspected partial bowel obstruction, caused by opioid painkillers she’d been taking after a knee replacement surgery earlier that month.
Although Scoggins had taken the painkillers as directed, opioid side effects can include constipation and bowel dysfunction. Scoggins’ husband, John, claims that neither Moldoveanu, nor Dr. Elizabeth Smith, who had seen Scoggins in the St. Mary's Medical Center ER a day before her admission to Athens Regional, diagnosed and treated her bowel obstruction in time to save her.
During Tuesday’s opening statements, John Scoggins’ attorney, the Bird Law Group’s William Bird, told jurors Smith did not properly rule out a small bowel obstruction when Scoggins visited the ER complaining of pain and nausea. While Smith ordered one X-ray, taken with Scoggins lying flat on her back that showed no signs of bowel obstruction, Bird said such an image had up to a 50% chance of producing a false negative. “If you stand the patient up and get an upright [X-ray] film you have a significantly better chance of getting an accurate reading on whether or not obstruction exists,” Bird said, adding that a CT scan, instead of an X-ray, could have definitively shown whether Scoggins was suffering from a bowel obstruction. “Defendant Smith didn’t follow the rules,” Bird said. “She should have followed differential diagnosis and ruled out obstruction, not just simply reached the opinion that it’s not very likely.”
Bird told jurors that error was compounded by Moldoveanu’s negligent treatment when Scoggins was admitted to the hospital, complaining of abdominal distension and shortness of breath. Although Moldveanu suspected a bowel obstruction, Bird said, he did not respond properly to imaging that supported that suspicion and lab results that were abnormal. Within hours of receiving those results, and after Moldoveanu prescribed an oral laxative and a saline enema, Scoggins began projectile vomiting, aspirated, and suffered a fatal heart attack.
Bird told jurors experts would testify Moldoveanu should have prohibited any medication by mouth, ordered a nasogastric tube to decompress Scoggins’ stomach, and consulted with a surgeon on additional steps. “The evidence will show you Dr. Moldoveanu did none of this,” Bird said. “[Moldoveanu] should have jumped all over [the situation] when the lab [results] came back,” he added. “She was in serious shape.”
But the defense counters that the doctors took appropriate steps under the circumstances and that Scoggins died from a tragic, yet rare complication not reasonably foreseeable.
During Tuesday’s opening statements, Smith’s attorney, Peters & Monyak’s Robert Monyak, told jurors Scoggins’ symptoms were consistent with opioid-induced constipation when Smith saw her and any obstruction likely occurred afterward. Noting that the X-ray Smith ordered showed no signs of obstruction, Monyak said Smith’s decision to forego more imaging did not breach the standard of care.
“The evidence didn’t point to an obstruction,” Monyak said, adding Smith prescribed medication for Scoggins’ constipation. “If you have a normal X-ray that shows there is no obstruction, you’re not required to keep taking more X-rays.”
In his opening, Moldoveanu’s attorney, Forrester & Brim’s James Brim, III, told jurors his client properly diagnosed Scoggins with an obstruction and started an appropriate treatment course before an unexpected bout of vomiting led to her ultimately fatal aspiration.
Brim said staff would testify Scoggins was not in severe distress in the moments before her final bout of vomiting, and contended Moldoveanu’s treatment plan was appropriate and effective, absent rare circumstances. “A massive aspiration like that is an incredibly rare event,” he said. “Is it possible? Yes, it happened here. Is it expected? Absolutely not. It was a shock.”
CVN is recording the trial and will provide continuing coverage of the case on its news page, as well as gavel-to-gavel video of the trial as soon as possible after the verdict.
Email Arlin Crisco at [email protected].
John Scoggins is represented by the Bird Law Group’s William Bird.
Dr. Elizabeth Smith and Athens-Clarke Emergency Specialists are represented by Peters & Monyak’s Robert Monyak.
Dr. Daniel Moldoveanu and Athens Regional Specialty Services Inc. are represented by Forrester & Brim’s James Brim, III.
CVN will provide gavel-to gavel video of the trial as soon as possible after the verdict.
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