A southeast Washington man who claimed his wife died because D.C. General Hospital did not transfer her to another hospital equipped with more sophisticated diagnostic X-ray equipment has been awarded $240,000 by a Superior Court jury.
At least eight other D.C. General patients who died during one six-month period last year might have been saved had the hospital had the specialized equipment, D.C. General documents allege. As a result, lawyers say that Tuesday's verdict raises the possibility that the city, which must pay the award out of its own funds, may be faced with still more suits.
The equipment in question is called a CAT-scan, a million-dollar device that takes three-dimensional pictures of the interior of the body and skull, allowing doctors to diagnose quickly damage caused by accidents and such maladies as strokes.
There are presently 10 CAT-scans at D.C. hospitals and one in a physicians office, according to city officials, D.C. General is the only major Washington medical facility that does not own the highly specialized x-ray machine. The smaller Sibley and Capitol Hill hospitals also do not have CAT-scans.
The jury verdict rendered against the city Tuesday came after Judge John F. Doyle ruled that, just because the hospital lacked a CAT-scan, the jury could not consider the hospital at fault. However, he said that the jury could find against the city, as it did, if it felt that personnel in the city-owned hospital were wrong in not immediately transporting the woman, 53-year-old Lorraine S. Blake, to any of the 11 other CAT-scan facilities in the city.
According to attorney Ronald Karp, who represented Blake's husband Oliver, the woman, a former Washington schoolteacher, was taken by ambulance to D.C. General the evening of April 24, 1980. She was kept in the emergency room for several hours, the apparent victim of a stroke, Karp said.
Karp argued that Blake's condition mandated an immediate CAT-scan, which she never received. Blake slipped into a coma the following morning, and died on May 8, Karp said.
"In this day and age," said Karp, "it's inconceivable to me that any major city hospital could handle a large volume of patients without a CAT-scan. When that ambulance pulled up to its front door, it should have been immediately diverted to a nearby hospital. . .Everybody's got to go sometime, but it ought to be when God tells us to go and not when D.C. General hospital says its time."
The use of CAT-scans, which have been widely hailed as a major technological advancement in the diagnosis of life-threatening internal problems, is currently part of the national debate over how to control rising medical costs. Many health care specialists claim, for instance, that their huge cost -- coupled with their relatively infrequent use -- mitigates against equipping every medical facility with one.
It is far wiser, they aregue, to simply transfer those patiesnts needing CAT-scans from unequipped hospitals to those hospitals that have them.
In fact, city officials turned down two requests by D.C. General for a CAT-scan because the 11 others in Washington have not been used enought to warrant another one in the area.
However, a new regulation makes an exception for health facilities like D.C. General, which handles a large volumen of patients. Accordingly, a D.C. General spokesman said yesterday that D.C. General is optimistic it will win permission.
General Executive Director Robert B. Johnson and Dr. Standord A. Roman, the hospital's former medical director, cited the eight patient deaths in hospital correspondence and official records. Roman, who resigned in January and now is a dean at Darthmouth Medical School, said yesterday that there were possiblly additional cases of patients who died because they were unable to receive an immediate CAT-scan at the hospital.
"I would suspect that you could go through any comparable period and come up with a comparable number of patients," Roman said. "It's unfortunate that that kind of thing occurs . . . ."
The eight cases also were cited in a letter to the agency written last year by D.C. General executive director Johnson, who could not be reached for comment.
D.C. General spokesman George Kressley and the Corporation Counsel's office declined to comment yesterday on the suit or its implications for the city.
The eight deaths, which apparently do not include the Blake case, occurred from Jan. 1 to July 1, 1980, according to testimony given by Roman last year to the D.C. State Health Planning and Development Agency, which overseas health planning in the city. "In all cases, deaths would have been prevented had there been immediate access to CAT-scanning," Roman testified.