The Pennsylvania Supreme Court refused to hear an appeal by Children's Hospital of Philadelphia, thereby upholding an $11.3 million verdict against it and three doctors for failing to diagnose an 11-month old boy who had meningitis.
The case is Shantice Tillery, In Her Own Right And Parent And Natural Guardian On Behalf Of Her Minor Son, Shamir D. Tillery v. The Children's Hospital Of Philadelphia, Children's Healthcare Associates, Inc., Monika Goyal, M.D., Joel Fein, M.D., and Kyle Nelson, M.D.
On December 21, 2009, the child was brought to the hospital suffering from fever
and difficulty breathing. He was sent home a few hours later with a diagnosis including upper respiratory infection and cough.
He returned the next day, suffering from worsening symptoms, including high fever, irritability, increasing pulse and respiratory rates, dehydration, and lethargy. Dr. Goyal ruled out pneumonia and viral upper respiratory infections. Without any further diagnostic testing, the boy was discharged with a treatment plan consisting of supportive care, a follow-up with a primary physician and return to emergency room instructions.
The boy returned to the hospital emergency department the next day. Dr. Nelson diagnosed the boy with fever, bronchiolitis, possible pneumonia, possible serious bacterial infection, and possible dehydration. Dr. Nelson offered a treatment plan including IV fluids, checking labs, and reassessing for a possible lumbar puncture.
Nearly an hour later the boy was transferred to Dr. Fein. Blood tests revealed elevated white blood cell counts and an elevated C-reactive protein. Dr. Fein ordered a lumbar puncture, which was not completed until nearly three hours later. The lumbar puncture results led to a diagnosis of meningitis and antibiotics were immediately ordered.
By then the boy had bilateral hearing loss and brain damage.
His mother filed a negligence suit in 2012. On November 16, 2015, the jury found in favor of the boy. The jury assessed 40% of the negligence to Dr. Goyal and 60% of the negligence to Children's Hospital for the treatment rendered by resident Ram Bishnoi, M.D.
The jury awarded a total verdict of $10,138,000. Adding delay damages, the judgment totaled $11,391,640.
The intermediate appellate court rejected five questions brought on appeal:
1. Whether Appellants are entitled to a new trial where Appellee’s experts’ opinions were based solely on their own experience and expertise, not scientific or empirical evidence.
2. Whether the trial court erred by failing to instruct the jury on the “two schools of thought doctrine” in determining whether the standard of care required Appellants to treat a bacterial infection with steroids.
3. Whether the trial court erred in allowing Appellee’s counsel to read to Dr. Poe a statement taken in 2013 from Children's Hospital website, where the statement, which post-dated the treatment by four years, was used to establish the standard of care and, hence, caused Appellants prejudice.
4. Whether the trial court erred in allowing Appellee’s neurootologist expert to present standard of care expert testimony against Appellant pediatric emergency medicine physicians in circumstances where Appellee’s expert was neither board certified nor practiced in the same sub-specialty as Appellant physicians.
5. Whether the trial court erred by not reducing the excessive verdict and in not reducing Minor-Plaintiff’s future medical expenses to present value before entering judgment as required by MCARE for purposes of calculating the judgment and delay damages.