Legal Question in Medical Malpractice in California

medical malpractice

It is a deviation of the standard of care for a family practitioner/primary care physician to fail to advise/diagnose a patient with renal disease or failure upon receiving a lab test result showing a Creatinine level of 4.74? If the physician knew that the patient had no idea why she was so sick and sought medical care to determine the cause, and there was no previous history of renal failure or disease, would a physician be liable for failing to advise of this very abnormal lab result when a Creatinine level of 4.74 indicates renal failure, and for failing to refer the patient to a renal specialist, and for failing to advise the patient of the condition or perform folllow up labs to monitor the Creatinine level at the next visit? The patient became increasingly ill and was never advised that she was in renal failure, or given any treatment options such as dialysis. Th patient developed uremic pneumonitis within months and died without ever knowing she was in renal failure and without ever being given treatment options. In short, a patient has a right to know of her medical condition, so failure to advise of diagnosis of renal failure, or to diagnose at all, is a breach of the standard of care, correct?


Asked on 6/22/07, 12:25 am

5 Answers from Attorneys

Armen Tashjian Law Offices of Armen M. Tashjian

Re: medical malpractice

With all due respect to the replies posted, some of the things said don't make a lick-o-sense. For example, they say you can't file suit without first getting doctor's advice; why not? All you need is your complaint and the filing fee, that's it. Perhaps they meant to say it is not smart to file it, before getting an expert's opinion, but I ain't no psychic. Also, if the doctor screwed up so badly that any one with an IQ of 50 can comprehend, why would you need an expert?

Lastly, I disagree on using a nephrologist as an expert. The doctor that allegedly screwed up was a GP, and not a nephro. Hence, the alleged broken standard is of the GP and you would need a well qualified GP to come in and say what the standard required. You may also get the defendant admit, without expert opinion that he indeed was required to do more upon discovering the abnormal lab result, but didn't for whatever reasons. Bam, no need for expert witness.

Lastly, as part of my practice I do med-mal and litigate cases like this one all the time. Having said that, I will only consider taking a case like this if there are substantial "special" damages involved (I.e., lost wages, etc.) Due to limitations of MICRA.

Sorry for your loss, and if you'd like to discuss your case, give me a call. 323*782*0099

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Answered on 6/23/07, 2:51 pm
JEB Pickett Wynne Law Firm

Re: medical malpractice

4.74 is a very high Creatinine level which will generally raise red flags as to a patient's condition and require serial re-testing or a Creatinine clearance test(measuring the levels in the urine over a 24 hour period). Factors other than the Creatinine level may also have been at issue, however, and review of the entirety of the medical records would be required to determine if any malpractice occurred.

Whether a breach of the standard of care occurred is a question that can only be answered by a doctor, preferably a nephrologist in this case. Before any attorney would consider filing an action, they would need an opinion from a physician establishing both that a breach of the standard of care occurred and that the breach was a cause of death in this case. If you are a family member or related, you need to gather all of the medical records you have, request the records from all treating physicians immediately and find an attorney experienced in medical malpractice actions to assist you in determining if a potential action exists and when it must be filed to avoid missing the statute of limitations on the case.

If you do not have an attorney, contact your local County Bar Association and ask for a referral to an attorney experienced in such cases. If you have any further questions, feel free to contact our office as well. 877.352.6400

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Answered on 6/22/07, 11:06 am
Terry A. Nelson Nelson & Lawless

Re: medical malpractice

This question is not properly asked of attorneys - the only useful opinion is from a doctor in that field. You can't file a malpractice claim without the doctor's opinion. If you can get one confirming your suspicions, then an attorney will be interested in the case. If you can't locate a doctor, an attorney can help you find one willing to review the patient chart. Be advised that doctors charge substantial fees to do such review and to provide an opinion. Consult with an attorney before paying such fees, to make sure the doctor will be a credible expert that is 'useful' at trial.

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Answered on 6/22/07, 1:01 pm
Michael Stone Law Offices of Michael B. Stone Toll Free 1-855-USE-MIKE

Re: medical malpractice

If the patient is a relative of yours, I'm sorry for your loss.

I'm not a physician and, although 4.74 is indeed a very high creatinine level, I'm not qualified to give an opinion as to whether the standard of care was violated.

The court is not going to accept testimony from you, or me, on the standard of care or on the meaning or significance of elevated creatinine levels. I do know medical experts who are in the business of reviewing medical records, and who possess the credentials necessary for their expert testimony to be admitted in evidence and believed by juries. And I do know how to prosecute lawsuits.

If a board-certified nephrologist agrees to testify that the standard of care was violated, and this caused the patient's death; if you are her next of kin; and if you have not done anything to mess up the case such as waiting until the legal deadline has expired, you may well have a good case, in which case you need to call a lawyer and have the medical records obtained and reviewed without delay.

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Answered on 6/22/07, 12:53 am
Robert F. Cohen Law Office of Robert F. Cohen

Re: medical malpractice

Without knowing more, it is impossible to say whether a physician committed malpractice. A lawyer will first get an opinion for an expert in the field before filing lawsuit. What you state sounds fairly egregious. There might be statutes of limitation applicable to your case, so if I were you, I'd bring all medical records with you to a meeting with a lawyer immediately.

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Answered on 6/22/07, 12:53 am


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