Brain-Damaged Woman Can Sue New York Hospital

MANHATTAN (CN) – A New York teenager who suffered a heart attack and brain damage can sue a hospital for allegedly failing to identify that her NuvaRing contraceptive device was causing her problems, a state appeals court ruled.

Sarah Adams sued Montefiore Medical Center and Dr. Juan J. Pilarte on charges of medical malpractice and lack of informed consent.

Adams was 17 years old in 2010 when a school clinic run by Montefiore gave her a NuvaRing, a hormonal contraceptive device that is inserted monthly.

Adams had a family history of heart disease, and suffered from a chronic heart murmur. NuvaRing is associated with a risk of blood clots, and Adams and her mother discussed these risks.

Less than two months later, Adams complained of chest pain and shortness of breath. The nurse practitioner concluded that she was dehydrated.

In an emergency room, her use of the NuvaRing was noted, but she was discharged without being checked for a thromboembolism.

Adams collapsed five days later, and her heart stopped for 8 minutes before EMTs were able to revive her.  She spent a month in hospital and was discharged with permanent brain damage. She requires care around the clock.

Montefiore sought summary judgment, its expert stating that Adams’ history of heart disease did not rule out the use of NuvaRing.

Adams’ expert said the NuvaRing should have been removed immediately when Adams first came to the school clinic.

The trial court refused to dismiss, and a Manhattan-based appellate panel affirmed 3-2 on June 15.

“As Montefiore’s expert acknowledges, ‘clot risk is gradually decreased after the ring is removed,’” Justice Sallie Manzanet-Daniels wrote for the majority of the Appellate Division’s First Judicial Department.

“Thus, while the nurse was not in a position to treat clots, she certainly was in a position to make the diagnosis and to direct the plaintiff to remove the likely source of her symptoms, lessening the risk of an adverse outcome.”

Manzanet-Daniels did, however, dismiss Adams’ claim of lack of informed consent.

“The record shows that the nurse practitioner disclosed and discussed the potential risks of the NuvaRing with the patient, including the risk of blood clots,” Manzanet-Daniels wrote.

Justice Richard T. Andrias wrote the dissenting opinion.

“Plaintiff’s vitals were normal on June 1 and she only complained of shortness of breath on exertion,” he wrote. “The theory that plaintiff was already suffering from a blood clot when she visited the clinic that day is based on supposition and hindsight, and is therefore insufficient to raise a material issue of fact.”

Justices Angela Mazzarelli and Troy Karen Webber joined in the majority; Acting Presiding Justice Peter Tom joined in the dissent.

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