Porter Hospital, physician prevail in malpractice lawsuit

MIDDLEBURY — An Addison County Superior Court jury on April 29 sided with Porter Hospital and one of its Emergency Department physicians in a malpractice lawsuit filed by the family of a Orwell man who died from a heart ailment in 2006.
The lawsuit was filed by the family of James R. Dubois, who was 27 years old when he died on Sept. 20, 2006, from a condition called “aortic dissection” — a tear between the inner and outer layers of the aortic wall. The aorta is the largest artery and delivers oxygenated blood to all parts of the body.
Dubois’ widow, Hayley Dubois, filed the civil suit on behalf of herself and the couple’s two small children. The lawsuit describes a series of three visits James Dubois made to the Porter Hospital emergency room during a five-day period during which he complained of the “sudden onset of low back pain with bending.”
During his initial visit on Sept. 15, 2006, Dubois — who complained of a pain registering “10” on scale of 1 to 10 — was diagnosed with a “lumbar sprain, strain,” and was treated with an injection of Demerol and Phenergan, and discharged with instructions.
But Dubois returned to the Porter emergency room later that evening complaining of the same back pain, “with radiation to the front of the abdomen and difficulty urinating,” according to the lawsuit.
A Porter Emergency Department physician, Dr. Geoffrey Knisely, diagnosed Dubois with a lumbar back strain and dehydration, according to the lawsuit. He administered his patient with a painkiller and a prescription for an additional supply, according to court documents. At the same time, according to the lawsuit, Knisely allegedly told Dubois that he had detected a heart murmur and advised him to follow up with his primary care physician.
Five days later, on Sept. 20, Dubois fell unconscious and required CPR, according to the lawsuit. Dubois was taken by ambulance to Porter Hospital were he was pronounced dead less than an hour after being admitted, according to court records.
The Dubois family, in its lawsuit, claimed that Porter should not have discharged him on Sept. 15; that Dubois was not offered “reasonable care to ensure that treatment and procedures were conducted thoroughly and appropriately”; and that his death was a “direct and proximate result of the actions and failures to act by (Porter Hospital and Dr. Knisely).”
Mrs. Dubois and her children asked the jury to award compensation for wrongful death, injuries and damages suffered by Dubois prior to his death, injuries and damages suffered by the Dubois family as a result of his death, and legal fees.
Knisely was among several physicians who testified during a trial that began on Monday, April 25, in the second-floor courtroom at the Frank Mahady Courthouse. Testimony spanned the better part of four days.
Witnesses taking the stand for the plaintiff included Dr. Robert Fuller, an emergency room physician at John Dempsey Hospital in Hartford, Conn. Fuller, during testimony, offered his opinion that Knisely and his staff “deviated from standard care” during Dubois’ second trip to the hospital when they noted the patient’s heart murmur and “failed to investigate the possibility of aortic dissection.”
But expert witnesses who took the stand for Porter and Knisely argued that Dubois’ symptoms were inconsistent with those that usually characterize aortic dissection.
Dr. Carlo Rosen, an emergency department physician at Beth Israel Deaconess Hospital in Boston, said medical reports showed Dubois’ pain was centered in his lower back — not in the upper back and chest, where aortic dissection symptoms are usually manifested.
Rosen testified that Dubois’ symptoms were consistent with “musculoskeletal low back pain.”
Dr. John Sanders, a retired cardiac physician and professor of surgery at Dartmouth-Hitchcock Medical Center, also provided expert witness testimony for the defense.
Sanders testified to his opinion that Dubois “exhibited none of the signs or symptoms of aortic dissection,” according to court documents. He told the jury that aortic dissection usually comes with “severe, tearing pain behind the breast bone, or chest pain radiating around the upper back.” Symptoms can also include paralysis, loss of pulse and shock, Sanders noted.
The jury received the case during the afternoon of Thursday, April 28, and rendered its verdict late the next morning. The jury decided in favor of Porter Hospital and Knisely and awarded no compensation to the Dubois family.
Peter Joslin, the attorney for Porter Hospital, said he was pleased with the verdict.
“It was a hugely emotional case; it involved the untimely death of a husband and a father,” Joslin said during a phone interview on Monday. But Joslin added he was glad the jury was able to set aside the emotional side of the case and focus on the key medical issues.
“It was highly technical medical testimony,” Joslin said. “It was clear the jury paid very careful attention and was very thoughtful in its analysis.”
Porter Hospital spokesman Ron Hallman issued the following statement on Monday: “We were gratified by the expeditious and positive decision in this matter and are absolutely confident that it was the correct and appropriate outcome.”
The Dubois family, meanwhile, is processing what for them was a very difficult verdict.
“We are very disappointed by the outcome,” said Tom McCormick, the attorney who represented the Dubois family.
Of Hayley Dubois, he said, “She has been through a lot, and this is one more sorrow for her.”
Reporter John Flowers is at [email protected].

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