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Valencia Assistant Principal Timothy Howard and his wife Mary Howard were awarded $5 million in a binding arbitration against Kaiser Healthcare.

Valencia Assistant Principal Timothy Howard and his wife Mary Howard were awarded $5 million in a binding arbitration against Kaiser Healthcare.  A panel of three arbitrators found that Kaiser phy­si­cians were negligent for failing to timely work up Mr. Howard’s transient ischemic attacks (TIA) of the retina which resulted in a devastating stroke and complications that included bilateral amputations of the patient’s legs.  “This is a flaw in the Kaiser system that I’ve seen over and over again.  Being in a hurry; not listening to the patient; not ordering tests,” said the Howards’ San Diego attorney, Robert Vaage, who has never lost an arbitration against Kaiser.  “How does Kaiser expect you to ‘thrive’ if its doctors won’t follow common sense medicine?”

In October of 2007, Mr. Howard was a healthy 46-year-old, working at a middle school in Valencia.  He was married and had two twin daughters.  He began having symptoms of intermittent “gray-out” or blindness in his right eye.  He saw his Kaiser primary care doctor, who referred him to an ophthalmologist, who found no structural abnormalities of the eye.  Mr. Howard continued to have vision symptoms, with new com­plaints of headaches, neck pain, and tingling in his left pinky.  At the insistence of his wife, Mr. Howard was seen by Kaiser Neurologist Marika Issakhanian, M.D.  It was alleged that Dr. Issakhanian was in a hurry and not interested in hearing the concerns of Mr. Howard and his wife.  She diagnosed Mr. Howard with an ocular migraine headache, completely ignoring the signs and symptoms of TIA of the retina.  To placate the Howards, she ordered an MRI and MRA (magnetic resonance angiography) of the head and neck, but not until December. 

On Thanksgiving evening, Mr. Howard experienced complete vision loss in his right eye.  He went to Kaiser Woodland Hills Urgent Care.  The doctor there told him he was experiencing an ocular migraine, but agreed to run a CT scan in order to placate Mrs. Howard, who was insisting something was wrong. While waiting for the scan results, Mr. Howard suffered a devastating stroke.  Kaiser emergency room doctors diagnosed a carotid dissection as causing the stroke.

Mr. Howard has not been able to return to work since the stroke.  He has no use of his left arm and has left-sided weakness.  He is wheelchair-bound and needs assistance with all aspects of his life.  He also has cognitive and mental deficits from his stroke.  He requires assistance 24 hours a day, 7 days a week.  His future care needs are estimated in the millions of dollars.

TIA of the retina is caused by intermittent disruption of blood flow to the eye, which causes the gray-outs or visual disturbances.  In men under the age of 60, the most likely cause is a carotid dissection.  It is diagnosed by MRI/MRA of the head and neck.  Treatment for a carotid dissection usual­ly involves taking anticoagulation medication to prevent blood clots.  The dissection or tear usual­ly repairs itself within 3-6 months, and the patient can return to a normal life.  Left undiagnosed and untreated, a carotid dissection can lead to a devastating stroke. 

Kaiser’s electronic records also may have played a role in preventing Mr. Howard from obtaining urgent scans.  “Once he was diagnosed incorrectly, that diagnosis followed him from doctor to doctor,” explained Vaage.  “When he arrived at Urgent Care, the doctor looked at the E-record, saw Dr. Issakhanian’s diagnosis, and accepted the diagnosis without further testing.  That’s all fine and good if you’ve got a good diagnosis.” 

“I don’t get it,” added Vaage.  “What happened to ruling out the worst potential cause first?  Dr. Issakhanian testified that she considered TIA of the retina, knew it could lead to a stroke, but did nothing to rule it out at the time.  All it took was one set of scans done within 24-48 hours, and Mr. Howard would have been back to work as an assistant principal.  Instead, the Howards’ lives are forever changed.” 

Because of the Medical Injury Compensation Reform Act (MICRA), the Howards’ general damages (non-economic damages) are capped at $250,000 apiece.  “The Howards’ lives have been destroyed,” said Vaage.  “Put in the context of healthcare reform, look at the cost to the public:  We’ve lost a hard-working member of society; we have to spend millions of dollars to care for Mr. Howard; the state of California is ending up spending hundreds of thousands of dollars in disability payments; and our health insurance premiums keep going up.  The real cost of healthcare is the cost related to the care of patients like Mr. Howard, not tort reform.  Kaiser completely failed him.”

For further information please contact:

Robert F. Vaage, Esq.

The Law Offices of Robert Vaage

110 West C St., Suite 2105

San Diego, CA 92101

(619) 338-0505

(619) 338-0588 - fax

http://www.vaagelaw.com/whyvaage.asp

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