Hospital failed to diagnose & timely treat calcified fibroid.

TINA AYALLA PRESENTED TO THE ER AT ST. LUKE'S ROOSEVELT HOSPITAL ON SEPTEMBER 15, 2005, AT 10:52 P.M. COMPLAINING OF VAGINAL BLEEDING AND THAT 'SOMETHING WAS COMING OUT OF HER VAGINA.' She described her pain as a 10 of 10 and noted that she had vaginal bleeding for three weeks prior to coming to the ER. She gave a history of fibroids and anemia. Her temperature was 97.1 Fahrenheit, her blood pressure was 115/72: and her pulse rate was 102 bpm. Dr. Jonathan McCauley, an ER physician, performed a gynecological exam on Tina. The exam revealed mild to moderate blood in the vault at the internal end of the vaginal canal, and a closed external orifice of the cervix. Dr. McCauley diagnosed Tina with anemia and with chronic blood loss secondary to vaginal bleeding. On September 16, he performed a second pelvic examination. He found a large amount of blood. Tina complained of an 8 of 10 pain level. At 1:20 a.m., the hospital intravenously administered 1,000 milliliters of normal saline and 4 milligrams of morphine. Dr. McCauley prepared Tina for discharge at 1:44 a.m. Her discharge diagnosis remained anemia with chronic blood loss and vaginal bleeding. According to medical records, Dr. McCauley instructed Tina to follow-up with her -regular doctor" for treatment of her anemia and fibroids, but to report back to the ER with any further problems. He also told her that she would likely need to have a hysterectomy to treat the fibroids. Tina left the hospital at 2:42 a.m. She was reported as ambulatory and "tolerating pain."

ON SEPTEMBER24, 2005, TINA WENTTOTHE ER AT NEW YORK-PRESBYTERIAN HOSPITAL, COMPLAINING THAT "TISSUE HAD PROLAPSED FROM HER VAGINA AND THAT SHE HAD ABDOMINAL PAIN." Initially, the hospital scheduled Tina's discharge for later that day but canceled that order. Tina was sent for an obstetric and gynecological consultation. Dr. Jennifer Tam, a gynecologist, found a circumscribed round structure. She believed this most likely suggested a calcified/degenerating, fibroid. Dr. Tam ordered a pelvic and abdominal MRI and repeat blood cultures. She suggested that Tina stay at the hospital overnight. Results from the MRI were reported and showed fluid collection, multiple fibroids and evidence of a calcified fibroid. Tina was initially scheduled for a hysterectomy but underwent a bilateral salpingo oophorectomy, and an appendectomy. She was monitored during her stay at the hospital for the next few...

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