Unread X-ray leads to $2.185M malpractice award

Zachary James died at at a North Philadelphia hospital when his heart stopped beating on April 20, 2006.

The next day, his wife's heart almost stopped, too, when she learned that his death may have been preventable, if someone had just looked at his X-rays before he died.

On Monday, following a 10-day trial, a jury awarded Rosalyn James, Zachary's widow, $2.185 million in a malpractice suit against St. Joseph's Hospital and two emergency-room physicians.

"I know it would never bring him back," she said. "But now he's at peace because I fought for him."

Rosalyn was in the middle of a two-week recovery at another area hospital when her husband, then 51, began experiencing chest, back and leg pains. He called 9-1-1 and was transported to St. Joseph's, at 16th Street and Girard Avenue, the closest hospital to the couple's home.

James was triaged within 10 minutes of his 8:35 a.m. arrival and seen by the attending emergency-room physician, Dr. Thomas Powell, within a half hour, according to court documents.

Powell ordered several lab tests, including X-rays and echocardiograms, but it took almost two hours for some of the tests to be performed, said attorney Stephen Pokiniewski, who served as co-counsel for Anapol Schwartz, the law firm representing James.

By 10:20 a.m., Powell left the hospital to attend a corporate meeting in Horsham, leaving Dr. Emil Skobeloff, who was serving his first day on the job at St. Joseph's, as the only attending emergency-room physician, the documents said.

"That was supposed to be Dr. Skobeloff's orientation day and Dr. Powell was supposed to be orienting him," Pokiniewski said. "Things fell through the crack with the changing of the guard."

After James' X-rays and other tests were developed, the emergency-room physician should have reviewed them before they were sent to radiology, as per hospital procedure, but Skobeloff or Powell never did, court documents said.

Zachary James died at 7:05 that night, from a dissecting aortic aneurysm, a condition in which blood gets between the layers of the aorta wall and fills up the sac surrounding the heart, constricting it until it's unable to pump, Pokiniewski sad.

The X-rays and other tests that would have revealed this condition weren't "interpreted" until the next morning, court records said.

Peggy Boemmel, hospital spokeswoman and chief financial officer for North Philadelphia Health System, of which St. Joseph's is a part, declined to comment.

Court records indicate that the hospital and doctors pursued two defenses at trial.

The first was that Zachary James had a history of hypertension and "chronic noncompliance" in taking his blood-pressure medication.

The second defense was that quickly identifying James' condition still may not have allowed enough time to properly transfer him to another hospital where the necessary surgery could have been performed.

"The defense argued that there wasn't enough time," Pokiniewski said. "I don't think anybody seriously would have said there wasn't some chance. The anger was, of course, that he was never given the opportunity to survive."

The jury found Powell 48 percent liable, Skobeloff 36 percent liable and St. Joseph's 16 percent liable, Pokiniewski said.

For Rosalyn James, who'd been married to Zachary for 17 years, the courtroom victory in his name was small consolation for the promise that she made to him on the phone that day from her hospital bed to his.

"I told him I was going to get him out of that hospital and I told him I loved him," she said. "Those were the last words we spoke." *