Physician Assistant Vindicated
On February 6, 2019, a Nassau County jury returned a unanimous verdict in favor of physician assistant Robert F. DiBaro. On February 21, 2010, then 47 year old Paul Chicoine was painting the ceiling of his basement when he suddenly experienced left sided weakness, slurred speech, nausea, dizziness and vomiting. He contacted his sister, Patricia Conti, and asked her to call Emergency Medical Services. EMS documented his complaints and brought him to St. Joseph Hospital. By the time he arrived, he was no longer experiencing left sided weakness or slurred speech. He was diagnosed with vertigo and sinusitis, and discharged on Biaxin and Meclizine with instructions to follow up with his primary care doctor.
Mr. Chicoine had an appointment to see his primary care doctor on February 26, but the office closed because of a snowstorm. His appointment was rescheduled to March 1. On Sunday February 28, Geralyn Chicoine, the plaintiff’s wife, called the office twice, and reached Mr. DiBaro, who was the covering health provider that day. She reported that her husband was still experiencing nausea, vomiting, dizziness and GERD since his discharge from the emergency room the prior week. She contends that on each occasion, she was told to keep her appointment with the practice on March 1. Mr. DiBaro documented that on each occasion, he instructed her to take her husband to the emergency room.
Mr. Chicoine did not go to the emergency room on February 28, but did appear for his appointment on March 1. Mr. DiBaro reached a differential diagnosis including a possible Transient Ischemic Attack (TIA), and again encouraged Mr. Chicoine to go to the hospital. The Chicoines contend that Mr. DiBaro never advised them to go to the emergency department. Mr. DiBaro made arrangements for Mr. Chicoine to be seen immediately by a neurologist, Dr. Adam Schneider. Dr. Schneider ordered an imaging study to rule out a vertebral artery dissection, which was to be performed on March 2. Overnight, Mr. Chicoine suffered a stroke secondary to undiagnosed vertebral artery dissection.
The plaintiff sued St. Joseph Hospital and Dr. Mendola, claiming that each failed to elicit and document a proper history including slurred speech and left sided weakness. Had they done so, plaintiff claimed, proper work up would have lead to diagnosis and treatment with anti-coagulants, and reduced the risk of stroke. Plaintiff alleged that Mr. DiBaro did not actually advise Mr. Chicoine to go to the emergency room on February 28 or March 1, and that it was a departure from accepted medical practice to send the plaintiff to a neurologist, instead of to the emergency room. Plaintiff claimed that in the ER, imaging studies would have been done emergently, and the plaintiff’s dissection would have been discovered and treated before his stroke.
Mr. Chicoine returned to work as a Court Officer in October 2010, and continued to work until July 2013. He contended that the effects of the stroke then prevented him from continuing the requirements of his employment. The jury found that Dr. Mendola and St. Joseph Hospital departed from accepted medical practice, and awarded damages for past and future lost earnings, loss of future pension benefits, past and future pain and suffering, and to Mrs. Chicoine, past and future loss of services. The jury returned a verdict in favor of Mr. DiBaro.