Question

PG 355 Moskovitz v. Mount Sinai Medical Center What happened in the case? What things went wrong? What are the relevant legal issues? How could the event been prevented? What would have happened if one fact of the case was changed and what would that fact be?

Figgie removed a mass from the Achilles tendon from Moskovitz. The tumor had a rare form of cancer. The scan of the bone showed that the cancer had metastasized. Figgie then referred Moskovitz to a orthopedic surgeon who specialized in oncology at the University Hospitals. All medical records and documentation starting from 1985 through 1987, which contained 7 pages of all the treatment that Moskovitz has had. Makley thereafter referred Moskovitz to radiation therapy at the University Hospital and sent the 7 page documentation. A month later, Makley’s office forwarded the chart to Figgie’s office. Moskovitz’s psychologist then got a copy. Makley’s secretary requested that Figgie’s office return the chart to Makley. It was discovered that the original chard had mysteriously vanished. When this was discovered, Moskovitz filed a complaint for discovery seeking to ascertain information relative to potential claim for medical malpractice. Mosckovitz claimed that she had never refused to have the tumor biopsied, but discrepancies were noted in her medical record. At the deposition, Makley produced a copy of page 7 of Figgie’s office chart. That copy was identical to the copy recovered by the plaintiff’s counsel from the radiation department records at the University Hospitals. The copy stated that Mrs. Mosckovitz comes in today for evaluation on the radiographs reviewed with Dr. York. He was not impressed that the mass on Moskovitz’s leg was anything other than a benign problem, perhaps a fibroma. Figgie and York elected to continue to observe. There was a notation made that Figgie did not want excisional biopsy, we will observe. Come to find out that Figgie’s statement had been whited out or deleted on the original chart from which the psychiatrist’s copy had been made, in a way that left no indication on the copy that the sentence had been removed from the original records. Eventually all record copies appeared and nowhere did it state that work up or biopsy was recommended by Figgie and refused by Moskovitz at any time. The panel decided if the biopsy was performed at the time it was found, that there would have been a good chance of long term survival. Dr. Figgie’s office chart, which is the primary reference material in analyzing a physician’s conduct, is filled with contradictions and inconsistencies

Answer 1

Moskovitz v. Mount Sinai Medical Center is the law suit raised against Mount Sinai medical center by Margaret Moskovitz.

The facts:

Margaret Moskovitz was an elderly woman was treated by Dr Harry Figgie, an orthopaedic surgeon for a degenerative arthritic condition in her knees. The patient had a history of benign and low-grade malignant tumours on her lower extremities when she started treatment with Dr Figgie. He had done the Joint replacement for the patient and she had seen Dr Figgie a number of times due to complications related to the surgery. Dr.Figgie did not recommend a biopsy when the patient complained of a lump on her leg and claimed that as calcified lesions even though he was aware of the patient’s history of malignancies.

In November 1986 Moskovitz again underwent a surgery but Dr Figgie had not done anything for the previously noted small mass. In November 1987 Dr Figgie performed another surgery on the patient and removed the mass and noted that as an epithelioid sarcoma. Then he referred the patient to Dr Makley an orthopaedic surgeon specialized in oncology. Dr Makely received the patient’s record from Dr Figgie’s office and then he started radiation therapy for the patient. Dr Figgie’s office requested the reports back and had never returned it to Dr Makley.
Later Dr Makley amputated the left leg of Moskovitz and later she was on chemotherapy. She died on December 5, 1988, and before that, she had filed a lawsuit in October 1988 against Dr Figgie. In her disposition, the patient denied that she had never refused a biopsy on the mass.

The original chart was purposefully hidden to avoid lawsuit on Dr Figgie.

The court identified it as an intentional tort of spoliation of evidence and consistent with the long-standing presumption for other intentional torts such as assault, battery and defamation. The hindrance of the patient ’s right was a punishable violation.

It is determined that Dr Figgie altered certain records to conceal the fact that malpractice had occurred. This could have been avoided by producing accurate reports. The alteration of health records removes the healthcare workers liability protection.