SOUTHEAST TEXAS RECORD

A Lamar County man alleges he was treated negligently at a veterans' hospital and is seeking $4 million in compensation from the U.S. government.

Plaintiffs Robert A. Brown and his wife Mary Mary Ellen Brown filed a medical malpractice suit against the U. S. Veterans Administration on April 4 in the Texarkana Division of the Eastern District of Texas.
Michael D. Mosher of Paris is representing the Browns.

The U.S. government, represented by Assistant U.S. Attorney Steven Mason, denies that it was negligent in Robert Brown's treatment.

On July 18, the parties conducted a Rule 26 conference relating to discovery and submitted a joint report on Aug. 16. They agreed that initial disclosures will be served by Oct. 1.

Brown is a veteran who served his country from 1957 to 1967. At the time he was discharged he had two service-connected disabilities; one related to hypertension and the other related to a permanent injury to his wrist.

Sometime in 2002, his blood pressure medication had been changed at the Salas Minor Emergency Clinic in Paris, Texas, and it appeared that the new regimen of blood pressure mediation was not working as well as the prior medication because his blood pressure was slightly elevated.
It was during this time period that Robert A. Brown scheduled his first appointment with the Sam Rayburn Veterans Service Center in Bonham in January 2003.

According to the plaintiffs' original petition, the physician's assistant who noted his elevated blood pressure and prescribed the same regimen of medicine that he had been on immediately preceding his visit, even though that medication had not controlled his blood pressure.

Brown says he requested that the VA resume the original medication he had been on for years "but the physician's assistant declined to do so."

She continued him on the same medication he had received at the Salas Emergency Clinic and scheduled a next visit for Brown in July 2003, seven months later.

For several months, Brown's blood pressure continued to be elevated and he began experiencing dizziness and other symptoms that he assumed were side-effects of his medication, including depression, anxiety and irritability. Then in June 2003, Brown suffered a heart attack, which was confirmed at his July appointment by the VA.

At this visit, he was seen again by the physician's assistant, Ms. Parsons, who scheduled a stress test for September 2003. She also gave him nitro-glycerine to take in case he experienced another heart attack.

"She did nothing else," the petition states.

The United States denies that Brown suffered a heart attack in June 2003 that was confirmed at the VA during his July appointment, and also denies that the physician's assistant "did nothing else."

During a stress test in Dallas in September, Brown was forced to stop after six minutes because of pain in his chest at or near his heart and from a restricted tight feeling in his chest. He was sent home with no further advice and no further medication although they did schedule a compensation and pension ("C & P") examination.

Brown alleges that the C & P doctor wondered aloud to Brown why, if Brown's elevated blood pressure had not been addressed and controlled, that the doctors in Bonham had not scheduled him for hospitalization for observation or changed his medication.

"This doctor suggested that Brown change his primary care from Bonham to Dallas immediately," the petition states.

But Brown kept his next appointment at the Bonham Medical Center in November 2003. Still reporting depression, dizziness and weakness, he requested a change in his medications because he "felt worse each week. "

The plaintiff says the Bonham VA made no changes to his medication, and scheduled his next appointment for June 2004 "with no attempt to address the fact that his blood pressure was not being controlled."

On Dec. 27, 2004, Brown fell in a neighbor's yard and was unable to rise. He was taken home and, when he did not improve after several days, he went to the Medical Center in Bonham. His blood pressure at that time was 160/130.

Brown was seen by Dr. Edward Sims at the VA Hospital in Dallas on Feb. 1, 2005. His blood pressure was recorded at 140/90 and a short while later at 163/99.

"At no time did any one at any of the hospitals involved ever attempt to find out why Brown's blood pressure was continuing to be elevated and why it could not be controlled," the suit alleges.

Brown was still experiencing pain in the shoulder from the fall in 200 and Dr. Sims scheduled an X-ray.

"By 2005, the VA Hospital had Robert A. Brown on seven medications a day, including pain pills, sleeping pills, mood pills and anti-inflammatories, in addition to the blood pressure and cholesterol medication," the suit states.

Brown was seen again on June 13 and September 10, 2005, and claims that "no one at the VA Hospital addressed his continued blood pressure problems or shoulder injury."

The suit alleges that he was told that his shoulder injury was simply arthritis and told to exercise the shoulder, even though Brown says he reported to the doctors that he could not move the arm at all.

On January 26, 2006, Brown saw a mental health team and a new primary care provider, Dr. David Reece. Despite the fact that his blood pressure medication had been doubled, it still could not be lowered below 148/87.

In March 2006, Brown collapsed. He claims that the pain in his shoulder from the December 2004 fall, that the VA doctors had been calling arthritis, was now so bad that he could not move.

He scheduled a visit with an orthopedic doctor who, prior to any X-ray or MRI, told Brown that he obviously had a torn rotator cuff. The doctor scheduled an MRI to confirm his diagnosis.

"As a result of the delay in treatment for the torn rotator cuff; it was impossible to fully repair the rotator cuff, so Brown's arm will never work properly again and he will always have pain," the suit alleges. "Moreover, because of the state of his heath by this time, they could not even do the surgery that could have alleviated some of the pain."

On July 22, 2006, Brown's uncontrolled blood pressure climbed to 182/130 and he could not stand up. His wife took him to the Salas Minor Emergency Clinic in Paris, Texas, and his blood pressure was 190/130. Over the next two hours it could not be lowered and Brown was referred immediately to the Paris Regional Medical Center were he saw a Dr. Hashimi.

Dr. Hashimi concluded that there had to be a reason the blood pressure would not remain normal with this much medication and it was "of the utmost importance to find that reason."

Dr. Hashimi ordered an echo-cardiogram and esophageal echo and determined that there was a blood clot in Brown's heart.
The suit claims that the clot "had been there so long it had become calcified. "

Plaintiff argues that after Dr. Hashimi began working on his blood pressure, altering the medications and monitoring the results, he stabilized Brown's blood pressure at 120/80 in two days, where it has remained.

Brown also says that Dr. Hashimi directed him to "throw out half the medications that he had and informed him that one of those medications had caused ulcers and that the bleeding ulcers had caused the anemia that had so weakened him."

"Mr. Brown's shoulder can never be repaired. The blood clot in his heart cannot be dissolved without the likelihood that it will break off and block another blood vessel causing a life-threatening stroke or heart attack," the suit alleges. "MRIs, EKGs, and other tests done on him now show that, as a result of the untreated high blood pressure for three years, Mr. Brown has damages to his heart, to his vascular system and to his brain. Numerous minor blood vessels have broken in his brain and atrophied significant portions of his brain."

Brown says that in 2002, he made more than $750,000, but "has not been able to do meaningful work since."

"Because of his expertise in the automobile wholesale and retail market, Mr. Brown had the opportunity in 2005 and 2006 to run the Florida dealership that was to be the major importer of a new Mercedes Benz's car model into the United States. This would have earned him over $1 million a year. Because of his health and the fact that he can no longer travel, Mr. Brown could not take this opportunity and he will never work again," the suit alleges.

The plaintiff says the VA's "utter failure" to properly treat his blood pressure resulted in permanent injuries and disabilities, extreme mental and emotional distress and physical pain and suffering.
On the part of Mary Ellen Brown, it has meant she has been converted from wife and helpmate to nurse and caretaker.

"In 2002 and before, she and Mr. Brown had a normal healthy sex life. In the following years, that sex life has utterly and completely disappeared because of Mr. Brown's health," the suit states.

"As a result of the negligent treatment by the VA Medical Center, the VA doctors and the VA physician's assistants, Robert A. Brown suffered losses in income in excess of $2 million; he suffered mental and emotional distress damages, physical pain and suffering, loss of bodily functions in an amount to be determined but not less than $1 million," the petition argues. "Mary Ellen Brown, as a result of the negligence of the VA, has lost the society and affection and sexual services of her husband, Robert A. Brown. She has been damaged in an amount to be determined but not less than $1 million."

In its original answer dated June 20, the United States denied the allegations of negligence.

"Defendant United States did not violate any actionable duty owed to Plaintiffs. No employee of the United States committed acts or omissions of medical negligence, nor did any act or omission of an employee of the United States proximately cause any damages or injuries to plaintiffs," Mason wrote. "Defendant United States, through its employees, acted at all relevant times with due care and diligence to plaintiff Robert Brown, and was not negligent."

If the court awards a recovery, the defendant "invokes the applicable cap or limit on damages in medical malpractice cases under the Texas Civil Practices and Remedies Code. (Subchapter G, Chapter 74, Title 4)."

Case 5:07-cv-00052-DF