Not guilty after death due to pneumothorax or methadone intoxication

Circuit Court of Cook County, Illinois
Counsel: Chad M. Castro and Krista Frick
Demand: None
Asked: $2.5 million
Outcome: Not Guilty

On July 10, 2007, the decedent was brought by ambulance to the emergency room due to complaints of shortness of breath. The co-defendant ER physician read the chest x-ray and diagnosed respiratory failure secondary to pneumonia based on a lower lobe infiltrate of the right lung. The x-ray film was not retained by the hospital. The decedent continued to experience increasing respiratory failure despite supplemental oxygen and breathing treatments. Five separate attempts were made to intubate the decedent. The decedent became asystolic, so aggressive CPR was begun and a tracheostomy was performed. Despite nearly three hours of resuscitative efforts, the decedent did not respond and passed away. He was survived by his mother and four sisters. An x-ray performed post-mortem revealed a tension pneumothorax in the lower right lung. Unknown at the time of treatment was the fact that the decedent had lethal levels of methadone in his blood as well as metabolites of heroin. The Cook County Medical Examiner determined that the cause of death was methadone and opiate intoxication.

Plaintiff claimed that the cause of death was an undiagnosed and untreated tension pneumothorax due to the fact that the co-defendant misread the x-ray which showed a tension pneumothorax. Plaintiff further contended that the defendants failed to timely diagnose and treat the tension pneumothorax. Plaintiff alleged that the standard of care required the co-defendant to perform a needle thoracotomy to treat a tension pneumothorax. Defendants contended that such a needle thoracotomy would have been reckless and dangerous. Defendants further asserted that the high levels of methadone along with severe cardiac and lung disease caused by years of cocaine abuse, heroin abuse, and heavy smoking, superimposed on a respiratory infection, led to the decedent’s rapid lung failure and death. Defendants claimed that the chest x-ray taken 20 minutes before the decedent’s death did not show a tension pneumothorax and that the tension pneumothorax present post-mortem was caused by the aggressive CPR and positive pressure oxygen administered in the interim.