She was working as a physician's assistant.
In a local emergency room here on Long Island.
"I diagnosed him with a corneal abrasion."
That's what she said when I questioned her during her pretrial question and answer session known as a deposition.
I was questioning her in her attorney's conference room.
There was no judge present.
There was no jury present.
A court reporter was there to record all of my questions and all of her answers.
Here was my first question...
"On November 13, did you diagnose a penetrating eye injury?"
Her answer was "I diagnosed him with a corneal abrasion."
An abrasion is really a scratch.
A corneal abrasion is a scratch on the cornea.
My client didn't have a scratch.
He never had a scratch on his cornea.
In other words, he had a hole in his eye.
And she missed it.
She misdiagnosed his obvious condition.
She missed the boat.
"My question is did you diagnose a penetrating eye injury?
She responded "A corneal abrasion, yes."
It gets better...
I then asked this penetrating question...
She answered "I guess, yes."
Fluid was leaking out of his eye and she failed to recognize it.
A corneal abrasion is not a punctured globe.
Not by a long shot.
She didn't even know the difference.
"Q: You are not an ophthalmologist, correct?
Q. You are not an optometrist?
Q. You are not a physician?
Q. You are not Board certified in emergency medicine, correct?
A. I am not Board certified in emergency medicine.
Q. In other words you're not a Board certified emergency room physician?
Q. You are not licensed as a medical doctor, correct?
This line of questioning quickly established what she was not.
Someone who couldn't tell the difference between a scratch on a cornea and a penetrating eye injury.
Someone who didn't even know when to ask for help.
Someone who didn't bother to ask an ER physician to see the patient.
Someone who never called in an eye doctor to examine the patient.
She sent the patient home with some eye drops.
She told him to follow up with an eye doctor in a few days.
When the patient went home, he had lots of fluid coming out of his eye.
He thought it was normal tears.
Turns out it wasn't.
It was viscous fluid from within his eye.
The fluid maintained the pressure within his eye.
He didn't know it yet.
She gave him the wrong diagnosis.
There was no urgency whatsoever when she told him to follow up with an eye doctor in a few days.
The next day he had significant pain in his eye.
It got so bad that he made an appointment to see the eye doctor the next day.
Waiting to be seen.
Fluid dripping down his face from his eye.
The eye doctor began to examine him.
He told him he needed to get to the hospital immediately!
"How did they not see this in the emergency room the other day?" he asked.
"I don't know. She said I had a corneal abrasion," he told the eye doctor.
"No. There's no corneal abrasion. You have a penetrating eye injury and you need surgery NOW!"
Well, there were a few problems.
That meant he couldn't have general anesthesia for his eye surgery.
That meant he'd have to be awake for the surgery.
He'd be given a local anesthetic.
He'd feel pressure.
He'd be able to see the instruments coming toward his eye.
He'd hear the doctors working on him.
He'd be awake!
That was problem number one.
The eye doctor needed to seal off the wound and maintain the integrity of the eye so the patient would have good usable vision.
That was problem number two.
Since much time had elapsed since the initial eye trauma and since a great deal of vitreous fluid had escaped his eye, it was no longer a firm globe with significant eye pressure within it.
It was now misshapen.
When the ends of the wound were closed together, it created a secondary problem for the patient.
Now his vision was totally distorted.
He couldn't see.
He coudn't see shapes.
He had no usable vision in this eye after this.
Ahh, but the defense argued that his vision loss wasn't from the physician's assistant's carelessness.
They argued it was from the original trauma.
That's a good argument.
But not here.
The surgeon who closed up his eye told me that if the patient had received timely treatment in the emergency room when he first arrived, he would have maintained the integrity of his eye.
It would have been easier to close up the wound at that time.
He would have had good vision had it been recognized and fixed immediately.
He may not have had 100% perfect vision, but the surgeon said he'd have been able to see about 80-90% of what he could see before this incident.
That's a significant difference.