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Florida jury grants $1.5 M settlement following unaddressed bleeding at hospital resulting in congestive heart failure

By Stephanie Srakocic | Fact-checked by Davi Sherman

Published September 5, 2023

Key Takeaways

A Florida man was admitted to a Florida hospital in 2017 with pain in his back, flank, and right leg. Although CT scans revealed bleeding, he was not given transfusions or blood clotting medications.
Miller’s blood loss led to multiple health complications, including right leg paralysis, congestive heart failure, and eventual death.
His widow sued two treating physicians and was awarded over $1.5 million.

The widow of a Florida man who died of congestive heart failure in March 2021 has been awarded over $1.5 million following a heavily contested medical malpractice case.

Ronald Miller of Pensacola, FL, began experiencing pain in his lower back, right flank, and right leg in December 2017. He sought care at West Florida Hospital and was admitted through the emergency room. A CT scan was ordered, revealing bleeding. This was attributed to Miller’s Lovenox prescription, which was immediately discontinued. However, hematology was not consulted, and treatments to address the bleeding, such as fresh frozen plasma and Protamine, were not ordered.^[]

Miller’s condition worsened, and a new CT scan revealed further bleeding. Protamine and fresh frozen plasma were still not ordered. By December 24, Miller’s blood loss had led to the development of multiple complications, including hemorrhagic shock, acute renal and liver failure, nerve compression, cardiac injury, and right lower extremity paresis. Miller remained at West Florida Hospital until January 19, 2018.

Although Miller returned home after his bleed, records show that his health had substantially declined. Miller experienced permanent paralysis of his right leg and subsequently visited local hospitals numerous times. Many of these visits became inpatient stays, including admissions in October, November, and December 2018; March, April, and September 2019; April, July, and October 2020; and January and February through March 2021. Miller’s medical records show many of these admissions were for congestive failure and pleural effusions. Miller did not develop congestive heart failure until after his December 2017 West Florida Hospital stay and had not previously experienced pleural effusions.^[]

After Miller died, his wife, Marylyn Miller, brought a medical malpractice suit against multiple parties involved in his care during his initial hospital stay, including West Florida Hospital. The hospital, along with several physicians, settled before trial. When the case went before a jury, it focused on two physicians who treated Miller in 2017, Imran Mirza, MD, and Sylvia Harris, MD.

The defense team for Dr. Harris and Dr. Mirza argued that the physicians were not to blame for Miller’s later health issues and death. It was the defense team’s belief that Miller suffered from a retroperitoneal bleed, arguing that this could not have been prevented by alternate actions on the part of either doctor. The defense also argued that there was insufficient evidence to prove causality between Miller’s December 2017 hospital stay and his later health decline.

Lawyers for the plaintiff, however, argued that the physicians failed to take appropriate medical actions, such as quickly diagnosing the bleed, ordering urgent imaging, consulting with hematology in a timely manner, administering Protamine, and closely monitoring Miller. They contended that this resulted in patient care that was below medical standards. They also stated that because Miller’s medical records do not show a pattern of frequent hospital admissions prior to his December 2017 West Florida Hospital stay, a link between that event and his decline in health is clear. Additionally, expert witnesses for the defense argued that Miller’s leg paralysis led to immobility, resulting in substantial weight gain and exacerbating his congestive heart failure.^[]

After three days of trial proceedings, the jury found that Dr. Harris was not responsible for Miller’s death. However, they found that Dr. Mirza had failed to meet medical standards, leading to Miller’s health decline and subsequent death. They ruled in favor of Miller’s estate. On February 17, 2023, the jury awarded Marylyn Miller $2,595,420.45 and assigned Dr. Mirza 100% of the financial liability. The defense appealed the verdict and requested a new trial. While this appeal was rejected, the total award amount was reduced. On June 12, 2023, a final award of $1,748,814.30 was declared.^[]^[]

Malpractice and patient safety

As is often seen in malpractice cases, lawyers for Ronald Miller’s estate argued that the physicians involved provided quality patient care. They pointed out that opportunity windows for treatments and consultations with other departments were missed, tests were not ordered, and Miller was not monitored appropriately, given the severity of his condition. All of these errors are also patient safety and patient care failures.

David L. Feldman, MD, the Senior Vice President and Chief Medical Officer of Healthcare Risk Advisors (a New York City–based group offering professional liability insurance to physicians) and Chief Medical Officer of The Doctors Company, the nation’s largest physician-owned medical malpractice insurer, says that it’s best to focus on improving care and preventing errors, rather than focusing on preventing malpractice.

“[It helps to] distinguish malpractice issues from just general mistakes or errors, most of which don’t become claims,” says. Dr. Feldman. “Things often go wrong in healthcare: missing diagnoses, wrong diagnoses, delayed diagnoses. But they don’t all become lawsuits. That’s important to remember because many doctors think about preventing lawsuits—but it starts with preventing these adverse events. That’s making sure things don’t go wrong. It’s saying, ‘What can be prevented?’”