Where it is alleged that the defendant’s failure to diagnose the decedent prior to their discharge cost them an opportunity for treatment which may have prevented their death, the plaintiff has sufficiently alleged proximate cause for medical negligence.

The 1st District Appellate Court reversed and remanded the decision of Cook County Circuit Judge Patricia O’Brien Sheahan.

Shiqian Bao suffered a sudden and severe headache on July 10, 2013, requiring her to be taken by ambulance to the emergency department of Swedish Covenant Hospital (Swedish). Dr. Kamran Kamal took a CT scan of Bao’s head and found no evidence of a brain bleed. Bao was discharged from Swedish Covenant at 3:20 a.m. However, on a secondary review of Bao’s CT scan, Dr. Tae-Woo Kim found evidence of a subarachnoid brain hemorrhage, and she was called back to Swedish Covenant at 9 a.m.

However, Bao, after being informed of Dr. Kim’s findings, declined treatment and went to the emergency department of Lutheran General, where she received another CT scan at 11:15 a.m. and a CT angiogram based on her history at Swedish. She was unable to obtain the CT scan from Swedish, and Lutheran General never received the images from the scan at Swedish. No brain bleed was identified, and Bao was discharged. She died on July 15, 2013, of an intracerebral hemorrhage. The pathologist who performed the autopsy opined it was unrelated to any bleed from three to five days ago.

Shicheng Guo, as special administrator of Bao’s estate, filed suit against multiple parties, including Kamal and Swedish, who moved for summary judgment arguing that no evidence connected Bao’s brain bleed on July 10 to the one which caused her death, and no evidence that Kamal’s failure to identify the brain bleed affected Bao’s ultimate course of treatment at Lutheran General. The court granted summary judgment to both on the issue of proximate cause, finding that Bao’s decision to decline treatment at Swedish and present herself at Lutheran General broke the causal chain between any alleged negligence and Bao’s death. Guo appealed.

On appeal, Guo argued that summary judgment was inappropriate because he had established questions of fact as to whether the two bleeds were related and whether Kamal’s failure to initially identify Bao’s hemorrhage proximately caused her death. Guo included an affidavit from a physician opining to within reasonable medical certainty that the two bleeds were caused by the same underlying condition: high blood pressure. Guo argued that Kamal’s failure to identify the bleed on the night of the July 10 led to Bao being discharged before the underlying cause was diagnosed, meaning she was deprived of an opportunity for treatment for the underlying condition which caused her death.

The appellate court agreed, finding that Guo had at least put forth sufficient allegations to create material questions of fact as to whether Kamal’s failure to spot the July 10 brain bleed proximately caused her fatal bleed on July 14 or her death. In addition, the appellate court found that question of facts existed as to whether Swedish’s failure to transmit the CT images showing a brain bleed to Lutheran General proximately caused Bao’s death.

The appellate court therefore reversed the circuit court’s grant of summary judgment and remanded the case for further proceedings.

Shicheng Guo v. Kamran Kamal M.D. et al.

2020 IL App (1st) 190090

Writing for the court: Justice Daniel J. Pierce

Concurring: Justices Michael B. Hyman and Carl Anthony Walker

Released: March 2, 2020