By Jeff Lehr

jlehr@joplinglobe.com

A Jasper County jury Tuesday began hearing a wrongful-death lawsuit brought against a Joplin family-practice physician by the wife and mother of a 28-year-old man who died more than four years ago of a pulmonary embolism, or blood clot.

The jury was selected Monday to hear the malpractice case of Ilinka Lakhdar and Janie Bratton against Dr. Thomas Hamilton in Jasper County Circuit Court in Joplin.

Kenneth Lakhdar died Nov. 7, 2003, at St. John’s Regional Medical Center in Joplin, five days after passing out at home and being admitted to the hospital. He had been under the care of Hamilton for two years before his death.

Joplin attorney Ed Hershewe, who represents the wife and mother in their suit, told jurors during opening statements that Hamilton failed to diagnose Lakhdar correctly over that period of time, and continued to treat him for an upper respiratory infection and allergies.

He said the alleged diagnostic failure took place despite repeated presentations of the patient with symptoms such as dark-colored sputum, shortness of breath and chest pains.

“When the symptoms are not getting better with the treatments he prescribes, he needs to consider these more dangerous causes,” Hershewe told jurors.

The plaintiffs allege that Hamilton failed to order tests or consultations with specialists that could have led to a correct diagnosis and saved Lakhdar’s life. Instead, the cause of his death was never learned until his wife had an autopsy performed by a St. Louis forensic pathologist.

The plaintiffs maintain that Hamilton’s handling of his patient constituted a breach of the standard of care to which physicians are held, and medical negligence.

Hamilton’s attorney, Brian Malkmus, of Springfield, said the plaintiffs’ case is disingenuous in that it seeks to make the cause of Lakhdar’s death appear to have been a progressive development over a period of several months when all evidence points to an acute onset of the embolism in November 2003.

Malkmus told jurors that Lakhdar was never tacchycardic, as patients with pulmonary embolisms usually are. His red blood cell counts were normal up until the time of his final admission to St. John’s, another indicator that the pulmonary embolism was sudden, not gradually developing, the defense attorney said.

He said Lakhdar had two echocardiograms conducted a few months before his death, including one at the end of August 2003, and they were normal. It was not until he suffered a sudden pulmonary embolism that an enlargement of the right side of his heart showed up, he said.

“When it was there was the day after the patient was admitted to St. John’s,” Malkmus told the jury.

He said the majority of such embolisms are never caught in time by doctors, especially in someone as young as Lakhdar, who would not normally be perceived as at risk for a pulmonary embolism. While a pulmonary embolism would be a possible cause of the symptoms he had presented in the months leading up to his death, it was never “a clinical suspicion” of Hamilton or any other doctor, including the emergency room physicians who had seen the patient, he said.