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Duletsky completes her testimony

NICOLE FORMOSAsummit daily news

BRECKENRIDGE – Former Frisco doctor Patricia Duletsky finished her testimony Wednesday in the $1.5 million medical malpractice suit a Silverthorne man filed against her for the death of his wife, standing by her medical decisions.Rob Small is suing Duletsky for the wrongful deaths of his wife, Susanna Martens, and their unborn baby girl.The lawsuit is being tried in Summit District Court in front of Judge Terry Ruckriegle.Martens was 36-and-a-half weeks pregnant when she visited Dr. Duletsky at 6 p.m. on March 14, 2000, because she felt ill. On that day, Martens had experienced two uterine contractions and had vomited once. She was also discovered to have a temperature of 101.2 degrees at the office visit. Duletsky diagnosed her with the stomach flu, gave her a prescription for a drug to help cease the vomiting and sent her home. Several hours later, Martens called Duletsky back because she was still vomiting and had developed diarrhea. Martens went to the Summit Medical Center at 9:45 p.m. to see Duletsky a second time, where she and the baby later died.The cause of death was cardiac arrest triggered by Group A streptococcus, a fast-acting bacterial infection.The plaintiff’s attorneys are arguing that Martens and the baby would have survived if Duletsky had administered antibiotics on March 14.Duletsky testified she never saw any indications of a bacterial infection in Martens and therefore had no reason to administer antibiotics.Duletsky also said she paid close attention to Martens’ condition and treated her using her knowledge, experience and training in the family practice medical field.During cross-examination, attorney Hollynd Hoskins brought up several points to demonstrate that Duletsky’s care of Martens was not adequate the evening she and the baby died.An expert witness for the plaintiffs testified last week that a doctor must assume a pregnant woman with a fever and uterine contractions has a bacterial infection until proven otherwise.Duletsky agreed with this assertion, but said more information and evaluation are needed with those symptoms.Hoskins argued that at the initial doctor’s appointment, Duletsky did not do a blood culture, did not confer with an obstetrician or infectious disease doctor and didn’t order an ultrasound of biophysical profile to check the well-being of the baby.She also said that the possibility of a bacterial infection was ruled out at the 6 p.m. doctor visit, before thorough testing was done.”I wasn’t ruling it out,” Duletsky said. “A differential diagnosis involves moving things up and down and seeing how symptoms progress over time. It’s not getting rid of it for all time.”Hoskins noted that a progressive care unit (PCU) nurse was caring for Martens all evening because Duletsky and the labor and delivery nurse were delivering another patient’s baby until about 10:15 p.m. PCU nurses are not trained to read fetal monitor strips, which keep track of the baby’s heartbeat. Earlier Wednesday morning, pathologist Dr. Wes Tyson testified that he believes Martens’ baby was infected by the bacteria before it spread to Martens.”It’s very unusual for the bacteria to be in maternal circulation, then gain access to the baby,” Tyson said.The bacteria ascended past the cervix and into the placental cavity and was then possibly swallowed by the baby, Tyson said. At that point, it gained access to the baby’s blood and was transferred to Martens’ blood, he added.The strep was in the amniotic cavity 24 to 48 hours before the baby died, he said.Once in the blood stream, the bacteria releases toxins that dissolve tissues and affect the body’s organs, he added.In the cross-examination, attorney Natalie Brown pointed out results from the autopsies that showed the level of tissue damage was far greater in Martens than in the baby, disputing Tyson’s opinion that the baby contracted the infection first.The first testimony of the day came from a medical technologist who works in the laboratory at Summit Medical Center, but who was not present the night of Martens’ death.Mary Drawbert testified that the lab processed Martens’ blood test “relatively quick” on the evening of her death. The request was received at 10:32 p.m. and results were printed to the nurses station at 10:59 p.m., Drawbert said.Those results showed an elevated white blood cell count, which is an indicator of a bacterial infection.Nicole Formosa can be reached at (970) 668-3998, ext. 229, or at nformosa@summitdaily.com


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