Chesnut v. United States, No. 20-6237 (6th Cir. 2021)
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On April 4, Debra went to Kentucky’s Manchester Memorial Hospital emergency room where she presented with numbness from the waist down, pain in both legs, with the right leg being worse and cold. On April 19, Debra’s right leg was amputated below the knee at the University of Kentucky Medical Center due to serious clots that restricted blood flow. Debra sued healthcare providers for failing to consider that Debra’s symptoms were caused by vascular issues rather than musculoskeletal abnormalities. The only remaining defendant is the government which was substituted under the Federal Tort Claims Act, 28 U.S.C. 1346, 2671–80, for its employee, Dr. Madden, who examined Debra at the federally-supported health center on April 12.
The district court entered judgment in favor of the United States. The Sixth Circuit reversed. The proper framing of the causation inquiry was not whether it would have made a difference as to the ultimate outcome if Dr. Madden had properly diagnosed the condition on April 12 but whether it would have made a difference to Debra’s outcome if Madden had considered the possibility of vascular causes as the source of her symptoms on April 12. The district court declined to resolve a dispute as to whether Debra suffered from ischemia from April 4 to April 13, or whether she suffered sudden ischemia on April 13, after she being seen by Madden.
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