Cook County Jury Verdict Reporter

On December 3, 2001, Dawn Kostal underwent a biopsy for two skin lesions which had recently developed. The biopsy specimen was sent to Pinkus Dermatopathology Laboratory, S.C., where it was read by Dr. Darius Mehregan. Dr. Mehregan read and reported the specimen as squamous cell carcinoma of the keratoacanthoma (KA) type. Ms. Kostal underwent total excision of the lesions, a standard treatment for KA. In late January 2002, Ms. Kostal developed migraine-like pain in her forehead as well as back pain. Ms. Kostal’s back pain increased and she went to the emergency department of Palos Community Hospital on February 5, 2002. At Palos, an MRI was obtained which showed destruction of her spine. Biopsies of the eroded vertebrae were obtained which revealed blastomycosis. Palos pathologist, Dr. Ruby, requested the slides from Pinkus to determine if in fact the patient ever had KA or if the blastomycosis was missed on the December specimen. Upon review, Dr. Ruby determined that the diagnosis of KA was incorrect and the correct diagnosis was blastomycosis. As a result of her significant bony erosion in her spine, Ms. Kostal required a fusion from T4-L1, which utilized a rib graft and instrumentation. Ms. Kostal was unable to return to work. Plaintiff contended that Dr. Mehregan, as agent of Pinkus, was negligent in incorrectly diagnosing the biopsy specimen. The defense contended that while Dr. Mehregan incorrectly diagnosed the biopsy specimen, he had complied with the standard of care. The defense further argued that Ms. Kostal had been experiencing back pain as early as October, evidencing that the fungal infection had already begun to erode her spine and eliminating causation as to the pathology diagnosis reported in December. The case proceeded to trial in September 2012. The jury awarded Ms. Kostal in excess of $3 million dollars.