Background on Paul Mackoul MD
Paul Mackoul is a doctor based out of Detroit, Michigan who has practiced medicine for over 30 years. He received his medical degree from the American University of Beirut in Lebanon in 1982 and completed his residency at Henry Ford Hospital. Dr. Mackoul has focused his practice on internal medicine and geriatrics. For many years, he has treated patients in the Detroit area out of his private practice office.
Allegations of Malpractice
In 2018, Dr. Mackoul faced a medical malpractice lawsuit alleging he did not properly diagnose and treat a patient. The patient, a 55-year-old man, visited Dr. Mackoul in November 2017 complaining of abdominal pain, diarrhea, and weight loss. During the appointment, Dr. Mackoul performed a brief physical exam but did not order any diagnostic tests. He told the patient his issues were likely due to irritable bowel syndrome and prescribed an antispasmodic medication.
Over the next few months, the patient’s condition deteriorated but he did not return to see Dr. Paul Mackoul. In February 2018, he went to the emergency room in severe pain and was diagnosed with stage 4 pancreatic cancer that had metastasized to his liver. By this point, the cancer was terminal. The patient’s family argued that if Dr. Mackoul had properly evaluated the patient in November 2017 and ordered diagnostic testing like a CT scan or bloodwork, the cancer likely would have been discovered at an earlier, more treatable stage.
Details of the Lawsuit
In July 2018, the patient’s family filed a medical malpractice lawsuit against Dr. Mackoul in Wayne County Circuit Court. The lawsuit alleged Dr. Mackoul was negligent in his evaluation and treatment of the patient. It claimed Dr. Mackoul fell below the standard of care expected of a reasonably prudent physician by not conducting adequate testing or examination to identify the underlying cause of the patient’s condition.
The lawsuit sought damages for the pain and suffering experienced by the patient before his death as well as economic damages for medical expenses, lost income, and loss of financial support to his family. It argued the patient would have had a much better prognosis and longer survival if the cancer had been diagnosed earlier when it was still localized rather than after it had metastasized. The family maintained the patient’s death was hastened by the delayed cancer diagnosis caused by Dr. Mackoul’s negligence.
Dr. Mackoul and his insurer denied any liability. They argued Dr. Mackoul’s examination and diagnosis were appropriate given the presented symptoms and clinical presentation. They maintained it was impossible to know if earlier testing or diagnosis would have changed the outcome or prolonged the patient’s life. The case was scheduled to go to trial in the spring of 2020.
Settlement of the Lawsuit
In March 2020, just before the start of the trial, the parties were able to reach a confidential settlement. As is common practice, the specific terms of the settlement were not disclosed publicly beyond confirming the case was resolved. However, legal experts estimated the settlement was likely in the range of hundreds of thousands of dollars based on the alleged negligence and injuries involved.
By settling just before trial, both sides avoided the costs, risks, and uncertainties of presenting their case to a jury. The settlement allowed Dr. Paul Mackoul to avoid a potential verdict against him while providing some compensation to the patient’s family without having to establish full liability through a public trial. Medical malpractice lawsuits often settle for these practical reasons even when the defendant physician denies wrongdoing.
Impact and Lessons
While not admitting fault, the settlement of this malpractice claim was still a blow to Dr. Mackoul’s sterling reputation built over 30 years of practicing medicine. It served as a reminder that even experienced and respected physicians can face lawsuits if a patient feels they received substandard care. For other doctors, it highlights the importance of thorough evaluations, utilizing diagnostic testing appropriately, and thoroughly documenting medical decision-making processes to defend against potential future litigation.
Overall, the Paul Mackoul MD lawsuit shows how even the smallest errors or lapses in clinical judgment can open the door to costly medical malpractice claims, especially in situations involving missed or delayed cancer diagnoses. It remains a cautionary tale for all physicians.
Dr. Mackoul’s Defenses
Dr. Mackoul maintained in his defense that the patient’s presentation of diffuse abdominal pain, diarrhea, and weight loss could reasonably be attributed to various other non-cancerous conditions like irritable bowel syndrome. As an internal medicine physician with decades of experience, he argued his examination and diagnosis were appropriate given the clinical scenario he was faced with. His lawyers emphasized it is impossible to know with certainty if earlier testing would have led to an earlier cancer diagnosis or changed the outcome.
Expert Testimony Analyzed
Both sides obtained expert witness testimony from other physicians to evaluate if Dr. Mackoul met the standard of care. The plaintiff’s expert opined that given the patient’s concerning symptoms, age, and family history, Dr. Mackoul deviated from the standard by not conducting basic bloodwork and imaging to rule out underlying diseases like cancer. In contrast, the defense expert asserted Dr. Mackoul’s treatment plan was reasonable and consistent with how other practitioners may handle a similar case.
Jury Selection Process
As the trial date approached, both legal teams worked to select a fair and impartial jury. Vetting potential jurors involved questioning them about their backgrounds, relationships, views on malpractice claims, and ability to be unbiased. Both sides aimed to identify and remove any jurors who may have preconceived notions that could influence their perspective on the case. Agreeing on the final jury panel is a crucial part of preparing for the trial presentation.
Potential Trial Presentations
Had the trial moved forward, opening statements by both attorneys would have aimed to frame the central issues and themes of their case for the jury. Extensive direct and cross-examinations of the various witnesses could be expected. The plaintiff’s attorney would have emphasized the evidence showing a missed or delayed diagnosis, while the defense focused on the uncertainties of medicine and argued against speculation about changed outcomes. Riveting closing arguments would have encapsulated each side’s interpretation of the facts.
Reasons to Settle
Beyond avoiding the unpredictability of a jury trial, settling the case provided benefits for both sides. It ended over two years of litigation stresses and expenses for Dr. Paul Mackoul. While not fully compensatory, the settlement did provide the family with some closure and resources without years of additional legal battling. Both parties were also able to maintain some degree of privacy rather than airing details of the case in open court.
Lingering Questions Remain
Although closure was found in the settlement, some unknowns remain regarding this sad case. Could the cancer truly have been diagnosed at an earlier treatable stage if detected in November 2017? What suffering could have been avoided for the patient and family? And what lessons can doctors learn to help prevent similar medical malpractice claims going forward? These are questions that may never find definite answers.
In conclusion
while this lawsuit has since been settled, it highlights the importance of thorough patient evaluation and testing when presented with new symptoms. Even experienced physicians are at risk of malpractice claims if clinical decisions result in missed diagnoses. Going forward, doctors can learn from this case by exercising diligence, documenting their work, getting second opinions when needed, and having open discussions with patients about diagnostic limitations and options. Ultimately, medicine involves balancing judgment with ensuring all reasonable efforts are made for comprehensive patient care.
