Kentucky Jury Awards $1.4M for Doctor’s Failure to Address Abnormal PSA Test Leading to Terminal Prostate Cancer

Crouch v. Riney

On February 8, 2024, the Kentucky jury unanimously found Dr. Jeffrey Riney liable for medical malpractice after he failed to respond to a troubling PSA test. They awarded Peggy Crouch, widow of James Crouch, $1,432,501 in damages.

Case Background

Peggy Crouch filed a medical malpractice case against Dr. Jeffrey Riney for the wrongful death of her husband, James Crouch, before the Kentucky Circuit Court, McCracken County. Judge W.A. Kitchen presided over this case. [Case number: 20-282]

Cause

James Crouch, who passed away in 2019 at age 78, began regular treatment with Dr. Jeffrey Riney, a family practice physician, in 2005. This care included annual prostate-specific antigen (PSA) tests. Riney managed several of Crouch’s co-morbidities, including a long history of heart disease. Crouch had already received a defibrillator.

In July 2014, Riney referred Crouch to urologist Dr. Patrick Ellison due to an elevated PSA level of 4.1, which is considered abnormal. Ellison examined Crouch three times from July 2014 through August 2015. He focused on the PSA velocity, which indicates how rapidly the PSA level increases—a sudden rise can signal prostate cancer. By August 2015, Crouch’s PSA level was 4.6, deemed stable, and Ellison recommended routine monitoring.

By May 2016, Riney recorded a PSA level of 5.8 for Crouch, up from 4.6 in nine months. This increase should have raised concerns about potential prostate cancer. However, Riney did not inform Ellison, perform a biopsy, or conduct a rectal exam. He claimed he advised Crouch about the rising PSA level and suggested he return to Ellison. Crouch, dealing with other conditions, declined further testing or a biopsy, and Riney did not document these discussions. It was argued Crouch was never informed of the results.

Three years later, on March 31, 2019, Crouch fell at home and fractured his hip. At the hospital, his PSA level was 300, revealing incurable metastatic prostate cancer that had spread to his skull, spine, ribs, shoulder, femur, and pelvis. The cancer had contributed to the hip fracture.

Crouch endured a difficult three months, frequently in hospitals and nursing homes, before passing away on June 20, 2019. He was survived by his widow, Peggy Crouch.

Damages

The medical malpractice caused the wrongful death of James Crouch. The estate sought $443,501 to cover Crouch’s medical bills and an additional $18,735 for his funeral expenses. The instructions capped the claims for Crouch’s suffering and his wife’s loss of consortium at $2,000,000.

Key Arguments and Proceedings

Legal Representation

• Plaintiff(s): Estate of James Crouch | Peggy Crouch
  • Counsel for Plaintiff(s): Brian Brownfield | Sarah Jane Dufour | Kelly J. Brownfield
  • Experts for Plaintiff(s): Dr. Alan David | Dr. Eric Gwynn

• Defendant(s): Dr. Jeffrey Riney
  • Counsel for Defendant(s): E. Frederick Straub Jr.
  • Experts for Defendant(s): Dr. James “Jed” Ferguson | Dr. Michael Yaffe

Claims

The Crouch estate filed a medical malpractice lawsuit against Dr. Riney, alleging that he had erred by failing to diagnose prostate cancer in 2016. They claimed that Riney had received an alarming PSA level, indicating a significant increase. They argued that even if Riney had performed a digital rectal exam then, he would have found Crouch’s prostate to be grossly abnormal. According to their theory, the cancer was still curable at that time. Unfortunately, by the time the cancer was identified three years later, it had become incurable.

Defense

Riney defended himself on multiple grounds. Firstly, he argued that he managed Crouch’s care appropriately and noted that ongoing PSA tests had limited value for patients over 70. This was particularly relevant in Crouch’s case due to his significant pre-existing co-morbidities that reduced his life expectancy.

Additionally, the defense challenged the causation of Crouch’s death. They argued that cancer was not the cause of death. Instead, Crouch’s death resulted from end-stage heart failure, renal failure, and pulmonary disease. Therefore, Riney contended that (1) he managed Crouch’s care correctly, and (2) his treatment did not contribute to Crouch’s death.

Expert Testimony

The Plaintiff’s experts included Dr. Alan David, a family practice physician from Granville, OH, and Dr. Eric Gwynn, a urologist from Bluffton, SC. They criticized Riney’s failure to investigate the alarming PSA level further and his inadequate medical record-keeping.

On the other hand, the defense experts were Dr. James “Jed” Ferguson, a urologist from Birmingham, AL, and Dr. Michael Yaffe, a family practice doctor from Columbus, OH. Yaffe acknowledged that while Riney could have improved his medical record documentation, these errors did not cause Crouch’s death.

Finally, the defense relied on Crouch’s treating cardiologist, Dr. Charles Hogancamp, to address causation issues.

Jury Verdict

The case was tried in Paducah over four days. On February 8, 2024, the Kentucky jury unanimously determined that Riney had breached the standard of care and found him liable for medical malpractice.

Regarding damages, the jury awarded the Plaintiff the claimed medical expenses of $443,501 but rejected the funeral expenses. They valued Crouch’s pain and suffering at $630,000 and awarded $350,000 for his wife’s consortium claim.

In total, the verdict for the estate amounted to $1,432,501.

Court Documents:

Available upon request