1101 ST. PAUL ST., SUITE 404 

     BALTIMORE, MD 21202

     TELEPHONE   410/ 539 7816 

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    Email  jameskoch@jpkochlaw.com


Representative Cases


Medical Malpractice, Hospital and Nursing Home Negligence


Insurance Coverage Disputes  (Disability, Accidental Death, Life, Health Insurance Claims)


Commercial Litigation, Creditors Rights, Bankruptcy 


Click here for list of cases which have resulted in published court decisions

Medical Malpractice, Hospital and Nursing Home Negligence

Failure to diagnose pulmonary embolism; wrongful death 

Surgeon perforates small bowel; septic shock and multiple organ failure; informed consent not obtained 

Failure to diagnose lung cancer; wrongful death  

Hospital fall; patient bedridden after fracturing femur in both legs 

Failure to diagnose necrotizing fasciitis (Fournierís gangrene); wrongful death  

Podiatrist injures nerves in foot; reflex sympathetic dystrophy (RSD) 

Abdominal hysterectomy complications; sepsis and scarring 

Failure to monitor patient's respiratory status; plugged tracheostomy tube; patient asphyxiates and dies

Patient with spinal cord condition injured in fall; central cord syndrome 

$2 million verdict for delayed treatment of bowel obstruction; adult respiratory distress syndrome (ARDS) and neuropathies         

Failure to diagnose surgical wound infection following spine surgery; chronic vertebral osteomyelitis 

Click here for information about filing a medical malpractice or hospital negligence case in Maryland

Commercial, Business, and Bankruptcy Litigation

Sam Wang Produce, Inc., et al v. MS Grand, Inc. et al (2014), representation of a secured creditor in a federal court receivership over the Grand Mart chain of grocery stores located in Maryland, the District of Columbia, and Virginia. Because many of the creditors in the receivership were produce vendors, this case raised difficult lien priority issues under the Perishable Agricultural Commodities Act (PACA) and the Uniform Commercial Code. A global settlement has resolved all creditor claims in the receivership case.    

In re Min and Man Kang, in the U.S. Bankruptcy Court for the Eastern District of Virginia. This case involved the representation of a secured creditor which a bankruptcy trustee sued in an attempt to invalidate a real estate mortgage which secured the creditor's claim. This case resulted in a mediated settlement which required the trustee to dismiss his claim and pay the creditor in excess of $1 million.         

Piril Insaat v. Wintara, Inc., $1.17 million judgment entered by the Maryland federal district court in favor of subcontractor and against prime contractor for breach of contract in connection with U.S. Army Corps of Engineers construction projects in Iraq (2010).    

Eun Kim et al v. Douglas Nyce et al, representation of investors in securities fraud litigation arising out of a failed real estate development in St. Mary's County, Maryland. This litigation has resulted in a $3.2 million judgment against the developer. In connection with ongoing efforts to enforce the judgment, the court has imposed a constructive trust on property acquired as a result of defendants' fraud. The court has published its decision in this case, see Kim v. Nyce, 807 F.Supp.2d 442 (D. Md. 2011). 

Hague et al v. Brennan, class action settlement for the benefit of consumers who lost funds which they had entrusted to a "debt management" firm to help them get out of debt (2008).   

In re Market Tire Educational Services, $748,000 bankruptcy court judgment against owner of company who fraudulently siphoned off company's assets shortly before placing company in bankruptcy  Click here to read a Washington Post account of this case. 

Insurance Coverage Cases

Long Term Disability Insurance:  Federal judge chastises UnumProvident Corporation for terminating long term disability benefits of woman with end stage congestive heart failure       .

Long Term Disability InsuranceInsurer misconstrues results of functional capacity examination in order to terminate client's disability benefits; law suit results in reinstatement of benefits   

Accidental Death Insurance: Insurer bases denial of benefits on erroneous policy interpretation; law suit results in payment of benefits  (2012)

Health Insurance: Federal judge orders reinstatement of health insurance benefits for woman undergoing treatment for chronic schizophrenia 

Medical Malpractice and Hospital Negligence Cases

Failure to diagnose pulmonary embolism; wrongful death 

        The decedent was a 53 year old Frederick County man. Five days after foot surgery, he experienced shortness of breath and lightheadedness. He called his surgeon (a podiatrist), who suggested that he was probably just experiencing some late anesthesia side effects. The podiatrist recommended that decedent go to the emergency room or call his primary care doctor if the symptoms did not resolve within the next couple of hours. Decedent's symptoms abated until the next day, when he again experienced shortness of breath and fatigue. As instructed by the podiatrist, he called his primary care doctor, who scheduled a CT scan for the following day at a local radiology center. Decedent went into respiratory arrest the following day before the scheduled CT scan. He was rushed to the hospital by ambulance, where he coded in the emergency room. He died two days later as the result of a massive saddle pulmonary embolism.   

        This malpractice case was filed on behalf of the decedent's surviving wife, son, and daughter. The basis of the law suit was the failure of the podiatrist and family doctor to recognize that decedent was at significant risk for a pulmonary embolism due to his recent surgery and obesity. The health care providers should have instructed decedent to go to the emergency room immediately when he reported symptoms consistent with this condition. Timely evaluation and treatment most likely would have saved decedent's life.  

        This case was settled shortly prior to trial.  

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Small bowel perforation leads to septic shock, multiple organ failure

          The plaintiff, a 65 year old Baltimore City man, underwent elective bowel surgery to remove a cancerous tumor. During surgery, the surgeon perforated the bowel, causing bowel contents to spill into the abdomen. Because the surgeon failed to detect and immediately repair the perforation during surgery, the plaintiff developed septic shock, multiple organ failure, and other life threatening complications. The plaintiff survived this critical illness, but suffered permanent lung impairment caused by prolonged dependence on a mechanical ventilator while confined to the hospitalís intensive care unit.

          The standard of care requires a surgeon who performs bowel surgery to meticulously inspect the area of bowel that is operated on before closing in order to detect and repair any leaks or perforations that may have occurred during surgery. A basis for this malpractice claim was the surgeonís failure to adhere to this standard.  

Additionally, Maryland law does not allow a surgeon to delegate the performance of surgery to another surgeon without the patientís consent. A patient has the right to know who will perform his surgery. In this case, the surgeon failed to disclose that a resident in the hospitalís surgery training program would perform plaintiffís surgery. The surgeonís failure to obtain plaintiffís informed consent was an additional basis for this lawsuit.

         The parties settled this case shortly prior to trial at mediation.

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Failure to diagnose lung cancer  

        The decedent was a 46 year old St. Mary's County woman who was hospitalized for hyponatremia (low sodium). At the hospital, her primary care doctor ordered a chest xray, which revealed a small nodule in decedent's right lung. The hospital radiologist recommended a follow up CT scan to evaluate the nodule. Decedent never obtained a follow up CT scan, though, because the primary care doctor never informed her about the abnormal chest xray. Subsequently, the decedent and her husband moved out of state.

        Fourteen months after the abnormal chest xray, the decedent developed a severe cough and other respiratory symptoms. Her new primary care doctor immediately ordered a CT scan of the chest, which showed a large and growing lung nodule. Further testing ultimately revealed that decedent had stage 4 lung cancer, which is invariably fatal. Decedent died several months after receiving her cancer diagnosis.   

        This malpractice case was filed on behalf of the decedent's surviving husband, son, and mother in the U.S. District Court for the District of Maryland (Greenbelt Division). The basis of the law suit was the first primary care doctor's failure to inform decedent about the abnormal chest xray and to order a prompt follow up CT scan, as recommended by the hospital radiologist. A timely follow up most likely would have revealed that decedent had stage 1 lung cancer, which can be treated and cured in most cases. Decedent's lung cancer progressed from stage 1 to stage 4  as a result of the primary care doctor's negligent failure to follow up.  

        This case was settled prior to trial in mediation before a U.S. Magistrate Judge. 

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Hospital fall results in femur fractures in both legs

        The decedent was a 65 year old woman who was admitted to the hospital for treatment of congestive heart failure. She was assessed to be at high risk of falling, based on her  impaired mobility, lower extremity weakness, and medications. On the night before her scheduled discharge from the hospital, she broke both of her legs when she fell while attempting to ambulate from her bed to the bathroom unassisted. This client died prior to trial. She remained bedridden as the result of her injuries at the time of her death.  

        The basis of this negligence case was the failure of the hospital's nursing staff to follow established safety procedures and protocols, which required the nurses to monitor and observe their patient closely, and to provide their patient with needed ambulatory assistance. Specifically, the hospital's nursing staff failed in this case to answer the patient's call bell promptly; provide the patient with her customary assistive device for walking; provide the patient with a bedside commode; utilize a bed alarm;  and move the patient to a room close to the nurse's station.    

        This case was settled prior to trial for a confidential amount satisfactory to the decedentís family.

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Failure to diagnose necrotizing fasciitis (Fournierís gangrene)

        The decedent, a 66 year old retired postal worker with a history of congestive heart failure, obesity, and diabetes, presented at his urologistís office with a three day history of severe pain and a grossly swollen scrotum the size of a cantaloupe. The urologist, based on a cursory physical examination, attributed the swelling and pain to edema caused by the decedentís heart condition. He sent the decedent home with instructions to rest and to call his cardiologist if his symptoms got worse. The decedent collapsed and died the next day. At autopsy, the cause of death was confirmed to be septic shock secondary to Fournierís gangrene.

        Fournierís gangrene is a form of necrotizing fasciitis, commonly referred to as the flesh eating bacteria infection. This kind of serious infection can progress in a matter of hours to life threatening sepsis. Fournierís gangrene is an absolute urological surgical emergency.

        The basis of the malpractice case was the urologistís failure, in light of the patientís multiple pre-existing medical conditions and his serious presenting symptoms, to obtain an immediate emergency room evaluation (including complete blood work, cultures, and diagnostic studies). Such an evaluation would have revealed the necrotizing process. The decedent most likely would have survived if the necrotizing process had been diagnosed in a timely manner and treated as a surgical emergency.

        This case was settled prior to trial at mediation for a confidential amount satisfactory to the decedentís family.

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Nerve Injuries to Foot 

        Plaintiff, a 40 year old Prince Georgeís County woman, developed a painful bump on the top of her left foot after dropping a ceramic bowl on it. Plaintiffís family doctor ordered an xray of the foot, which showed no fracture or other abnormality of the bones or joints. The family doctor diagnosed the bump to be a soft tissue cyst. He referred the plaintiff to the defendant podiatrist for further treatment.

        Even though the xray was normal, the podiatrist diagnosed the bump to be an exostosis, a bony growth on the surface of a bone. The podiatrist recommended immediate surgery to remove the exostosis. During the surgical procedure, the defendant caused traumatic injury to plaintiffís deep and superficial peroneal nerves, resulting in neuritis. These injuries necessitated a subsequent surgical procedure to sever the affected nerves. Severing the injured nerves, however, did not alleviate plaintiffís pain syndrome. Instead, plaintiff went on to develop reflex sympathetic dystrophy (RSD), an incurable and disabling post-traumatic chronic pain syndrome.

        The allegations of negligence in this case included the podiatristís misdiagnosis of the condition affecting plaintiffís left foot; failure to treat plaintiffís condition conservatively before attempting surgery; performing unnecessary surgery; and surgical error resulting in traumatic nerve injuries to the deep and superficial peroneal nerves.

        This case was settled prior to trial at mediation for a confidential amount.

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Abdominal hysterectomy complications

            The plaintiff, a 40 year old Harford County woman, developed life threatening septic shock less than 24 hours after undergoing a routine, elective abdominal hysterectomy. In order to determine the cause of this rapidly progressive infection, her surgeon had to perform exploratory abdominal surgery. During this subsequent procedure, the surgeon lacerated the patient's bladder.   

            The basis of the malpractice claim was the defendant gynecologist's failure to adhere to well established clinical practice guidelines which required him to administer prophylactic antibiotics prior to the abdominal hysterectomy. If the patient had received prophylactic antibiotics, she most likely would not have developed sepsis and other serious complications, which included a disfiguring abdominal scar, vesico-vaginal fistula, persistent urinary tract infections, pelvic adhesions, and post-traumatic stress disorder. This case was settled for a confidential six figure amount shortly prior to the commencement of trial in Baltimore County.   

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Tracheostomy patient asphyxiates and dies

        The decedent, a 68 year old Baltimore woman with a complicated medical history, was hospitalized with breathing difficulties secondary to a constricted airway. In order to open her airway, she received a tracheostomy. The medical condition which had caused the constricted airway, a blood infection, was successfully treated during the hospitalization. However, on the day before her scheduled discharge, decedent asphyxiated when a mucous plug obstructed her tracheostomy tube.  The asphyxiation led to respiratory arrest, severe hypoxic brain damage, and ultimately death. 

        The basis of this lawsuit was the nurses' failure to adequately monitor the patient's respiratory condition. This patient required constant monitoring because she had, during the 24 hours prior to the respiratory arrest, experienced several episodes of respiratory distress caused by a plugged tracheostomy tube. The nursing staff therefore knew or should have known that the patient's respiratory condition put her at high risk for airway obstruction and respiratory arrest. The decedent's family agreed to settle this case at pre-trial mediation.  The settlement amount is confidential. 

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Patient with spinal cord condition injured in fall

        The plaintiff was hospitalized for treatment of dysphagia, an inability to swallow. This condition developed as a complication of surgery to decompress the plaintiff's cervical spinal cord. Plaintiff was at risk for falling because he had a spastic, unsteady gait related to his neurological condition; and because he had been prescribed multiple medications, including intravenous narcotics, sedatives, and analgesics. In addition, although this underweight and malnourished plaintiff was unable to swallow, hospital staff neglected to provide an alternative form of nutrition. On his sixth hospital day without nutrition, plaintiff fell while getting out of bed unassisted to go to the bathroom. As a result, he developed central cord syndrome, a severe spinal cord injury which caused permanent upper extremity weakness and loss of coordination. 

            The basis of the malpractice claim was the failure of the hospital's nursing staff to implement fall prevention protocols and procedures in accordance with established hospital policy.  

        In a related case, suit was brought against the neurosurgeon who had performed the surgery to decompress plaintiff's spinal cord. This suit alleged that the defendant negligently failed to completely decompress the spinal cord. Consequently, plaintiff was at risk for serious spinal cord injury from a minor trauma, such as a fall.   

        This case was settled during trial in the Circuit Court for Baltimore City. The amount of the settlement is confidential. 

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Plaintiff's verdict for delayed treatment of bowel obstruction

        A Baltimore City jury awarded a 65 year old woman $2 million because her surgeon, after diagnosing a bowel obstruction, delayed urgently needed surgery for three days.  As a result, the woman developed severe sepsis, which led to multiple complications, including adult respiratory distress syndrome (ARDS). Although plaintiff survived, she continues to suffer from sensory and motor neuropathies caused by prolonged confinement in the hospital's intensive care unit and dependence on a mechanical ventilator. If the surgeon had performed emergency surgery within hours after diagnosing the obstruction, as required by the standard of care, plaintiff would not have developed these life threatening complications and permanent injuries. Subsequent appeals were filed in this case.   Click here for newspaper coverage of this case 

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Failure to diagnose surgical wound infection following spine surgery

        Plaintiff, a 42 year old woman with "failed back syndrome", had undergone multiple lumbar spine surgeries to treat her chronic back pain. Shortly after the last of these surgeries, she developed a deep surgical wound infection. Initially, the defendant orthopedic surgeon treated the infection with oral antibiotics. However, the standard of care required him to open, explore, and debride the wound site, and to commence intravenous antibiotics, if the infection failed to resolve after 10 days of oral antibiotics. In this case, despite the presence of clear signs and symptoms of persistent infection, defendant continued to treat the infection with oral antibiotics for nearly six months. As a result, plaintiff developed chronic vertebral osteomyelitis, an incurable bone infection in the spine. This condition substantially worsened plaintiff's pain syndrome, and has impaired her ability to walk. This case settled for a high six figure amount on the fourth day of a jury trial before the Circuit Court for Baltimore City.   

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Watson v. UnumProvident Corporation

       In this case, a federal district court judge ruled that the UnumProvident Corp., the country's largest provider of disability insurance, acted in an "unprincipled, if not fraudulent" manner when it terminated a Baltimore woman's long term disability benefits. The court ordered the insurer to reinstate plaintiff's benefits immediately, retroactive to the date of termination. 

        Plaintiff was a 56-year old woman with end stage congestive heart failure. Her treating cardiologist had repeatedly certified that she was totally disabled, even that she was at risk of sudden death on the job if she attempted to work. Prior to terminating her benefits, the insurer requested all of the plaintiff's medical records from her cardiologist. After legal proceedings had commenced, it was discovered that the cardiologist had mistakenly sent the insurer another patient's records. The insurer apparently failed to notice that plaintiff's file contained the wrong patient's medical records when it determined that the plaintiff was no longer disabled.  

        The court published its decision in this case, Valerie Watson v. UnumProvident Corp., 185 F.Supp.2d. 579 (D. Md. 2002).

        Click here  to read read a report in the Wall Street Journal which cites the Watson case as an example of UnumProvident's abusive disability insurance claims practices.

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Lanham v. UnumProvident Corp.

      UnumProvident Corp. terminated a client's long term disability benefits, even though the client's doctors had repeatedly certified that he was totally disabled as the result of chronic pain syndrome caused by a spinal cord injury. The client's doctors further certified that his condition had steadily deteriorated since the onset of disability. UnumProvident based its decision to terminate benefits on the results of a functional capacity examination. According to the insurer, the FCE indicated that the client was capable of performing sedentary work. 

        After the lawsuit was filed,  it was discovered that UnumProvident had seriously misconstrued the results of the FCE. Although the client was capable of performing some sedentary work, the FCE revealed that the client was capable of sustained work for  no more than a couple of hours each day. When UnumProvident's erroneous interpretation of the FCE was brought to the court's attention, the insurer agreed to reinstate the client's disability benefits.    

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Rosskamp v. Prudential Insurance Company of America

         This federal district court case arose out of an insurance company's denial of plaintiff's claim for benefits under an accidental death policy. The policy in question provided benefits for death caused by accidental injury and no "other cause". The decedent died as the result of intracranial hemorrhage caused by an accidental fall. The insurance company claimed that decedent was anticoagulated as the result of taking medication for a heart condition, and that anticoagulation was an "other cause" of death because this condition contributed to the size and progression of the fatal intracranial hemorrhage. When applicable Fourth Circuit case law was brought to the insurer's attention, the insurer agreed to reverse its erroneous denial of plaintiff's claim. 

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Adelson v. GTE Corporation

        The family of a woman diagnosed with chronic schizophrenia filed this lawsuit after the defendant group health plan terminated the woman's inpatient hospital and medical benefits. Defendant asserted that the woman was only receiving "custodial care" at the hospital because her condition was unlikely to improve.  "Custodial care" was not covered under Defendant's health plan. On the patient's behalf, we argued that her psychiatric treatment was not custodial, because she needed a trained psychiatrist to supervise and monitor her medication regime. Furthermore, the interruption of her inpatient treatment had caused her mental condition to deteriorate. Ruling in plaintiff's favor, the court ordered the health plan to reinstate the patient's health care benefits for the inpatient treatment of chronic schizophrenia.

         The court published its decision in this case, Robert Adelson et al v. GTE Corporation, 790 F. Supp. 1265 (D. Md. 1992)

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