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Couple claims delayed diagnosis led to irreversible end stage renal disease

A Center Township man and his wife have filed a lawsuit claiming a yearslong delay in diagnosing his kidney disease led to him developing irreversible end state renal disease.

Chad and Michelle Kuzar filed the suit last week seeking unspecified damages in excess of $35,000.

The suit names doctors Kevin A. Leighton and Mark Provenzano, physicians assistant Jennifer S. Lazor and Butler Medical Providers as defendants. Neither Leighton, Provenzano or Lazor could be reached for comment.

Kuzar was in his early 30s in 2006 when he was diagnosed with ankylosing spondylitis, an autoimmune condition that causes inflammation of the spine and creates an increased risk factor or the kidney disease IgA nephropathy, which damages the kidney’s small glomerule filters making it difficult for the kidneys to filter waste, according to the suit. In addition, he said he was hypertensive.

He was prescribed Enbrel and took it until 2014 when his ankylosing spondylitis was found to be in remission. He then began taking nonsteroidal anti-inflammatory drugs for joint pain, but those drugs also are known to create an increased risk of kidney disease, according to the suit.

While under the care of a rheumatologist, the doctor ordered routine blood work to assess his serum blood urea nitrogen and creatinine levels, which are indicators of kidney function, according to the suit.

In February 2015, Kuzar said he was evaluated by Leighton for complaints of increased blood pressure. Blood tests ordered by Leighton found essentially normal blood urea nitrogen and creatinine levels, according to the suit.

In the suit, Kuzar said he was seen by Leighton 10 more times through his March 14, 2023 diagnosis with end state renal disease, but Leighton didn’t obtain additional blood work to assess his kidney function at any of those visits.

In September 2018, Kuzar was evaluated by Provenzano, a pulmonologist, for increased shortness of breath while under exertion, a cough and wheezing, which are believed to be symptoms of interstitial lung disease secondary to ankylosing spondylitis, according to the suit.

Provenzano ordered a blood test to assess his kidney function before ordering a CT scan of his chest. Results of the Oct. 22, 2018 blood test reported to Provenzano showed a blood urea nitrogen level of 28, a creatinine level of 1.8 and an estimated glomerular filtration rate of 45. Normal blood urea nitrogen levels range from 7 to 22 and normal creatinine levels range from 0.5 to 1.3, and the three results reflect stage III kidney disease, according to the suit.

Kuzar said he was not informed about the elevated levels, even though he was seen by Provenzano four times between Oct. 22, 2018 and March 14, 2023. Provenzano didn’t discuss the kidney function test results with Leighton or any other health care provider to establish a plan of care, according to the suit.

Leighton was aware of the test results, but didn’t order additional tests or assessments, according to the suit.

For three years from July 3, 2019 and May 16, 2022, Leighton treated Kuzar’s high blood pressure, but didn’t evaluate him or order blood tests to assess his blood urea nitrogen, creatinine and glomerular levels even though he concluded at a May 22, 2019 office visit that Kuzar’s creatinine levels were abnormal, according to the suit.

Lazor evaluated Kuzar for an acute right arm injury in May 2022 and found he had an elevated blood pressure reading of 194/116, and included the Oct. 22, 2018 test results in her office notes, but didn’t order additional blood tests to check his kidney function, according to the suit.

A urine and blood test Kuzar took in February 2023 to renew his life insurance found a blood urea nitrogen level of 75 and a creatinine level of 6.9, which confirmed he had end stage renal disease, according to the suit.

After being told about those test results, Leighton told Kuzar to report to Butler Memorial Hospital’s emergency department. Kuzar spent three days in the hospital in March 2023 receiving treatment for a hypertensive crisis and was advised to begin hemodialysis, according to the suit.

Since the March 2023 diagnosis, Kuzar initially received hemodialysis three times a week and he is currently receiving peritoneal dialysis seven days a week while he waits for a kidney transplant, according to the suit.

The suit alleges negligence against Leighton, Provenzano, Lazor and Butler Medical Providers, and a count of loss of consortium against all four defendants.

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