Eight months after 13-year-old Molly Banzhoff died from an undetected brain tumor, her family is suing Concord Hospital, its affiliates and three of its doctors for medical negligence.

For months leading up to her death in early May, Molly’s pediatricians and emergency room doctors did not perform diagnostic brain imaging, even as the young teen repeatedly complained of severe migraines, nausea, problems with her vision and tongue numbness, which are “classic signs of a pediatric brain tumor,” according to the suit filed by Molly’s parents, Barb Higgins and Kenny Banzhoff.

Even after Molly was admitted to the emergency room on May 1, doctors at Concord Hospital did not order an emergency CT brain scan until after Molly was unresponsive and had stopped breathing twice, the lawsuit states. At that point, the tumor growing in her brain was so large that it caused fluid to build up and massive pressure that “destroyed all neurologic function,” according to the suit.

Molly was declared brain-dead five days later and was eventually removed from life support at Dartmouth-Hitchcock Medical Center in Lebanon, surrounded by her family members.

“Not only did they endure a loss that no family should have to endure, they watched helplessly as Molly needlessly suffered before her death,” the suit states. “They were forced to make the difficult decision to remove Molly from life support. After doing so, they laid with Molly, listening to her heartbeat slow and eventually stop.”

Banzhoff and Higgins are seeking damages from Concord Hospital Inc., Concord Pediatrics, Concord Emergency Medical Associates, Concord Family Health Center, and Capital Regional Health Care Corp. as well as individual doctors Dolly Courtemanche, Elizabeth Hoffman and Ashley Fox.

“Rather than order diagnostic testing to rule out the most dangerous possible cause of Molly’s symptoms, a brain tumor, the defendants either assumed Molly was faking it or that the most benign possible cause was the source of her symptoms,” the lawsuit states.

Concord Hospital officials said they could not comment on medical care of a minor or on a pending lawsuit, but they released a short statement on Monday.

“All of us at Concord Hospital were saddened to learn of the tragic death of Molly Banzhoff,” the statement said. “Although we are unable to comment on pending litigation, our sincere thoughts and prayers are with Molly’s loved ones and friends, who we know miss her dearly.”

Months of missed signs

The lawsuit, due to be filed in Merrimack Superior Court on Tuesday morning, lays out the months leading up to Molly Banzhoff’s death in painstaking detail. It cites nine “missed opportunities” where doctors could have ordered a brain scan but didn’t.

Molly first went to Concord Pediatrics on Feb. 28 complaining of headaches and was told to come back if they persisted, got worse or other symptoms like vomiting occurred.

She was back in the doctor’s office on April 21 after waking up describing “squiggly lines” in her peripheral vision, as well as a headache, nausea and vomiting. Examined by Courtemanche, Molly said she had experienced “pounding headaches” for three weeks and intermittent nausea for a month.

Courtemanche diagnosed Molly with a “classical migraine headache” and instructed further follow-up if the symptoms persisted.

Six days later, on April 27, Molly woke up with similar symptoms and returned to Concord Pediatrics, where she was again examined by Courtemanche. During the visit, the teenager told the doctor she had experienced a pounding headache that morning, as well as several episodes of vomiting. She also complained of a new symptom – numbness in her tongue – according to the lawsuit.

Courtemanche diagnosed Molly with a migraine and sinusitis and did not order any diagnostic tests, the lawsuit states. Instead, she prescribed Molly anti-nausea medication.

Emergency room visit

On May 1, Molly went to the Concord Hospital Emergency Department after being woken up by a bad headache, nausea and vomiting that lasted for several hours, the lawsuit states.

She was evaluated by Hoffman, who documented Molly had not had brain imaging for her headaches and prescribed medication for her symptoms. While Hoffman did recommend brain imaging, she ordered an outpatient MRI to be done at a later date, rather than a CT scan, the lawsuit states.

In the emergency room that day, Molly’s health worsened. She became lethargic and was unable to follow the doctor’s commands when she was re-evaluated in the afternoon, according to the lawsuit.

A pediatrician, Dr. Joseph Toshach, also evaluated Molly on May 1, the lawsuit states. He did a physical examination on the teenager, during which she did not respond to verbal commands.

“Dr. Toshach attributed Molly’s sleepiness to her medication and lack of sleep,” the lawsuit states. “He recommended further observation in the emergency room to allow Molly’s medication to wear off and discharge her if her mental status improved.” Toshach also did not order a CT scan for the patient, according to the lawsuit.

A few hours later, Hoffman came back to re-evaluate Molly and found she was still asleep, even though she had been given medication several hours prior. Hoffman signed Molly’s care over to Fox, the lawsuit states.

That night, Molly’s health continued to deteriorate. She needed two people to help her get to the bathroom that night, leaning heavily on Higgins, walking with her eyes closed and swaying while her mother tried to help her sit on the toilet, according to the suit.

When Toshach returned to re-evaluate Molly, she was not responding to verbal stimulation or shaking.

“Rather than order an emergent CT to rule out the most dangerous possible cause for Molly’s symptoms, a brain tumor, Dr. Toshach apparently assumed Molly was exaggerating, noting that there ‘appear[ed] to be a behavioral component to her somnolence,’ ” the lawsuit states. Toshach admitted Molly to the hospital for observation, ordering pain medications and IV fluids for her.

When Molly was transferred to the hospital’s pediatric floor, nursing staff noted she had dried blood in her nose, swollen eyes and rapid breathing. By 1 a.m., her pupils were different sizes.

During a catheterization by hospital staff, Molly stopped breathing twice and her face turned gray as her heart stopped, the suit states.

“Molly’s family watched in horror as the nurse began chest compressions and called a Code Blue,” the suit states. Molly was put on a ventilator and Toshach “finally ordered an emergent CT scan.”

The scan revealed a large tumor causing pressure in her brain. A neurosurgeon was called to drain the fluid, after which he told her family “the pressure on her brain had been very high and, as a result, the brain injury she sustained may be irreversible,” according to the lawsuit.

She was transferred to Dartmouth-Hitchcock Medical Center in Lebanon for emergency brain surgery to remove her tumor. She was never able to regain neurological function and was declared brain-dead a few days later.

After hundreds of her friends came to the hospital to visit and say goodbye, Molly’s family removed her from life support on May 7.

Molly, a seventh-grade student at Rundlett Middle School when she died, was remembered later that month in a huge communitywide celebration called “Molly B: The Musical,” which included tributes and performances from friends and family members at Concord’s Capitol Center for the Arts. Many in the audience wore pink – Molly’s favorite color.

“As a result of the defendants’ failures, Molly, a young, fun-loving, thirteen-year-old girl, is dead,” the suit concludes. “Molly will never dance in another recital or be part of a musical. She will never have a slumber party with her best friends. She will never laugh while making silly music videos with her sister. And, she will never grow up to graduate high school and college to be the successful woman that she was motivated to become.”

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(Ella Nilsen can be reached at 369-3322, enilsen@cmonitor.com or on Twitter @ella_nilsen.)