A jury in Fresno, California reached a verdict of 11-1, deciding that a patient’s permanent coma was the result of negligence on the part of a heart surgeon who left the operating room during a surgery to replace the patient’s aortic heart valve. The amount of damages was not specified; the jury must deliberate further about the defendant’s history of malicious conduct, based on the testimony they have heard, and this will influence the court’s decision on how much to award.
In 2012, the patient, a 70-year-old man, went to the emergency room complaining of severe chest pains. He had no history of serious illness; he was a retired manual laborer who was the primary caregiver for his wife, who was suffering from dementia. Doctors diagnosed the patient with an aortic aneurysm.
On April 2, 2012, the patient underwent a surgery in which surgeons repaired the aneurysm and replaced his aortic heart valve. Accounts of what happened differ, based on statements by the various people who were present in the operating room during the surgery, but what is certain is that, shortly after the surgery ended and all the patient’s surgical incisions had been closed, he had suffered excessive blood loss, resulting in a lack of oxygen to the brain, and he has been in a coma since that day.
The doctors and hospital staff who were in the room during the procedure also agree that the defendant left the hospital while the patient was still under anesthesia. The defendant went to a lunch meeting at a nearby restaurant. During the meeting, he received a call that the patient was in distress, and he returned to the hospital.
A physician assistant to the defendant remained in the operating room during the surgery, and a general surgeon remained in the room after the defendant left. The physician assistant testified that the defendant left the hospital while the patient’s chest was still open. A general surgeon was also present during the surgery, and he helped the physician assistant wire the patient’s sternum back together. He also helped her stitch the patient’s muscles and fat, but then he left, meaning that the physician assistant stitched the patient’s skin without help or supervision from a surgeon. She said that, when the defendant left, the patient was in stable condition, and neither she nor anyone else believed that it was risky for the defendant to leave the operating room when he did.
The patient’s stepson filed a complaint, and the California Department of Public Health conducted an investigation. Representatives of the California Department of Public Health interviewed the nurses who had been present during the surgery, and they said that the physician assistant had been left alone to finish closing the patient’s chest.
During the trial, a critical piece of testimony came from the perfusionist who operated the heart-lung machine during the procedure. He cited his notes, which indicated that the defendant left the room 20 minutes before the general surgeon and the physician assistant finished closing the patient’s chest. His notes also indicated that the patient was bleeding when the defendant left.
The defendant argued that the patient’s complications from the surgery were rare and not the result of any error or negligence on his part. He said that, by returning to the hospital when he received the call about the patient’s distress, he had saved the patient’s life. He also said that the perfusionist’s notes were incorrect.
Colleagues spoke highly of the defendant’s reputation as a talented surgeon who has performed many high-risk surgeries successfully and saved patients’ lives. During the trial, the same nurses, who had told the Department of Public Health investigator that the physician assistant had finished stitching up the patient alone, changed their story and said they could not remember when the defendant left the room, if at all. The physician assistant who completed the process of closing the patient’s surgical incisions testified that she had had a three-year romantic relationship with the defendant.
Whether the blood loss began before or after the surgical incisions had been closed, an expert heart surgeon would have been able to detect and stop the bleeding more quickly if he had been in the room the entire time. A physician assistant can not reasonably be expected to know how to intervene to reverse blood loss that occurs in the immediate aftermath of heart surgery. Although the perfusionist noted the bleeding, treating a patient for excessive bleeding falls beyond the scope of his responsibilities. The time it took for the defendant to return from the restaurant to the operating room could have made all the difference in the patient’s outcome. The attorneys for the plaintiff successfully argued that the patient would likely have made a full recovery if the defendant had not left in the middle of the surgery.
The patient’s stepson also brought a lawsuit against the hospital where the surgery took place. That lawsuit reached a settlement without going to trial; the parties kept the settlement amount confidential. Medical expert witness testimony is essential to the outcome of trials like this one.
