Verdict & Settlement Wins
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Court: Court of Claims of Ohio
Plaintiff's Counsel: David M. Paris
OSU Hospital Pays Family $1 Million in Wrongful Death Suit
Our wrongful death client is survived by his wife of 11 years and their son. He was diagnosed with a bronchial carcinoid that needed to be removed. This was an elective procedure and he had a very good prognosis because this was early stage and a low grade lesion with a survival rate at 5 years of 90 percent.
A sleeve lobectomy is a very challenging procedure. There are different techniques to remove an upper lobe. Between pneumonectomy, VATS lobectomy, and sleeve lobectomy, the latter is the most challenging. In fact, of the 300-400 annual thoracic surgeries performed by the defense expert, only 3-5 were sleeve lobectomies and only 5-10 percent of the plaintiff’s expert’s annual lobectomies were sleeve lobectomies.
We contended that the defendant surgeon did not have the experience needed to competently perform this procedure unsupervised. He had been a cardiovascular fellow from 2007-2009, where he performed, under supervision, about 20 removals of carcinoid tumors using a sleeve lobectomy technique. Our client was his first such unsupervised patient at Ohio State. The defense expert opined that for a VATS Lobectomy, a less challenging procedure, in order to achieve the level of “competent,” one must have performed 25 cases. And to achieve the level of “proficient”, one must have performed approximately 150 cases.
In a sleeve resection, if the tumor is in close proximity to the lobar/apical branches, as it was with our client, authoritative literature recommends proximal control of the main pulmonary artery. This is done because accidental injury/bleeds to a pulmonary vessel in a distal location is a foreseeable risk under these circumstances. Thus, when the defendant surgeon accidentally injured and caused a bleed at the junction of the pulmonary artery and lobar/apical branch, he placed a clamp proximal to the bleed. He then sutured the injury. After placing the sutures, he released the clamp completely at which time a massive amount of blood obscured the operative field. It was our contention that the standard of care is to release such a clamp slowly to ensure that the sutures withstand the change in pressures within the vessel.
To compound the failure to enlist an experienced surgeon at the outset, the defendant surgeon encountered several unexpected anatomical anomalies in the patient, which made the procedure even more challenging and technically complex. First, when he entered the chest cavity, he found that our client had a left hemidiaphragm which was significantly elevated and occupied more than half of his thoracic cavity. This meant that a shorter distance existed between all the vessels and organs and they were more closely approximated than normal. In other words, there was less room in the operative field to work than expected.
Second, our client’s left upper lobe had collapsed, and there was substantial inflammation, which led to adhesions of the upper lobe to the chest wall. All of these technical challenges should have led a reasonably prudent physician with the defendant’s limited experience to seek assistance. We believed that his failure to do so was a breach of the standard of care and a proximate cause of our client’s death.