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VERDICT—Procedure goes wrong, results in brain damage

Plaintiff says doctor went in incorrect order, surgery aborted intra-operatively

In a lawsuit filed in Washtenaw County Circuit Court, and consolidated with a lawsuit filed in State of Michigan Court of Claims, plaintiff Angela Smith, next friend to plaintiff Alexander Miller, sought compensatory damages from defendants Dr. Eric Devaney; University of Michigan Board of Regents; University of Michigan Health Center; and the University of Michigan Hospital, on claims of severe brain- and heart-related damage arising from cardiac surgery that had to be aborted intra-operatively.

The intended operation on Miller, by Devaney, was a complex heart surgery designed to revise a prior heart surgery performed some 17 years before to treat a congenital heart defect.

At the outset of surgery after opening Miller’s chest, there was a tear of the right atrium with resulting hemorrhage and a need to resuscitate the patient with blood transfusions. Thereafter, as Devaney then attempted to “mobilize the chest,” he tore Miller’s aorta, resulting in even more hemorrhage and a surgical crisis. Additional surgeons were summoned emergently to assist, and more resuscitation was required.

Until this time, and contrary to the standard of care, no efforts had been undertaken to have the patient prepared to go on emergency bypass. Plaintiff’s proofs demonstrated that, as Devaney attempted to gain vascular access, he went in the wrong order, beginning with venous access. Compounding his errors, it was further contended, Devaney wasted precious time discovering the femoral veins were occluded, facts that were well established in the UMHS records and well-known to other UMHS physicians.

By the time bypass was finally established, Miller resuscitated, the hemorrhaging stopped and the damage repaired, Devaney and his colleagues had to abort the entire operation. Within minutes of leaving the operating room, Miller then suffered cardiac arrest requiring the emergent re-entry of his chest to restart his heart (open cardiac massage).

In the aftermath, Miller wound up in a coma, with anoxic brain damage and other extensive injuries. Moreover, nothing had been done to correct the underlying heart conditions; he was not amenable to further surgery; and that plaintiff’s only viable option was heart transplant.

Plaintiff further claimed his brain damages resulted in hemiparesis, a foot drop, and an aggravation of his already compromised cognitive function such that he would never be able to live independently.

In addition, evidence was presented to demonstrate that Devaney never met the patient or his parents until minutes before the surgery; that he failed to present the case at a planning conference; and did not collaborate with the cardiology and surgical team, as was the norm at heart centers around the country. It also was asserted that Devaney failed to account for Miller’s multiple risk factors, and completely failed to have an appropriate plan in place to initiate emergent bypass.

Defendant Devaney claimed there was no violation of the standard of care; that there was no need for a preoperative planning conference; and that he was aware of plaintiff’s pre-existing femoral vein occlusion. It was further asserted that Devaney’s operative report contained a dictation error, and that he had, in fact, proceeded in the correct sequence to establish emergency bypass.

It also was asserted that the patient was stable during the intra-operative bleeding events and that he was able to get the patient safely on bypass. In addition, defendant contended that plaintiff’s life expectancy was highly limited, and would be the same regardless of his receiving a heart transplant.

The jury found for the plaintiff and awarded $2.5 million.

Type of action: Medical malpractice

Type of injuries: Brain damages resulting in hemiparesis, foot drop and aggravation of already compromised cognitive function

Name of case: Smith, et al. v. Devaney, et al.

Court/Case no./Date: Washtenaw County Circuit Court, State of Michigan Court of Claims; 09-810-NH (Washtenaw), 09-91-MH (Court of Claims); Sept. 30, 2011

Names of judges: Timothy P. Connors (Washtenaw); Joyce Draganchuk (Court of Claims)

Verdict amount: $2.5 million

Most helpful experts: Dr. Bradley Sewick, neuropsychologist, Southfield; Dr. Owen Perlman, physical medicine and rehabilitation, Ann Arbor; Dr. David Clarke, pediatric cardiothoracic surgeon, Denver; Nitin Paranjpe, economist, Bloomfield Hills; Marianne Boeing, life-care planning expert; George Cyphers, rehabilitation counselor, Cleveland

Insurance carrier: Self-insured

Attorneys for plaintiff: Stephen Goethel, Chad D. Engelhardt

Attorney for defendant: Scott D. Feringa

Source:  MI Lawyers Weekly at http://milawyersweekly.com/news/2012/01/06/procedure-goes-wrong-results-in-brain-damage/

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