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Defense verdict reached in $5M med mal suit | Virginia Lawyers Weekly
This lawsuit was brought by a patient who had a septoplasty procedure performed at a local surgery center to address sleep apnea and migraine headaches.
valawyersweekly.com
Laryngospasm and NPPE.
“Date resolved: 9/26/2023
Demand: $5,000,000
Verdict or settlement: Verdict
Amount: $0 (defense)
Dillman
Attorneys for defendant: Rodney S. Dillman and Brett M. Saunders, Virginia Beach
Description of case: This lawsuit was brought by a patient who had a septoplasty procedure performed at a local surgery center to address sleep apnea and migraine headaches. The procedure itself was without complications, however following extubation, the patient suffered a laryngospasm (vocal cords shutting abruptly), which prevented her from being ventilated, and she eventually suffered negative pressure pulmonary edema (lungs filling with fluid). This resulted in the patient having large amounts of pink froth coming from her throat requiring reintubation. The patient was subsequently put into a medically induced coma for nearly two weeks.
After the patient was brought out of her coma, she spent a total of 34 days in the hospital before receiving many additional months of rehabilitation treatment. The patient had no memory of her life prior to her surgery and continued to have frequent seizures following her hospitalization. The patient eventually moved back in to live with her parents for support and continued to have issues with memory, concentration, problem-solving and almost daily seizures. The patient’s friends and family members described her as a completely different person than before the surgery.
The plaintiff-patient alleged that the anesthesiologist defendant should have been present for the extubation and stopped the extubation from occurring.
The plaintiff’s standard of care experts testified that there was no doubt that the patient was not ready for extubation based on both the ventilatory data that was recorded and the values that were changed by the CRNA. They further testified that extubating her too soon directly caused her laryngospasm and negative pressure pulmonary edema. Each expert also testified that the patient’s ventilatory data was updated to make her appear appropriate for extubation when she was not and that they had not ever seen a medical provider alter medical data in this way in their entire careers. Plaintiff’s audit trial expert testified regarding how unusual the CRNA’s changes to the records were as well.
Plaintiff’s standard of care experts testified that the defendant anesthesiologist should have been present for the extubation based on the patient’s various comorbidities noted prior to surgery. If he had been present, they explained that the standard of care would have required him to prevent the CRNA defendant from extubating the patient.
Plaintiff’s causation and damages experts testified that the patient undoubtedly suffered a hypoxic brain injury because of her lacking oxygen following extubation. This could be seen on the patient’s MRI imaging taken while she was in a coma. The plaintiff further suffered a permanent major neurocognitive disorder, dissociative amnesia and frequent seizures all secondary to her hypoxic brain injury. Plaintiff’s experts testified that the plaintiff required 24-hour supervision for the rest of her life and that she was not capable of competitive employment for the rest of her life.
Defense experts, Thomas Pajewski, M.D., W. Paul Murphy, M.D., and Suzanne Wright, CRNA, countered that the plaintiff’s ventilatory data was impacted directly by her coughing and moving her arms. It was not unusual for a patient who was coughing to have aberrant values entered with the ventilatory data. They testified that based on the patient’s overall condition prior to extubation, including her being able to open her eyes and respond to commands, she was appropriate for extubation. They also explained to the jury that a laryngospasm is a known complication that can occur without any negligence and that the patient survived her complications due to the quick reaction from the CRNA and anesthesiologist.
Defense expert, David Cifu, M.D., explained that the patient had a hypoxic event, but did not suffer a hypoxic brain injury. He further explained that the patient’s current seizures and cognitive disabilities were not related to any complications from her surgery.
After a six-day trial, on the seventh day, the jury deliberated for over four hours before returning a verdict in favor of the defendant CRNA, anesthesiologist and their employer.”