Monmouth County – A $2,700,000 recovery, including waiver of $800,000 lien for medical costs, was obtained in a medical malpractice action where the plaintiff was not properly monitored and left in prone position during Achilles tendon surgery performed under regional anesthesia. Plaintiff experienced respiratory arrest, anoxic encephalopathy, brain damage with very significant concentration and memory deficits and inability to continue working as a hospital CFO.
The 44 year-old male plaintiff was undergoing a surgical repair of a ruptured Achilles tendon, performed under regional anesthesia, specifically by epidural with conscious sedation. It was alleged that approximately 90 minutes into the procedure the plaintiff’s vital signs significantly changed and his oxygen saturation level went from 99% to 59% over the course of several minutes. It was alleged that these changes were caused by respiratory insufficiency that was being experienced by the plaintiff, who was in a prone position for the subject procedure, and that the defendant anesthesiologist negligently failed to monitor the patient and appreciate distress. The declining oxygen saturation rates resulted in the plaintiff suffering respiratory arrest. The plaintiff contended that he suffered brain damage that has left him with permanent and very significant difficulties with short-term memory and communication skills. The plaintiff, who had worked as a CFO for health care system, maintained that he is permanently unemployable.
An oxygen-measuring valve had been placed on the plaintiff’s finger. The defendant anesthesiologist contended that he properly monitored the patient and maintained that he reasonably believed that the changing signs were merely indicative of the “motion artifact” which occurred because the plaintiff’s hand had been moving during the procedure. The defendant also contended that the plaintiff may well have experienced a central neuraxial blockade, which is a phenomenon that occurs with epidural anesthesia on rare occasions and which can cause cardiac arrest for unknown reasons.
The plaintiff countered that the plaintiff had been wearing the device on his finger during the entire 90 minute procedure and that the vital signs had decreased dramatically on only one occasion, denying that the defendant’s position should be accepted. The plaintiff would have also argued that since the arrest occurred after the vital signs had been depressed for approximately five minutes, the defendant’s position as to this rare complication should be rejected.
The plaintiff further further maintained that shortly before he suffered respiratory difficulties, the defendant anesthesiologist, with whom he had met prior to the procedure, had been replaced with an associate. The plaintiff elicited testimony during the deposition testimony of this associate that he may have been arranging his instruments at the time the vital signs changed. The plaintiff maintained that this factor lent additional support to the plaintiff’s position that adequate monitoring had not been provided. The plaintiff also contended that although the anesthesiologist with whom he met was an attending physician, that he was advised that the informed consent form so reflected and maintained that the hospital should be vicariously liable on an apparent agency theory.
The plaintiff maintained that when he suffered the respiratory arrest, a code was called and that although the plaintiff was revived, he sustained anoxic encephalopathy with significant injury to the brain, resulting in the plaintiff being comatose for nine days and spending the next seven months in various rehabilitation facilities. The plaintiff contended that he has very limited short-term memory and has great difficulties interacting with his wife and children, remembering people that he recently met, and assistance with the activities of daily living.
The plaintiff also maintained that it was ultimately deemed to be permanently disabled due to his continued significant deficits in short-term memory and language/communication skills and the plaintiff would have pursued very significant future income claims. The plaintiff’s wife has been appointed his legal guradian.
The case settled prior to trial for $1,900,000 and a waiver of the $800,000 medical lien.
Plaintiff attorney: Charles A. Cerussi of the Law Offices of Charles A. Cerussi