Facts

Plaintiff Donna Arevalo, 47, underwent a bilateral mastopexy and augmentation and abdominoplasty performed by Dr. Eugene Wu. The abdominoplasty was to her satisfaction, however at the first postoperative visit, the inverted T wounds from the mastopexy on both breasts showed signs of epidermylosis. The wound on the right breast healed much faster than the wound on the left breast. Approximately 20 days postoperatively, the wound around the nipple areolar complex on the left breast separated. Approximately eight months after the surgery, the wounds on the left breast healed.

PLAINTIFF'S CONTENTIONS:
Donna Arevalo contended that had she been advised by Dr. Wu that there was an increased risk of vascular compromise by combining a mastopexy and augmentation, she would not have consented to undergo the surgery. She claimed that the bilateral mastopexy and augmentation was negligently performed causing her to sustain damages and injuries.

She alleged that during her first and second pre-operative consultations, she was pressured by Dr. Wu's consultant/assistant to also undergo breast augmentation. Donna produced cancelled checks made payable to Dr. Wu's assistant for $1,500 evidencing sums she loaned her to pay the additional cost of implants.

Donna Arevalo contended that after approximately four months of wound care by Dr. Wu, she went to see her primary care physician at Kaiser, John Vander Hulst, M.D. who immediately admitted her to the ICU for surgical debridement. Dr. Vander Hulst testified that when he initially saw Donna Arevalo, he believed she had a life-threatening wound with the potential to go into sepsis, which is why he sent her to the ICU for immediate debridement by a plastic surgeon. She underwent the surgical debridement followed by treatment at the wound care clinic at Kaiser, including use of a wound vac, and approximately four months later the wounds on her left breast healed.

DEFENDANT'S CONTENTIONS:
Dr. Wu claimed that he provided appropriate informed consent prior to the bilateral mastopexy and augmentation procedure. He denied any negligent act or omission in the performance of the procedure, and that there was any negligent act or omission on his part that was a substantial factor in causing plaintiffs' alleged injuries.

Settlement Discussions

Donna Arevalo demanded $195,000. Danny Arevalo demanded $60,000. Dr. Wu offered a waiver of costs in exchange for dismissal with prejudice.

Damages

Donna Arevalo sought damages for loss of past and future income in the amount of $36,081 and noneconomic damages in the amount of $388,000. Danny Arevalo alleged loss of consortium in the amount of $135,000 as a result of the injuries to his wife.

Result

The jury returned its verdict in favor of defendant Dr. Wu, 9-3 on Donna Arevalo's negligence claim, and 12-0 on her lack of informed consent claim. As there was no negligence found, the jury did not make a determination on plaintiff Danny Arevalo's loss of consortium claim.

Other Information

Danny Arevalo took 96 photographs of his wife's necrotic wound over the course of several months, 17 of which were admitted into evidence and it was subsequently determined that the left inverted T wound and the nipple wound were infected with Staphylococcus aureus and pseudomonas aeruginosa. EXPERT TESTIMONY: Plaintiff's expert, Dr. Thomas Taylor, M.D., plastic surgeon, testified that Dr. Wu did not advise Donna about an increased risk of vascular compromise in performing a mastopexy with augmentation and this was not sufficient and below the standard of care. He further testified the significant postoperative complications in the left breast after the bilateral mastopexy and augmentation must have occurred as a result of vascular compromise during the surgery and were of the kind that could not have occurred in the absence of negligence. Defense expert, Dr. Marc Mani, M.D., plastic surgeon, testified that Dr. Wu gave appropriate informed consent to Donna prior to performing the bilateral mastopexy and augmentation. Dr. Wu's operative procedure in performing the bilateral mastopexy and augmentation was appropriate and within the standard of care as was his post-operative care and treatment of Donna. The post-operative complication of wound dehiscence and delayed wound healing was exacerbated by a secondary infection, all of which were known risks of the procedure and occurred in the absence of negligence. There was no negligence by Dr. Wu that was a substantial factor in causing plaintiffs' injuries.

Deliberation

2.5 hours

Length

six days