Confidential
Settlement – $375,000Court
Ventura Superior
Attorneys
Plaintiff
Defendant
Jennifer E. Gysler
(Monroy, Averbuck & Gysler)
Experts
Plaintiff
Thomas W. Broderick
(medical)
Brendan J. Carroll
(medical)
Michael P. Ward
(technical)
Defendant
Harvey A. Kalan
(medical)
Facts
On Jan. 1, 1999, the plaintiff was admitted to the hospital with abdominal pain. An ultrasound examination
revealed the presence of gallstones and there was a diagnosis of cholecystitis. On January 2, the patient was
taken to surgery by Dr. Doe who performed a laparoscopic cholecystectomy with an intra-operative
cholangiogram.
In his operative report, Dr. Doe stated that he identified the cystic duct, placed metal clips on the duct and then
divided the duct or transected the duct between the metal clips. The vascular structures of the gallbladder were
also identified and clipped off allowing for laparoscopic removal of the gallbladder. It turned out that Dr. Doe
had in fact transected the common bile duct. Post-operatively, the patient continued to have complaints
including progressive jaundice, a low-grade fever and mid-abdominal pain. Her laboratories showed an
increase in her liver enzyme study and bilirubin.
On January 6, Dr. G, a gastroenterologist, subsequently performed an endoscopic retrograde
cholangiopancreatography (ERCP) on the patient which revealed a complete occlusion of the proximal
common bile duct in the area of the surgical clips placed by Dr. Doe during the January 2, procedure.
On the evening of January 7, at approximately 7:45 p.m., the patient was returned to the operating room for a
repeat surgery (an open procedure as opposed to laparoscopic), which was not completed until approximately
11 a.m., the next morning. Dr. Doe was the surgeon, Dr. D, was initially the assistant surgeon, but at about 6
a.m., Dr. D was replaced by Dr. K, who according to the records became co-surgeon with Dr. Doe. During the
surgery, it was determined that during the prior surgery of January 2, Dr. Doe had clipped off and transected
the common bile duct, rather then the cystic duct as he had intended.
On January 8, at approximately, Dr. K was called to relieve Dr. D. On the arrival of Dr. K., he and Dr. Doe
discussed how best to repair the common duct. Dr. K suggested repairing the common bile duct by connecting
both ends of the severed section together with sutures over a T-tube. Dr. Doe adopted the recommendation of
Dr. K and both Dr. Doe and Dr. K performed this procedure together. Dr. K is unable to distinguish what
specific portion of the repair procedure was performed by him and what specific of the procedure was
performed by Dr. Doe.
The plaintiffs contended that Dr. Doe was negligent in performing the initial laparoscopic cholecystectomy in
that he failed to properly identify the anatomy and transected the plaintiffÆs common bile duct; that Dr. Doe
was negligent in that there was an unreasonable delay in diagnosing the occluded duct.
The plaintiffs further contended that Dr. Doe was negligent in attempting the repair procedure, and in the
execution of the repair procedure; the patient should have been transferred to a more appropriate facility for the
repair.
Injuries
The plaintiff was required to undergo a major 16-hour open surgical procedure. She suffered from multiple occlusions of common bile duct, leading to jaundice and all its ramifications (nausea, vomiting, inability to eat). She was required to undergo blood tests every two to four weeks. She has undergone some six ERCPs for purpose of evaluation, stent placement and stent removal and duct dilation. She has been hospitalized on multiple occasions over the last year and a half as a result. She underwent an extensive surgical procedure called Hepatico Jenjunostomy. This procedure involves the creation of a direct connection between the liver and the small intestine. If this procedure should fail, the next step might very well be a liver transplant. The months following the initial procedure and for periods of time, since the plaintiff husband was required to undertake the duties of housekeeper, and parent of five. This is in addition to his own full time employment.
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