Facts

On June 26, 2012, 26-year-old Kurt Poole went to Naples Medical Group. Poole told the medical assistant that his chief complaint was an infected cyst on his back. Roger G. Nash, D.O., performed a physical examination, confirming that Poole had an infected sebaceous cyst of the mid back. Dr. Nash's treatment plan was to perform an incision and drainage of the cyst under local anesthesia. Dr. Nash explained to Poole that he would first numb the area with a local anesthetic before draining the cyst. Poole consented to the procedure.

PLAINTIFF CONTENTIONS:
Nash injected the area with lidocaine/epinephrine. Dr. Nash used enough lidocaine/epinephrine to produce a 5-6 mm wheal. The amount was not documented. Dr. Nash then told Poole he would be back in a few minutes and would make a phone call while waiting for the anesthesia just to take effect. Dr. Nash then left the treatment room. About two minutes later, Poole lost consciousness and fell face first off the examination table onto the floor.

Poole fractured off half of his left front tooth, loosened other teeth, sustained a puncture wound to his inner lip, and sustained a wound to his chin. Dr. Nash returned to the room and evaluated Poole, concluding that Poole had suffered a vasovagal reaction and syncope. Dr. Nash completed the incision and drainage of Poole's sebaceous cyst, sutured Poole's inner lip laceration, prescribed antibiotics, and performed a neurological examination. Dr. Nash then discharged Poole home with instructions for Poole to follow up with a dentist and have a recheck in two to three days.

Plaintiff contended that Dr. Nash violated the standard of care by not laying Poole down for the lidocaine injection and by leaving him unattended and sitting upright after administering lidocaine.

DEFENDANT CONTENTIONS:
Poole did not voice any complaints or state to Dr. Nash that he was fearful about the proposed procedure, injections, or local anesthesia. At no time did Poole see the needle. Neither prior to, during, or immediately after the injection did Poole tell Dr. Nash that he was apprehensive, lightheaded, or did not feel well. Lidocaine is a local anesthetic commonly used in minor procedures, including cyst drainage. It does not carry a high risk of causing vasovagal syncope. Absent information from a patient that the patient is at risk for vasovagal syncope, it is not the standard of care for a physician to take special precautions to avoid a vasovagal episode when injecting a patient with lidocaine.

Damages

Plaintiff requested $225,000 for past/future pain and suffering, and $15,800 for past/future medical expenses.

Injuries

After leaving Dr. Nash's office, Poole went to dentist Benjamin Choi, D.M.D. Choi removed and replaced the inner lip sutures with his own and ultimately performed a root canal and placed a cap on Poole's left front tooth, which he opined would have to be replaced every ten years for the rest of Poole's life.

Result

Defense verdict.

Other Information

FILING DATE: June 13, 2013. 

Deliberation

2.5 hours

Poll

9-3 (negligence in favor of defendant)