Facts

Plaintiff Alfonso Castro, then 59, had been assaulted, which caused him to sustain a bilateral jaw fracture. On June 1, 2011, he presented to Providence Holy Cross emergency room for treatment. Defendant Dr. Zareh H. Vartivarian, M.D., a plastic surgeon, was on trauma call and saw plaintiff in the emergency room. He decided to perform an open reduction and internal fixation of the jaw fractures.

Plaintiff underwent a mandible ramus fracture repair. Plaintiff was thereafter sent to the intensive care unit, remaining intubated. He stayed four additional days in the ICU. When he was extubated on June 6, he had a severe right-sided facial droop from an apparent nerve injury. He was discharged from the hospital four days later. Plaintiff was thereafter admitted to Olive View UCLA Medical Center, where exploratory nerve surgery found a complete avulsion of the main trunk of his right facial nerve as it exited his skull. Surgery had not been performed at the site of the nerve injury.

Plaintiff filed suit

PLAINTIFF'S CONTENTIONS:
Plaintiff contended that Dr. Vartivarian, in performing the right mandible fracture repair, completely avulsed the main trunk of plaintiff's facial nerve through excessive force and traction during the surgery. Plaintiff further contended that he did not give his informed consent for the surgery. Dr. Vartivarian should have proceeded with a conservative treatment by wiring the jaw shut as opposed to operating to attempt to reduce this very difficult fracture. Plaintiff contended that Dr. Vartivarian failed to use nerve monitoring to protect the nerves and avoid this injury. He also negligently injected Lidocaine, which anesthetized the face and nerves, also resulting in this injury.

DEFENDANT'S CONTENTIONS:
Defendant contended the surgery was difficult and lasted six hours. Dr. Vartivarian struggled to reduce the right jaw fracture, which was high and near the patient's ear. He called former co-defendant Dr. Rafael Quinonez, an ear nose and throat surgeon, to assist towards the end of the surgery. Dr. Quinonez attempted to gently manipulate the fracture from the outside to accomplish reduction. This failed.

Dr. Vartivarian contended that although difficult, the surgery was indicated to repair a severely displaced fracture and performed in a delicate and meticulous manner. It was reasonable and prudent to call in the consulting ENT surgeon to help. It was also reasonable to stop before fixing the fracture. By sending the plaintiff to the ICU, they were protecting his airway because there was so much manipulation and swelling during the surgery.

Defendant claimed that some other unknown event must have caused the transection of the main trunk of the facial nerve, a rare complication as of yet unreported in the world's medical literature relating to this specific surgery.

Settlement Discussions

Plaintiff demanded $374,000. Defendant made no offer, no consent.

Specials in Evidence

$368,000 $81,000

Damages

$250,000

Injuries

Plaintiff suffered complete interruption of the main trunk of the right facial nerve resulting in right facial paralysis and inability to close the right eye.

Result

Defense verdict.

Other Information

Former co-defendant Dr. Rafael Quinonez was granted summary judgment in June 2014. DATE FILED: Aug. 28, 2012.

Deliberation

1.5 hours

Poll

11-1

Length

nine days