Veronica Romero v. Terry A. Gillian
Published: Apr. 6, 2002 | Result Date: Dec. 21, 2001 | Filing Date: Jan. 1, 1900 |Case number: 6436018 Verdict – $0
Judge
Court
Fresno Superior
Attorneys
Plaintiff
James J. Mele
(Mele Law Office)
Defendant
Experts
Plaintiff
Ghol Bahman
(medical)
Defendant
Charles S. Lane
(medical)
Facts
Plaintiff Veronica Romero first consulted Dr. Gillian on July 15, 1998, about significant and disabling problems
with both her right and left hands. She is left-handed. She presented with a two and one-half-year history of
bilateral nocturnal parasthesias of both hands, greater in the left hand, with bilateral tenderness over the medial
and lateral epicondylitis, forearm tenderness bilaterally and numbness and tingling in both hands.
The results of nerve conduction studies were consistent with carpal tunnel syndrome, moderate on the left side,
but also present on the right. After examining the patient, Dr. Gillian assessed her as having bilateral carpal
tunnel syndrome with possible bilateral compression of the ulnar nerves at the wrist and elbow, bilateral de
Quervain syndrome possible bilateral chronic palmar tenosynovitis. He ordered laboratory studies to rule out
any underlying medical causes for the symptoms, ordered bilateral wrist x-rays, and prescribed Indomethacin
to reduce inflammation in the forearms. He instructed the patient to use bilateral wrist braces and to avoid
repetitive and strenuous activities. She was to return to work on light duty and was to return to see Dr. Gillian
in one week.
Dr. Gillian saw her again on July 22 and she was not improved. He discussed with her the benefits and risks of
surgery and estimated her length of disability to be 6-8 weeks. On Oct. 8, 1998, Dr. Gillian took the plaintiff to
surgery and performed decompression anterior position of the left ulnar nerve at the elbow, decompression of
the left median nerve at the wrist, decompression of the left ulnar nerve at the wrist, left palmar
tenosynovectomy, release of the left de Quervain, application of a long arm fiberglass splint, regional wrist
block at the elbow and the wrist, and Kenalog injection of the left and right lateral epicondyles. Dr. Gillian
reported no complications at surgery. Dr. Gillian saw the plaintiff in his office numerous times following that
surgery.
On November 4, he assessed her as having persistent weakness and stiffness in her left hand status post
surgery. His plan was for her to continue in formal hand therapy, as well as home therapy, and return in two
weeks. He estimated her length of disability to be at least 4-6 weeks and he released her to return to light duty,
right-handed work if such work was available. If none was available, then she was to continue on total
temporary disability. When she was seen by Dr. Gillian on December 2, he documented her complaints of
shooting pains on the dorsum of the left wrist, but otherwise her left upper extremity was improving. He noted
that she was able to touch the fingers to the mid palm and fully extend the fingers, but that she had some loss
of control in the little finger and had difficulty abducting and adducting it. She had full extension of the thumb
and was able to flex it to touch the head of the fifth metacarpal. Her grip strength in the left hand was 13, 18,
15 and the right hand was 43, 30, 28. She complained of increasing symptoms in her right hand because she
was doing more work with the right hand. She was assessed as having weakness and loss of dexterity and
endurance in the left hand. His plan was to have her continue with formal hand therapy to increase her range of
motion, strength and function as well as to continue with home therapy. She was to return in two weeks. He
estimated her length of disability at four more weeks.
The plaintiff returned in two weeks, on Dec. 16, 1998, with complaints of pain in her left thumb. He treated
this by injecting a mixture composed of Kenalog and Xylocaine into the area. His plan was to have her
continue with exercise and massage. The Kenalog injection was repeated on Jan. 13, 1999.
The plaintiff returned on January 25, stating she had experienced no improvement since
her last visit. * * *
Settlement Discussions
The plaintiff demanded $249,999 per C.C.P. Section 998. The defense made no offer.
Damages
Permanent injuries and disfigurement to left (dominant) hand resulting in loss of function and pain.
Injuries
Permanent injuries and disfigurement to left (dominant) hand resulting in loss of function and pain.
Result
Defense verdict.
Other Information
* * * Dr. Gillian noted that her x-rays appeared to be within normal limits, and he assessed her as having chronic stenosing tenosynovitis of the left flexor pollicis longus tendon and mild entrapment of the first dorsal compartment. His plan was to schedule her for a tenovaginectomy of the left flexor pollicis longus tendon and a Kenalog injection in the first dorsal compartment, as an outpatient procedure, under a Bier block anesthesia. The plaintiff next presented to Dr. Gillian on Feb. 24, 1999, complaining of continued pain and tenderness in her left hand, and numbness and tingling on her right, from the elbow to the wrist, which was increasing. She had evidence of compressive neuropathy in the right hand. Dr. Gillian noted his opinion that she would need to eventually undergo decompression surgery in that hand. He discussed the risks and complications of the proposed surgery with her. On Feb. 25, 1999, Dr. Gillian took the plaintiff back to surgery and performed chronic stenosing tenosynovitis of the left flexor pollicis longus tendon, Kenalog injection into the left first dorsal compartment, Kenalog injection into the left medial epicondyle, and application of a thumb spica type splint. No complications were noted at the time of surgery. The plaintiff returned to Dr. GillianÆs office on March 3, 1999, and he noted that the left thumb was healing without evidence of infection and had only mild swelling. The splint was discontinued and the patient was to be started on active and passive range of motion exercises in the left thumb. He noted that she may return to right handed light duty work if such work was available. On the next visit, on March 8, 1999, the plaintiff complained of swelling and some drainage from the left thumb, where the wound had partially separated. The sutures were removed and the patient was to cleanse the area twice a day with hydrogen peroxide and apply Bacitracin and Neosporin ointment and a Band-Aid. She was to let her hand rest. He prescribed antibiotics in case she was developing an underlying infection, although there was no gross evidence of this. When she returned next on March 17, 1999, the plaintiff complained of increasing pain and swelling in the left thumb and little finger. She stated that she still had drainage from the thumb, although no drainage was evident at the time Dr. Gillian examined her. He did note swelling but no true erythema or increase in warmth. A culture revealed no growth from the wound. She was to continue antibiotics and return in five days, or sooner if her swelling and redness increased or if there was any increase in temperature. Dr. Gillian saw the plaintiff for the last time on March 29, 1999. At that visit, Dr. Gillian noted that the left thumb swelling and infection had resolved, but she was unable to fully extend the left thumb because the extensor pollicis brevis tendon was subluxing from the first dorsal compartment, along with the extensor abductor pollicis longus tendons. He thought that the ligaments of the first dorsal compartment had disrupted, because when the tendons were held in place, the patient was able to extend and flex the thumb properly. He also noted palpable tenderness over the left long, ring and little fingers at the A-1 pulleys, with thickening. His plan was to do a repair reconstruction of the first dorsal compartment ligament. That surgery was never done, as the plaintiff never returned to Dr. Gillian. Once the plaintiff discontinued seeing Dr. Gillian, she consulted Dr. Randi Galli, a plastic surgeon and hand surgeon in Fresno, who most recently operated on her on May 29, 2001. Regarding plaintiffÆs current condition, at the time of her deposition in September of this year, the plaintiff testified that she still had not been determined to be permanent and stationary. Her attorney stated that he believed this finding would be made within the next couple of months.
Deliberation
two hours
Poll
9-3
Length
four days
For reprint rights or to order a copy of your photo:
Email
jeremy@reprintpros.com
for prices.
Direct dial: 949-702-5390