Johnny Leal v. Doe Hospital, Peter Golden, M.D., et al.
Published: Jul. 2, 1994 | Result Date: May 18, 1994 | Filing Date: Jan. 1, 1900 |Case number: VC004018 – $14,942,700
Judge
Court
L.A. Superior Norwalk
Attorneys
Plaintiff
Defendant
John R. MacRill Jr.
(Davis, Grass, Goldstein & Finlay)
Experts
Plaintiff
Donald F. Mills
(medical)
Thomas Nueman
(medical)
Ronald M. Schilling
(medical)
Peter Formuzis Ph.D.
(technical)
Defendant
Paul Cianci
(medical)
Jon Belville
(medical)
Facts
On February 8, 1991, Plaintiff Johnny Leal, a 29-year-old warehouse foreman, underwent video arthroscopic knee surgery for a torn meniscus. He came out of the surgery in a persistent vegetative coma and remains hospitalized. Video arthroscopies require the knee joint to be distended to obtain adequate visualization. Two methods exist for achieving distention, one being with saline fluid and the other with non-toxic gas. In the United States, liquid saline is used far more frequently than gas. However, during this particular surgery, the surgeon decided to use a CO2 laser to vaporize the meniscus, and the laser could be used only in a gas distention medium. Therefore, a device called a CO2 gas "insufflator" was used in conjunction with the laser to distend the knee joint. The laser and insufflator were owned and maintained by a small hospital equipment leasing company which leased the laser and insufflator to local hospitals and physicians on an as-needed basis. The equipment was delivered to the hospital by a technician who would set up and monitor the equipment during surgery. The gas insufflator was designed to deliver gas to the patient at a pressure no greater than 2.2 psi. In order to prevent delivery of gas under excess pressure, the device was made with a pressure relief valve designed to pop off whenever the pressure reached 2.2 psi. As manufactured, this relief valve was directed toward a back plate so that it could not be accidentally blocked. In this case, the leasing company modified this configuration by turning the valve so that it was parallel to the back plate. The company also performed various repairs on the device, ignoring the manufacturer's express instructions that the device be returned for factory repairs. Finally, the technician provided by the company to monitor the device during this surgery had not read manuals accompanying the device, did not understand its operation, and did not know the function of the pressure relief valve. During surgery, the surgeon complained that he was not getting adequate gas flow to distend the knee joint. The technician investigated and found gas was escaping out of a valve which he later learned to be the pressure relief valve. The technician alleged that the physician instructed him to block this valve during surgery, which he did; the surgeon alleged that they corrected the problem by changing the tubing. The blockage of the valve caused excess gas to be delivered under excess pressures. During the course of the 6-to-7-minute use of the laser, the gas accumulated in the thigh under such a high degree of pressure that it undermined a thigh tourniquet inflated to 350mm of mercury, got into the abdominal cavity, spread throughout the subcutaneous tissues, and entered the chest where it displaced the lungs and the heart, causing a cardiac respiratory arrest. The anesthesiologist, Defendant Dr. Peter Golden, did not perceive any changes in the patient's condition until the surgery was basically completed. Because of the draping on the patient, the other physicians and personnel in the operating room could not see the patient's skin or the monitoring machines. According to the nursing code blue records, there was a 16-minute delay following the cardiac arrest before any effort was undertaken to remove the gas in the chest which was compressing the heart and lungs. External cardiac massage failed. When the chest was opened, the gas escaped, the lungs re-inflated, and the heart began beating. By this time, Plaintiff had sustained severe and permanent brain damage due to lack of oxygen. Prior to trial, Plaintiffs settled with all Defendants except the anesthesiologist.
Settlement Discussions
Plaintiffs contend their pretrial demand was a 998 in the amount of $1,000,000 (policy limits) and Defendant anesthesiologist made no offers.
Specials in Evidence
692,651 $632,790 $23,000,000
Injuries
Severe brain damage and ongoing coma. Mrs. Leal claimed loss of consortium injuries and is left alone to rear their three young daughters.
Result
The jury returned a total award of $14,942,651. The Court: cut the verdict by $5,000,000 in non-economic damages under MICRA; applied offsets from prior settlements of $2,800,000; ordered prejudgment interest of $224,895 on past damages only; and ordered that the judgment be paid with $2,300,000 cash and yearly payments of $364,000 for 14 years.
Deliberation
3 hours
Poll
10-2
Length
2.5 weeks
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