Merrilynn Clark, William Clark v. Theodore G. Obenchain, Theodore G. Obenchain, M.D., Inc.
Published: Jun. 22, 2002 | Result Date: Apr. 18, 2002 | Filing Date: Jan. 1, 1900 |Case number: GIN006238 Verdict – $0
Judge
Court
San Diego Superior
Attorneys
Plaintiff
Defendant
Experts
Plaintiff
Guy Corkill
(medical)
Richard M. Holstrom
(technical)
Defendant
Brian R. Copeland
(medical)
Facts
The plaintiff, Merrilynn Clark was a 50-year-old, right-handed married woman, and mother of two teenage sons.
She had a history of difficulty walking for two years with "listing to the left" and having fallen from four to five
times during the previous year when she first saw Dr. Theodore Obenchain on Jan. 15, 1999. The plaintiff had
treated with podiatrists and chiropractors during the preceding two years, but in December 1999, was referred
to an orthopedic surgeon who, when working up her complaints, ordered an MRI brain scan which was done
on Jan. 12, 1999 and showed a midline mass based on the posterior falx that measured 5.5 cm.
The orthopedic surgeon referred the plaintiff to Dr. Obenchain who examined her for the first time on Jan. 15,
1999. William Clark, the plaintiffÆs husband, who claimed damages for loss of consortium was present on this
first office visit during which Dr. Obenchain explained that the plaintiff needed to have surgery sooner, rather
than later. He explained what the surgery would involve and advised the plaintiffs that there was a very high
likelihood that the plaintiff would need more than one operation to remove the large meningioma tumor. The
tumor extended into the right and left cerebral hemispheres as it came off the falx in both directions.
Dr. Obenchain discussed the attendant risks, including the fact that the plaintiff could be made worse
neurologically. He also suggested that the Clarks get another opinion should they so desire. He then ordered a
magnetic resonance venogram to study the enlarged draining hemispheral veins into the superior sagittal sinus
to better plan an operative approach.
The MRI was done on Jan. 20, 1999 and demonstrated a prominent anastomotic vein on the right joining the
superior sagittal sinus. This was very close to the tumor on the right side. Dr. Obenchain discussed this
complicating factor with the plaintiff and her husband on Jan. 21, 1999 explaining the significance of the large
draining vein and the need to operate around it, salvaging it. He again discussed the aims, techniques and
attendant risks of the surgery, including the risk of death, as well as the possible need for two different
operations.
On Jan. 22, the defendant - Dr. Obenchain met with the plaintiff and her sister. He again reviewed the aims,
techniques and attendant risks of the surgery and explained to the plaintiff and her sister that he had decided it
was in the plaintiffÆs best interests if he approached the tumor through her dominant hemisphere (the left side)
rather than the non-dominant hemisphere. He explained that this was a change in plans due to the venous
drainage, plus the size of the tumor.
The plaintiffÆs preoperative MRI scan demonstrated a small amount of edema on the
right side of the tumor and none on the left side. As a result, Dr. Obenchain chose not to utilize
preoperative steroids. The plaintiff was taken to surgery on Jan. 26, 1999. Surgery lasted over
seven hours. Significant intraoperative swelling was encountered for which Dr. Obenchain
utilized Mannitol and steroids to attempt to control it. Dissection was slow and the brain appeared
tight, hypervascular and "angry." Dr. Obenchain was only able to resect approximately 10-15
percent of the tumor, but due to increased brain swelling, chose to terminate the procedure,
rather than continuing. The bone flap was left out due to the significant swelling. * * *
Settlement Discussions
The defendants served the plaintiffs with a C.C.P. Section 998 offer for zero dollars and a waiver of costs.
Injuries
Brain damage to the left motor strip. The patient had minimal sensation and motor ability in her right arm, right leg, left leg and was confined to a wheel chair.
Other Information
* * * Immediately postoperatively, it was determined that the plaintiff had suffered a right-sided hemiplegia. She also had difficulty with speech, but this resolved after several weeks. The plaintiff underwent many weeks of intensive rehabilitation therapy, but only regained minimal sensation and motor ability on her right side. She required an additional surgical resection which was done at UCLA and subsequently radiosurgery to treat the residual tumor. The plaintiff was confined to a wheelchair and began suffering seizures which were documented to have begun several weeks after the first surgery. In March 2001, the plaintiff fell from her wheelchair hitting her head, leaving her paralyzed in the left lower extremity and thereby rendering her triplegic with her only useful limb being her left upper extremity. The plaintiffÆs youngest son was in high school at the time of the subject surgery and it was her plan to return to work as a bookkeeper when her youngest son went off to college.
Deliberation
one hour
Length
seven days
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