Facts

Debra Figueroa developed cancer of her bile duct, also known as ampullary adenocarcinoma. Robert Warren M.D., a physician at the University of California San Francisco Medical Center informed Figueroa, 45, that a surgical procedure known as a Whipple procedure would be necessary to remove the cancer. During the procedure, parts of the stomach and pancreas, as well as part of the hepatic duct would be removed and subsequently attached at the small intestines. Warren also informed Figueroa about the various risks of the surgery taking into consideration her obesity. One such risk was that a leak may form where her pancreas and small intestines meet. Figueroa subsequently underwent the Whipple procedure on June 27, 2002. The procedure lasted more than 10 hours. Prior to her surgery, a pancreas surgery expert by the name of Kimberly Kirkwood M.D. also discussed the risks of the surgery with Figueroa.

Although the procedure itself was without incident, post surgery, Figueroa's blood pressure went down and she developed a fever. Suspecting a leak after seeing fluid build-up in drains that had been placed in Figueroa during the surgery, Kirkwood determined that an additional surgery would be required to determine where the leak was. The problem was detected at the site where the pancreas and small intestines connected. After the problem was repaired, Figueroa's condition began to improve until July 5. On that date, Figueroa once again developed a fever, a drop in blood pressure and respiratory problems. Figueroa was diagnosed with bacterial sepsis. The condition was controlled after she was placed on antibiotics.

Within a few weeks, the condition flared up again and was treated again with antibiotics. Thereafter, Figueroa was forced to undergo a third surgery after she suffered internal bleeding. During that surgery Figueroa lost a lot of blood. Kirkwood determined that a pseudoaneurysm had formed at the same site. Figueroa died on August 2 from complications that arose as a result of the Whipple procedure. Figueroa's husband and two daughters filed a lawsuit against the Regents of the University of California and the physicians who treated her.

PLAINTIFF'S CONTENTIONS:
The plaintiffs claimed that the defendants failed to properly diagnose and treat the complications that arose after the decedent underwent the Whipple procedure. Through an infectious disease expert, the plaintiffs claimed that cultures from the fluid that had been drained during the plaintiff's second surgery should have been tested. Those cultures would have indicated the existence of a localized bacterial infection caused by an abdominal abscess. The pseudoaneurysm was the end result. Further, the decision to stop the administration of antibiotics caused another infection due to peritoneal soilage. When the second surgery was performed, the decedent's condition had reached a point where the antibiotics were no longer effective.

The plaintiff's contentions were supported by the decedent's autopsy which confirmed that she suffered from an infection for a long period of time.

DEFENDANT'S CONTENTIONS:
The defense claimed that defendant Kirkwood responded properly and did not act negligently in the manner she treated the decedent. Initial changes in the decedent's condition hours after her surgery were not necessarily attributable to, or indicative of an infection. Rather, the response could have been a reactive response to the existence of the fluid enzymes.

The defendants' experts contended that had an infection existed, it would have been discovered during the decedent's surgeries. None of the reports detailing the surgeries indicated evidence of an infection. The experts took the position that the infection was caused by bacteria that had traveled from the colon after the decedent's second surgery was performed. Defense experts further contended that lack of drainage where the leak occurred at the point the pancreas and small intestines connected was the cause of the pseudoaneurysm. The leak was unusual and hard to control because it began hours after the surgery was completed. The experts claimed that such leaks usually take more time to mature and when they do they are easier to control because scar tissue forms, containing the leak.

Settlement Discussions

The plaintiff demanded $450,000.

Damages

The decedent's death significantly affected her family's financial status. As a result, the plaintiffs sought $1,404,258. They also sought $250,000 in general damages and $872,870 for loss of household services.

Result

Defense verdict.

Deliberation

3.5 hours

Poll

12-0

Length

10 days