Doctor died days after performing procedure, patient died years later
By Catherine Martin
The Daily Record Newswire
ST. LOUIS - After almost 10 years and the deaths of the plaintiff and defendant, a jury ruled that a Saint Louis University doctor was not negligent in a medical procedure that ultimately ended with the patient having part of his leg amputated.
In 2005, James Harris, a then 76-year-old veteran, was taken to the VA hospital with a low heart rate and chest pain. Since he had previously had heart attacks, the VA sent him to Saint Louis University Hospital, where a doctor performed a cardiac catheterization, which involves sticking a needle into the femoral artery and threading a catheter to the heart, said Christine Vaporean, the attorney representing SLU.
The procedure went fine, Vaporean said, but complications with a device used to close the incision caused a blood clot to form, and Harris lost circulation in his foot. Doctors had to amputate his leg below the knee.
Harris filed a suit against the hospital and doctors. The negligence claim was based on the fact that the closure device, called a Duet Pro, came with instructions that said not to use it on a patient with severe peripheral vascular disease, from which Harris had suffered, said Leonard Cervantes, the attorney for Harris' estate. That information was in Harris' records, Cervantes said.
"Our contention was, since the literature said don't use it on a patient who fits that profile, he never should have used it," Cervantes said.
Vaporean argued that the traditional method for closing incisions, manual compression, could have been just as problematic. In manual compression, a doctor or nurse applies pressure on the site until a clot forms, and then the patient has to stay still for four to six hours after the procedure. In this case, she said, the doctor determined the patient might not be able to stay still for that long.
"I argued that there was a good chance no matter what he did, there was going to be a bad outcome for the patient," she said.
The doctor died just a few days after performing the procedure, so Vaporean said she had to argue the case based on medical records and expert testimonies.
Those records, however, don't show any written record from before the procedure that indicated concerns about manual compression, Cervantes said. After the fact, he said the doctor wrote an addendum explaining he didn't use manual compression because he was worried about the patient moving.
Regardless, the jury ruled that the doctor had not been negligent.
"The jury just concluded there was no negligence, that he did the best he could in the situation he was in, and unfortunately it resulted in a bad outcome for patient," Vaporean said.
Cervantes said he doesn't know why the jury reached its verdict. In addition to the decision to use the closing device, Cervantes said the doctor was negligent in the way he used it. He said the directions instruct that the doctor must maintain constant tension on the balloon, which is part of the device. An expert said the doctor didn't, Cervantes said.
"I thought the evidence was pretty strong, in terms of proving negligence," Cervantes said.
Before trial, Cervantes said the plaintiffs had offered $200,000, but Cervantes said he was told there was "no offer" when he mentioned that amount later.
He speculated that one reason the jury ruled for the defense was because Vaporean presented evidence that Harris had had a cardiac catheter done in his other leg two years prior, and the doctor then used a closure device without issue. Cervantes said he didn't think that had any bearing on the safety of its use in 2005.
Cervantes said he plans to file an appeal in the case, which has been going on years even after the death of the doctor and Harris, who died of unrelated causes. Vaporean said the case was held up by procedural delays, including removal to federal court.
Published: Tue, Dec 16, 2014
