Case details
Bile duct injury occurred in absence of negligence: surgeon
SUMMARY
$0
Amount
Verdict-Defendant
Result type
Not present
Ruling
KEYWORDS
bile duct, daily pain, pain
FACTS
On Jan. 14, 2014, plaintiff Margarita Romo, a housewife, underwent gallbladder surgery by Dr. Sebastiano Cassaro, a surgeon, at Kaweah Delta Hospital, in Visalia. Romo previously presented to the emergency room of Kaweah Delta Hospital on the night of Jan. 10, 2014, with complaints of right, upper quadrant pain. The emergency room work-up included an ultrasound of the abdomen, which documented the presence of gallstones. An endoscopic retrograde cholangiopancreatography was subsequently performed on Jan. 12, 2014, which removed the gallstones from the common bile duct and sludge from the same anatomical region. Cassaro was consulted, and he recommended that Romo undergo gallbladder surgery. Romo was informed about the risks of the surgery — which included bleeding, infection, and possible unintended injury to the biliary tree — and she consented to the procedure. She then underwent surgery on Jan. 14, 2014. The procedure was performed with a laparoscopic approach. However, significant scar tissue and an inflammatory reaction in the involved area caused Cassaro to be unable to visualize the normal landmarks, and he was unable to see the “triangle of Calot” or achieve the “critical zone of safety” view. As a result, Cassaro elected to convert the procedure to an open laparotomy and upon making the surgical incision, he observed the presence of bile fluid. Dr. Victoria Gerken was called into the operating room to assist Cassaro at that point and, intraoperatively, the fluid was traced back to the common bile duct, which was nearly transected. Cassaro then performed a choledochojejunostomy, which successfully repaired the unintended common bile duct injury. The T-tube was to be removed in the spring of 2014, approximately three months after the surgery, but Romo became pregnant and the tube was left in place until July 2014 in order to avoid radiation from X-rays to the developing fetus. As a result, Romo delivered a healthy seventh child in 2015. Romo sued Kaweah Delta Medical Center, Cassaro, and Gerken. Romo alleged that the defendants failed to properly perform the surgery and that this failure constituted medical malpractice. Gerken and Kaweah Delta Medical Center were ultimately dismissed prior to trial for waivers of costs. Thus, the matter proceeded to trial against Cassaro only. Plaintiff’s counsel contended that Cassaro cut the common bile duct without positively confirming, prior to any dissection, what was being cut. Thus, counsel argued that Cassaro’s surgical technique was below the standard of care. Romo did not dispute that, before the surgery was performed, she consented to permitting Cassaro to convert the surgery to an open procedure, if it became necessary to do so. Cassaro maintained that nothing was cut during the procedure and that no sharp instrumentation was used by him. Thus, he contended that the injury to the common bile duct occurred during the blunt dissection portion of the procedure, during which he was attempting to separate and divide scar tissue in order to reach a position where he could, hopefully, visualize the biliary tree and conclude the surgery via laparoscopy., Romo’s common bile duct was nearly transected during the gallbladder surgery. As a result, the procedure was converted to an open laparotomy and a choledochojejunostomy was performed. The common bile duct injury was successfully repaired and a T-tube was left in place in order to reduce the potential for a stricture problem. Romo was then discharged on Jan. 26, 2014, in good condition. The T-tube was to be removed in the spring of 2014, approximately three months after the surgery, but Romo became pregnant and the tube was left in place until July 2014 in order to avoid radiation from X-rays to the developing fetus. As a result, Romo delivered a healthy seventh child in 2015. Romo maintained that she suffers daily pain ever since the Jan. 14, 2014 surgery was carried out. She claimed that because her pain complaints are so severe, she has gone from a “happy-go-lucky”, “life of the party” type individual to a sullen, non-social type and that her life has been profoundly changed because of her complication. Romo elected to waive special damages and asked the jury to award $495,000. Romo’s husband, Gustavo Romo, 37, a dairyman, discontinued his derivative claim prior to trial.
COURT
Superior Court of Tulare County, Tulare, CA
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INJURIES:
- anxiety
- brain
- brain damage
- brain injury
- cognition
- depression
- epidural
- extradural hematoma
- face
- facial bone
- fracture
- head
- headaches
- hearing
- impairment
- insomnia
- loss of
- mental
- nose
- psychological
- scapula
- sensory
- shoulder
- skull
- speech
- subdural hematoma
- tinnitus
- traumatic brain injury
- vision
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