Case details

Defense: Decedent adequately assessed before operation





Result type

Not present

anoxia, arterial, blood loss, brain, death, innominate artery, pulmonary, respiratory, vascular
On Sept. 5, 2017, plaintiff’s decedent Rolph Mosley, 48, underwent a complex neck surgery at UCSF Medical Center, in San Francisco. The surgery was performed by Dr. Chase Heaton, an oncological head and neck surgeon, to remove remnants of a cancerous thyroid tumor. Mosley previously underwent a procedure to address his thyroid cancer on July 6, 2017. That surgery was performed by his prior surgeon at John Muir Health Walnut Creek Medical Center. During the surgery, Mosley’s cancer was noted to be present outside of the right lobe and due to there being extra thyroidal extension of the tumor, Mosley’s prior surgeon elected to close Mosley and perform further imaging to better evaluate the extent of the cancerous tumor. The next day, a CT angiogram was performed, and an MRI was done on July 8, 2017. The studies, along with the prior surgeon’s operative report, were sent with Mosley to UCSF Medical Center for further surgical exploration and management, if possible. At UCSF Medical Center, Mosley underwent another MRI, and it was determined that Heaton would perform the neck surgery to remove the remnants of the cancerous thyroid that were left behind. During the surgery, while Heaton was dissecting the tumor away from the carotid artery, a massive bleed occurred. Efforts were made to control the bleeding, and a vascular surgeon and, ultimately, a cardiothoracic surgeon were brought in to the operating room. Mosley was opened up and repaired the bleeding vessel, which was found to be the innominate artery (also known as the brachiocephalic trunk or brachiocephalic artery), which supplies blood to the right arm and the head and neck. Mosley was closed, but it was determined that Mosley had suffered significant blood loss during the procedure. As a result, Mosley suffered an anoxic brain injury due to the decreased blood flow to his brain. He never recovered, and he was removed from life support and died on Sept. 12, 2017. The decedent’s wife, Tammie Mosley, acting individually and as the successor-in-interest to her husband’s estate, sued Heaton; the assistant surgeon, Dr. Jonathan George; and the operator of UCSF Medical Center, The Regents of the University of California. Ms. Mosley alleged that the defendants failed to adequately perform their own tests and failed to consult with the necessary specialists. She also alleged that the defendants’ failures constituted medical malpractice. Plaintiffs’ counsel argued that there was a failure to anticipate any vascular problems during the subject surgery and that a vascular surgeon should have been present from the beginning of the surgery. Counsel contended that the extension of the tumor to the artery was not identified preoperatively and that the imaging studies did not show an invasion of the artery. However, plaintiffs’ counsel argued that the defendants failed to obtain adequate imaging since it was only determined intraoperatively, after the bleed occurred, that the cancer had invaded the outer layer of the innominate artery. The plaintiffs’ expert radiologist opined that the MRI and CT scans did not adequately visualize the artery and that if the scans were done properly, Mosley would have been advised to pursue other treatments to address the cancer. The plaintiffs’ expert vascular surgeon opined that Heaton and George were on notice that the decedent’s tumor went into the chest (mediastinum) preoperatively from the prior surgery at John Muir Health Walnut Creek Medical Center and the MRI and CT scans. The expert opined that the doctors needed to get a proper roadmap before operating, such as a CT scan of the neck and chest, and that the doctors should not have performed the surgery through a neck incision alone, as a median sternotomy was needed. The expert further opined that the doctors should have had a cardiothoracic surgeon in the operating room at the operating table at the time of surgery. Based on the plaintiffs’ experts’ opinions, plaintiffs’ counsel argued that Heaton and George failed to do proper preoperative planning and/or failed to stop the surgery when they found the tumor going down into the chest before the performing a dangerous dissection without proper exposure and vascular control, and creating the exsanguinating hemorrhage. Counsel further argued that the doctors should have anticipated that the innominate artery was weakened and would burst, and had a proper operative approach and that if an injury to the innominate artery occurred, it would have been controllable with adequate exposure and vascular control. Plaintiffs’ counsel argued that if the doctors had done that, Mr. Mosley would still be alive. Defense counsel noted that, prior to the subject surgery, Mr. Mosley was evaluated by Heaton, and another MRI was ordered and obtained at UCSF Medical Center. Counsel also noted that Mosley’s case was presented to the UCSF tumor board. As such, defense counsel argued that Mosley was adequately worked up, but that there was an inability to visualize the arterial invasion of the cancer preoperatively. Counsel also argued that Heaton and George adequately assessed Mosley’s status and that the standard of care did not require a vascular surgeon to be present during the subject procedure. The defense’s radiology expert testified about his interpretation of the imaging, and opined that, while not ideal, it was adequate and did not demonstrate any invasion of the artery. Thus, defense counsel contended that it was a rare complication that led to Mosley’s death., Mr. Mosley suffered significant blood loss during the subject surgery. As a result, he suffered an anoxic brain injury due to the decreased blood flow to his brain. He was eventually taken off life support and died on Sept. 12, 2017. Ms. Mosley, a professor at California State University, East Bay, claimed that her husband was “Mr. Mom” and that he was a wonderful father who took care of his four children. She also testified that he coached football at the local high school and coached his children’s sports teams as well. She further claimed that all of their children were exceptional athletes and that her husband transported them to their games and practices. The plaintiff’s expert economist estimated an income loss for 10 years with an earning capacity of $65,000 per year through the end of Mr. Mosley’s life expectancy. The expert opined that the loss of Mr. Mosley’s income totaled $1,122,063, which included $149,347 for the past loss of income and $972,716 for the future loss of income. The expert also opined that the loss of Mr. Mosley’s household services totaled $420,706, which included $44,063 for the past loss of household services and $376,643 for the future loss of household services. In addition to Mr. Mosley’s loss of earnings and household services, Ms. Mosley, acting on behalf of her husband’s estate, sought recovery of unspecified amounts for the past and future loss of Mr. Mosely’s gifts and/or benefits, and for Mr. Mosely’s funeral and burial expenses. Ms. Mosley, acting individually, also sought recovery of past and future non-economic damages for the loss of Mr. Mosley’s love, companionship, comfort, care, assistance, protection, affection, society and moral support. Plaintiffs’ counsel asked the jury to award $5 million in economic damages and a little over $2 million in non-economic damages. Defense counsel disagreed with the plaintiffs’ alleged economic damages. Specifically, defense counsel noted that there was documented income for one year showing that Mr. Mosley earned $65,000 in 2015, but that there was no other income reported for the three or four years before Mr. Mosley’s death. Counsel also noted that the plaintiff’s expert economist calculated Mr. Mosley’s future income number based on Mr. Mosely obtaining a position with a Major League Baseball team’s baseball manager, which was to start after the football season in 2017, and which Mr. Mosley would be paid $65,000. However, defense counsel noted that the number was confirmed in a phone call that the plaintiff’s expert made to the baseball manager and that Judge Suzanne Bolanos would not allow the expert to testify about the phone call, but allowed the expert to blackboard the number. The defense’s economics expert disagreed with the plaintiffs’ alleged income loss number due to an income history that had a couple of years that were unaccounted for, and ultimately opined that the plaintiffs’ had an income loss of $20,000 per year, which was offset by Mr. Mosely’s personal consumption of household income. Accordingly, the expert opined that there were no economic damages due to Mr. Mosely’s own personal consumption.
Superior Court of San Francisco County, San Francisco, CA

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