Case details
Surgeon claimed surgical technique was appropriate
SUMMARY
$0
Amount
Verdict-Defendant
Result type
Not present
Ruling
KEYWORDS
bile duct, diarrhea, digestive, disfigurement, gastrointestinal, nia, scar, ventral
FACTS
On June 2, 2014, plaintiff Sharrell Castro, 32, an auto detailer, underwent a laparoscopic cholecystectomy (gallbladder removal) in the outpatient surgery unit of San Joaquin General Hospital, in French Camp., after having severe abdominal pain and a pre-operative workup that confirmed the presence of gallstones and an inflammation of the gallbladder. The operative report prepared by the surgeon, Dr. Jorge Enriquez-Diaz, indicated that the procedure was uneventful and that the total surgical time was 38 minutes. Castro was then discharged home. Castro presented to the emergency room of Bakersfield Memorial Hospital, in Bakersfield later that day with severe pain. Further workup using a CT scan and a HIDA scan (a scan that produces images of the liver, gallbladder, biliary tract and small intestine) documented a biliary leak. As a result, Enriquez-Diaz was concerned about the possibility of a trocar injury to the large bowel. An exploratory laparotomy was carried out by Enriquez-Diaz at Bakersfield Memorial Hospital on June 3, 2014, but no bowel injury was found, although biliary leaks were seen and sutured. Thereafter, Castro was transferred by ambulance to Keck Hospital of University of Southern California, in Los Angeles, on June 5, 2014, where she remained hospitalized until June 18, 2014. Prior to her discharge, on June 12, 2014, Castro underwent a Roux-en-Y hepaticojejunostomy, which is currently considered the definitive treatment for iatrogenic bile duct , and the procedure was successful. However, during the course of the surgery, it was discovered that approximately three clips were placed on Castro’s common bile duct. Castro sued Enriquez-Diaz, alleging that Enriquez-Diaz was negligent in the performance of the laparoscopic cholecystectomy and that this negligence constituted medical malpractice. Plaintiff’s counsel contended that Enriquez-Diaz failed to meet the standard of care in terms of the surgical technique utilized by him during the June 2, 2014 surgery. Specifically, counsel argued that the critical view of safety could not have been achieved by Enriquez-Diaz, thereby permitting misidentification and confusion, unknown to him at the time, which caused him to operate on the common bile duct rather than the cystic duct. Plaintiff’s counsel further argued that Enriquez-Diaz caused direct injury to the common hepatic duct, thereby proving that he had failed to use the surgical skill required by the standard of care. Enriquez-Diaz claimed that he has performed approximately 5,000 gallbladder procedures in his career and that the surgical technique employed by him for the subject surgery was substantially identical to his other cases. He also claimed that some form of unappreciated anatomic variation had to have existed, inasmuch as he did not knowingly operate on the wrong duct or fail to follow established surgical dissection principles geared to avoiding the very type of injury that occurred., Castro underwent a Roux-en-Y hepaticojejunostomy, during which it was discovered that approximately three clips were placed on her common bile duct. She remained hospitalized at Keck Hospital of University of Southern California, in Los Angeles, until June 18, 2014. Following some brief outpatient care, Castro was released from further care at USC and told to only return on an as-needed basis in late July 2014. However, in September 2015, Castro was found to have approximately nine ventral hernias and required surgical repair of the hernias utilizing mesh throughout her abdomen. Castro claimed that she underwent multiple surgeries as a result of clips placed on the common bile duct. She also claimed that the surgery caused scar formation and uncontrollable diarrhea, which is frequently seen as a side effect of undergoing a hepaticojejunostomy. Castro withdrew her loss of earnings claim prior to trial, and her Medi-Cal lien of approximately $91,000 had been asserted by the state of California. Plaintiff’s counsel then asked the jury to determine a fair and reasonable damages award without requesting a specific figure.
COURT
Superior Court of Kern County, Kern, CA
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