Case details

Surgeon: Gallbladder surgery was appropriately performed

SUMMARY

$0

Amount

Verdict-Defendant

Result type

Not present

Ruling
KEYWORDS
bile duct, cardiac, cardiac arrest, death, digestive, gastrointestinal, hepatic, septic shock
FACTS
On Oct. 20, 2015, plaintiffs’ decedent Thomas Ferrill, 84, underwent a laparoscopic cholecystectomy, which involved removal of the gallbladder. The procedure was performed by a general surgeon, Dr. William Davis, at Hoag Memorial Hospital Presbyterian, in Newport Beach. Ferrill was previously admitted to Hoag Memorial Hospital Presbyterian with complaints of nausea and diffuse abdominal pain on Sept. 8, 2015. An abdominal ultrasound confirmed the presence of gallstones, but without significant acute inflammation of the gallbladder. A general surgery consultation was then obtained from Davis, who felt that surgery to remove the gallbladder was not indicated at that time. Ferrill was discharged from the hospital on Sept. 10, 2015. Approximately one month later, on Oct. 12, 2015, Ferrill presented to Davis’ office with persistent abdominal discomfort, which had become more localized to the right, upper quadrant of the abdomen. Davis recommended that Ferrill undergo a laparoscopic cholecystectomy, which was performed by Davis on Oct. 20, 2015. The surgery was uneventful. However, Ferrill returned to Hoag Memorial Hospital Presbyterian five days later, after developing severe pain to the right, upper quadrant of the abdomen that day. Evaluation over the next several days revealed the presence of a bile leak. On the evening of Oct. 28, 2015, Ferrill was returned to surgery, as he became progressively septic. In his operative report, Davis identified a thermal injury and a bifurcation of the common bile duct that extended into the right hepatic duct, resulting in the bile leak. The injury was repaired by Davis during the surgery, but Ferrill suffered a cardiac arrest in the operating room, minutes after the surgery was completed. He was pronounced dead at 12:54 a.m. on Oct. 29, 2015. The decedent’s wife, Stacha Ferrill, and their two adult sons, Timothy Ferrill and Patrick Ferrill, sued Davis, alleging that Davis was negligent in the performance of the initial surgery on Oct. 20, 2015 and that his negligence constituted medical malpractice. The decedent’s sons voluntarily dismissed their claims early on. Thus, Ms. Ferrill was the only plaintiff who continued to trial. Plaintiff’s counsel contended that Davis’ operative report expressly identified the bile leak to be from a thermal injury, which was located at the bifurcation of the common bile duct and extending into the right hepatic duct. Based on the operative report, plaintiff’s counsel contended that Davis burned the bifurcation of the common bile duct and the right hepatic duct during his use of electrocautery during the surgery on Oct. 20, 2015. Counsel argued that there was simply no excuse for that type of injury in an otherwise uncomplicated laparoscopic cholecystectomy with no significant inflammation, scar tissue, adhesions or anatomic anomalies to obscure or distort the anatomy. Counsel also noted that the operative report made no mention of any anatomic anomaly of the bifurcation of the common bile duct or of the right hepatic duct, nor was any such anatomic anomaly mentioned to the family or in an addendum to the operative report when it was signed by the decedent four days after the Oct. 20, 2015 procedure. Thus, plaintiff’s counsel argued that any alleged anatomic anomaly of the bifurcation of the common bile duct and the right hepatic duct was invented by the defense during the course of litigation with no such anomaly ever being documented in any of the medical records in the case. Defense counsel contended that the Oct. 20, 2015 surgery was performed appropriately and within the applicable standard of care and that a thermal bile duct injury is a known, potential risk of the surgery in the absence of negligence. Davis claimed that he only used electrocautery within the gallbladder fossa during the surgery on Oct. 20, 2015 and that the common bile duct and right hepatic duct would not normally be vulnerable to injury from use of the electrocautery in that area of the anatomy. Moreover, he testified that when he returned the decedent to surgery on Oct. 28, 2015, he discovered that the right hepatic duct (not the bifurcation) had sustained a thermal injury due to an anatomic anomaly, which placed the right hepatic duct within the gallbladder fossa. However, Davis noted that the alleged anatomic anomaly had never been previously described in medical literature, and had never otherwise been experienced by him or the expert witness general surgeons. In addition, although Davis testified that he had thought that he had described the anatomic anomaly in his operative report following the second surgery, he was chagrined to discover during the course of the litigation that he had not done so., Thomas Ferrill suffered a thermal injury of the right hepatic duct, and a bifurcation of the common bile duct that extended into the right hepatic duct. (It was disputed as to whether the thermal injury was at the location of the bifurcation or only to the right hepatic duct.) As a result, he suffered a bile leak and became increasingly septic. The bile leak was required during a subsequent surgery, but he suffered a cardiac arrest in the operating room, minutes after the surgery was completed. Ferrill was ultimately pronounced dead at 12:54 a.m. on Oct. 29, 2015. Ferrill, 84, was survived by his wife and his two adult sons. His wife, Stacha Ferrill, claimed that she lost her husband at the point in her life where she needed him the most, as she became afflicted with progressive Alzheimer’s dementia. Thus, she claimed she lost the love of her life, and the comfort and support of spending their final years together. Ms. Ferrill sought recovery of non-economic damages based on her husband’s wrongful death.
COURT
Superior Court of Orange County, Orange, CA

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