Sunday, December 1, 2002

Jury Enters Verdict Against Interventional Radiologist for $1.2 Million Dollars Following Negligent Stenting Procedure

The jury found that the defendant, an interventional radiologist, had negligently performed the bilateral iliac stenting procedure at a Morris County hospital on November 14, 1995 The plaintiff had previously undergone a diagnostic arteriogram for evaluation of left lower extremity ischemia, or loss of blood flow, the same day. This demonstrated an irregular moderately severe left common iliac artery stenosis, a left superficial femoral artery occlusion, as well as a moderate right common iliac artery stenosis.

As a result, it was decided by the interventional radiologist that the plaintiff required placement of arterial stents at the level of the bilateral stenoses to improve or reestablish blood flow. Arterial sheaths were then advanced beyond the stenoses. Bilateral balloon expandable stents were then advanced within the sheaths to the level of the stenosis, in what is known as a "kissing balloon" technique. This is a procedure designed to expand both of the iliac arteries at the same time, to avoid having arteriosclerotic plaque pushed over to one side or the other, thereby causing other complications. Without adequately pulling back the sheaths, both balloons were expanded within the sheaths, resulting in a stretching of the sheaths and an immediate obstruction of the blood flow to both lower extremities. This then required emergency aortobifemoral bypass surgery and stent removal by a vascular surgeon.

The emergency surgery required extensive incisions along both femoral arteries and a 29 cm. abdominal incision to below the umbilicus, in order to remove the obstructing stents. Further, to re-establish blood flow, it was necessary for the vascular surgeon to perform a graft from the aorta to the femoral arteries using an artificial Dacron graft.

As a result of the emergency surgery, the plaintiff was required to remain hospitalized for twelve days, with numerous complications, which would not have occurred had the angioplasty/stenting procedure been performed properly as a same day outpatient procedure.

Further, while the plaintiff remained in the hospital, he developed a hospital-borne infection, known as a methycillin resistant staph abscess (MRSA) in his left foot. The infected foot resulted in a substantial loss of tissue, later fractures of the heel from osteomyelitis, (an infection of the bone) all of which required extensive plastic surgery and reconstruction. Ultimately, a large free flap of muscle from the abdomen was grafted onto his foot in order to revascularize the foot, fight off the osteomyelitis infection, and allow it to heal. The free flap graft was covered with split thickness skin grafts obtained from his right thigh and covered the open wound of the left foot. As a result of the deformities to the left lower extremity, the plaintiff became totally disabled from his employment.

The matter was tried over a four week period, and for 18 trial days.

The plaintiff's were represented by Amos Gern, Esq. and John J. Ratkowitz, Esq.
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