Verdicts & News

Unanimous Defense Verdict in New York after COVID-19 Mistrial

May 16, 2022

Jury rejects allegations that anesthesiologist failed to properly monitor patient and delayed resuscitation.

Overland Park, Kansas – May 16, 2022 – Preferred Physicians Medical (PPM), industry-leading provider of professional liability insurance for anesthesia practices, announced that a jury in Orange County, New York, returned a unanimous defense verdict in favor of an anesthesiologist and practice group insured by PPM. The case previously proceeded to trial in March 2020, but the judge ordered a mistrial after 2 weeks of testimony due to the COVID-19 pandemic.

A 36-year-old male presented to an ambulatory surgery center for pars plana vitrectomy. A PPM insured anesthesiologist provided MAC with sedation for the procedure. The patient had a history of diabetes, hypertension, hypercholesterolemia, chronic kidney disease, ischemic cardiomyopathy, coronary artery disease, peripheral artery disease, and lower extremity neuropathy. Ten months before the procedure, he suffered a myocardial infarction as the result of a LAD coronary artery occlusion, and two cardiac stents were placed.

The patient received supplemental oxygen and 150 mg of propofol, which was titrated slowly. Shortly after the ophthalmologist performed a peribulbar block and inserted a canula in the eye, the patient became bradycardic and hypotensive. The anesthesiologist promptly instructed the surgeon to stop the procedure, the drapes were removed, atropine and epinephrine were administered, and the patient was ventilated with a bag-mask. The patient became apneic, and a code blue was called. The anesthesiologist intubated the patient while another provider performed chest compressions. The patient developed PEA, and the code team administered 2 additional amps of epinephrine and atropine. Approximately eight minutes after the code was called, the patient’s blood pressure, circulation, and spontaneous respiration were restored. The patient was transferred by EMS to an adjacent hospital.

Unfortunately, the patient was subsequently diagnosed with anoxic encephalopathy. After a 3-week admission, the patient was transferred from the hospital to a rehabilitation facility, where he resided for 15 weeks. The patient was then discharged home. He ultimately passed away approximately 4 years later. From the date of the procedure until his death, the patient never regained the ability to ambulate, speak, or perform daily functions.

The patient’s mother brought professional negligence and wrongful death actions on behalf of the estate against the facility, the anesthesiologist, and the anesthesia practice group. The plaintiff alleged that the anesthesiologist caused the patient’s injury by failing to properly monitor his ventilation during the procedure and neglecting to respond to the crisis in a timely manner.

Plaintiff’s anesthesiology expert, Sheldon Deluty, MD, of Englewood, New Jersey, testified that the 100% oxygen saturation recorded by the anesthesiologist was inconsistent with a hypoxic brain injury and incompatible with the patient’s outcome, and therefore, the anesthesia record was inaccurate. Dr. Deluty deduced the anesthesiologist did not properly monitor the patient’s ventilation, and that the patient’s heart became oxygen deprived, resulting in bradycardia and then PEA. Dr. Deluty further surmised the anesthesiologist did not administer rescue medications or intubate the patient until 3 minutes after the code was called. In forming his opinion, Dr. Deluty relied upon inconsistencies in the documentation, particularly regarding the handwritten times entered in the anesthesia record and the code sheet.

On cross-examination, Dr. Deluty was forced to acknowledge there are other causes of bradycardia besides oxygen deprivation, and that he had no objective evidence to support his assertion that the anesthesia record was inaccurate.

The defense anesthesiology expert testified the anesthesiologist recognized the patient’s deteriorating vitals in a timely manner, and that appropriate measures were taken in response to the patient’s falling blood pressure and diminished respirations. He strongly disagreed with Dr. Deluty’s opinion that the anesthesia record was incompatible with the patient’s outcome. He explained that a patient who is properly ventilated can still experience a hypoxic brain injury if the heart is not circulating oxygenated blood to the brain. The patient’s history of vascular disease and poor cardiac function further complicated the issue. The anesthesiology expert offered his opinion that the patient’s apnea was preceded by bradycardia. This was likely triggered by the surgeon’s block, which was a known risk of the procedure.

During closing arguments, plaintiff’s attorney asked the jury to award $5,000,000 for pain and suffering and $1,000,000 to compensate the patient’s son for loss of parental guidance. The jury deliberated for less than three hours before returning a 6-0 defense verdict in favor of the anesthesiologist, the anesthesia group, and the co-defendant facility.

Bruce Brady, Esq. of Koster, Brady, Nagler, LLP, New York, New York, represented PPM’s insureds. Paul Lefebvre, Senior Claims Attorney, managed the file on behalf of PPM.

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