Missouri Unanimous Defense Verdict

October 08, 2018

Jury agreed supervising anesthesiologist was not required to be present for leak test.

Overland Park, Kansas – October 8, 2018  Preferred Physicians Medical (PPM), industry-leading provider of professional liability insurance for anesthesia practices, announced that a Cape Girardeau, Missouri jury returned a unanimous defense verdict in favor of PPM’s insured anesthesiologist and his practice group.

A 60-year-old male underwent a laparoscopic sleeve gastrectomy. General anesthesia was provided by a CRNA employed by the hospital. The CRNA was supervised by a PPM insured anesthesiologist. Common practice at this hospital was for the CRNA to place and operate the gastric calibration tube at the direction of the surgeon. During the leak test, the gastric calibration tube balloon ruptured causing an esophageal perforation. The PPM insured anesthesiologist was not in the O.R. during the leak test. A thoracotomy was performed to facilitate the repair of the esophageal perforation. The patient was hospitalized for forty-six days before being discharged.

The patient and his wife filed a lawsuit against PPM’s insured anesthesiologist, his practice group, the hospital employed CRNA, and the hospital. Plaintiffs alleged that the CRNA negligently connected the air supply to the incorrect port of the gastric calibration tube causing injury to the plaintiff. Plaintiffs alleged further that PPM’s insured anesthesiologist and the hospital were negligent for failing to properly train and supervise the CRNA on the use of the gastric calibration tube.

All parties participated in mediation prior to trial. PPM’s insured anesthesiologist and his practice group did not consent to settlement so no monies were offered on their behalf. The hospital did not reach a settlement so the case proceeded to trial.

During trial plaintiffs’ counsel stressed that “Safety Requires Supervision,” and argued that PPM’s insured anesthesiologist and the hospital both failed to supervise the CRNA. Plaintiff’s counsel further argued that all defendants had violated “Patient Safety Rules,” which exist for the safety of everyone and that the violation caused plaintiff’s injuries.

The CRNA testified that she connected the air supply to the correct port of the calibration tube. She demonstrated to the jury that in order for her to connect the air supply to the wrong port she would have needed to force the air supply into a port that did not fit properly. She testified further that a stop cock would need to be turned for the balloon port to allow the air through. Defense counsel argued the CRNA would have needed to make a series of errors with respect to the use of calibration tube and nothing she did caused the patient’s injuries.

Plaintiff’s anesthesiology expert W. Stephen Minore, M.D., Rockford, Illinois testified that all of the defendants fell below the standard of care. He also testified that the leak test was a critical portion of the anesthesia care and that the PPM insured anesthesiologist should have been in the room for the leak test or otherwise ensured that the CRNA was properly trained to perform the procedure.

The anesthesiology expert for PPM’s insured anesthesiologist testified that the anesthesiologist acted appropriately at all times with respect to plaintiff’s care and there was no deviation from the standard of care. The defense expert testified that the leak test is not a critical portion of the anesthesia care and the supervising anesthesiologist was not required to be in the O.R. when the test was performed. He testified further the CRNA was well-trained and competent to place the calibration tube and there was no reason for PPM’s insured anesthesiologist to doubt her skills or experience.

After a five-day trial, plaintiff’s counsel asked the jury to return a verdict in favor of the plaintiffs for $2,500,000. The jury deliberated for approximately three hours before returning a unanimous verdict in favor of PPM’s insured anesthesiologist, his practice group, the hospital and the hospital employed CRNA.

Greg Minana, Esq. and Ashley Rothe, Esq. of Husch Blackwell, LLP, St. Louis, Missouri represented PPM’s insureds. Brian Thomas, Vice President - Risk Management, and Danon Williamson, Claims Attorney, monitored the file on behalf of PPM.

News Archive

3/5/2019 Missouri Unanimous Defense Verdict

Jury rejected contention that CRNA failed to properly recognize and respond to respiratory arrest.

11/21/2018 New York Defense Verdict

Jury rejected theory that medications were contraindicated and caused cardiac arrest.

10/16/2018 Derick George, MD Joins PPM Board of Directors

PPM policyholder appointed new board member.

10/8/2018 Missouri Unanimous Defense Verdict

Jury agreed supervising anesthesiologist was not required to be present for leak test.

7/12/2018 PPM Announces Officer Promotions and Claims Staff Addition

New roles for seasoned staff and an addition to claims department.

6/4/2018 New York Wrongful Death Defense Verdict

Jury agreed the risk of postponing an emergency surgery for a critically ill patient outweighed the risks of proceeding.

2/15/2018 PPM Secures 44th Consecutive Upper Extremity Nerve Damage Verdict

Court recognized upper extremity nerve injuries can occur absent negligence.

1/25/2018 PPM Contributes to ASA Monitor Article

Recent publication of “Distractions in the O.R.”

11/21/2017 Leadership Transitions at PPM

Steve Sanford retires as CEO and joins PPM Board. Wade Willard promoted to COO.

10/19/2017 PPM Conducts 400th Risk Management Seminar

Milestone marks continued commitment to patient safety and risk management.

6/30/2017 PPM Contributes to Special Article Featured in Anesthesia & Analgesia

Recent publication of “Falls From the O.R. or Procedure Table”

6/28/2017 Directed Verdict in Virginia Wrongful Death Trial

Court orders a directed verdict after finding no reasonable jury could reach a decision to the contrary.

3/22/2017 IV Infiltration Burn Case - Arizona Defense Verdict

Jury overcomes sympathy of injuries to minor patient.

2/17/2017 Arizona Wrongful Death Defense Verdict

Jury rejects plaintiffs’ arguments that anesthesiologist’s heroic rescue efforts were negligent.

1/3/2017 NORCAL Mutual Acquires PPM Services

Partnership Expands NORCAL’s National Footprint and PPM’s Anesthesia Brand

12/6/2016 PPM Shareholders Approve Merger with NORCAL Mutual
11/21/2016 PPM Services to be Acquired by NORCAL Mutual

Partnership Expands Anesthesia Leadership for PPM and National Footprint for NORCAL

11/2/2016 PPM Announces Claims Staff Addition

Mr. Danon Williamson joins PPM as Claims Attorney.

10/12/2016 Directed Verdict Granted in New York Fall Injury Trial

Prolific plaintiffs’ expert’s trial testimony fails to meet burden of proof.