Paralyzed teen wins $5M verdict

Thomas Guzzetta’s parents looked all over the country for a surgeon to repair his congenital hollow chest and brought him from Southern California to the Children’s Hospital of the King’s Daughters in Norfolk.

Dr. Donald Nuss had developed a minimally invasive technique there to repair what physicians call pectus excavatum and had trained the surgeons who performed the operation regularly.

The surgery itself was successful, but Guzzetta, who was 16 at the time of the surgery in January 2007, was unable to move his legs when he recovered from the anesthesia.

A jury in Norfolk Circuit Court concluded last month that anesthesiologist David Blakey and his practice group were negligent in allowing Guzzetta’s blood pressure to drop to a dangerous level. The jury awarded him $5 million, the amount requested by plaintiff’s attorneys Lisa P. O’Donnell and Amberley G. Hammer.

The state’s cap on medical malpractice awards will require reduction of that amount to $1.85 million.

Brewster S. Rawls, the Richmond attorney who represented Blakey, said no decision has been made on whether to appeal the verdict.

O’Donnell said Guzzetta and his family had been aware for some time that he suffered from the defect, which involves abnormal growth of the sternum and several ribs.

The surgery can be performed at any time from infancy on, but it is often delayed until the teen years. Guzzetta’s family decided to finally have it done because the condition had become a factor in Guzzetta’s athletic pursuits.

He had competed successfully in swimming, track and football, but the malady was limiting his lung capacity and endurance, O’Donnell said.

The case turned on “a dispute between well-credentialed experts on both sides,” O’Donnell said, with her experts contending that Blakey had given insufficient weight to Guzzetta’s baseline blood pressure while he monitored the patient’s vital signs. During surgery, it is the anesthesiologist’s responsibility to monitor the signs.

Rawls said his experts, including the chairman of the national board that certifies anesthesiologists, testified that the complication that Guzzetta experienced is a very rare event and that the defense experts had “blessed the care in this case” in finding that Blakey had met the standard of care.

O’Donnell’s experts testified that Guzzetta’s paralysis resulted from insufficient blood flow to the spine because of the low blood pressure.

Her experts said the blood pressure could have been elevated to a safe level by injecting more fluids intravenously, providing medication or repositioning Guzzetta during surgery.

Guzzetta spent several months in rehabilitation, the first two at CHKD, and has regained much of the use of his legs. However, he cannot walk long distances or compete athletically. He also has lost the ability to feel pressure and temperature changes in his legs.

His most significant long-term injuries are a neurogenic bladder and bowel, which require him to use a catheter and suppositories. He incurred $320,000 in medical expenses, and O’Donnell presented evidence that his lifetime care will cost $1.1 million.

O’Donnell said Guzzetta was an excellent witness who was unemotional and reflected “a very optimistic personality” despite his injuries.

The defendants made no offer to resolve the case before trial, O’Donnell said. “It’s unfortunate that the case was not negotiated for settlement because [Blakey is] a very well-respected doctor.”

Rawls said he believed the evidence was compelling that Blakey “did everything he should have done.”

That evidence was outweighed, however, “by an immensely sympathetic patient with a lifelong injury,” he said.