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Man died during heart surgery – Defense Verdict

Virginia Lawyers Weekly//April 23, 2018

Man died during heart surgery – Defense Verdict

Virginia Lawyers Weekly//April 23, 2018

William Johnson, age 51, had longstanding cardiac arrhythmia resulting in cardiomyopathy and a severely reduced ejection fraction (29 percent). In February 2015, he underwent an endocardial ablation procedure in an attempt to cure the arrhythmias. The procedure failed. On March 5, 2015, he underwent a more invasive and risky epicardial ablation, which involves ablating (or burning) the outside of the heart in an attempt to stop the arrhythmias. During the four-hour-plus procedure, the electrophysiologists placed multiple wires, sheaths and catheters into and around his heart. The right ventricle was punctured during the surgery; however, there was no clinical sign of the injury because  Johnson’s blood pressure remained stable during surgery and an echocardiogram, which ran continuously during surgery, showed no sign of a bleed. After the electrophysiologists removed all of their catheters and sheaths,  Johnson became hypotensive. The defendant anesthesia team addressed the hypotension with medications and fluids, extubated  Johnson, and transported him to the Cardiac Care Unit, conversing with  Johnson during transport.  Johnson remained hypotensive in the CCU, so anesthesia obtained a bedside echocardiogram, which revealed a pericardial effusion (fluid around the heart).  Johnson was promptly returned to the Electrophysiology Lab where the fluid compressing his heart was drained. He arrested soon thereafter, underwent surgery to suture the hole in his heart that same day, but he never regained consciousness and died four days later.  Johnson’s widow sued the anesthesia providers alleging that they failed to timely recognize that his post-operative hypotension was due to a pericardial effusion, and their delay in diagnosing same caused his premature wrongful death. Plaintiff asked the jury in opening statement and closing argument for an award of $7 million.

The defendants claimed that it was reasonable to suspect other causes of Johnson’s hypotension, rather than pericardial effusion, because there had been no clinical evidence of pericardial effusion during the surgery. All of the experts agreed that if the heart is punctured during a procedure, which is what happened here, one sees low blood pressure and bleeding on the echocardiogram intraoperatively. That never happened with  Johnson. Plaintiff claimed that Johnson’s wife suffers from post-traumatic stress disorder, complex bereavement disorder and depression from the sudden death of her husband, and called the defense case nothing more than trickery and deception.

After six days of evidence, the jury returned a defense verdict in 30 minutes.


Type of action: Medical Malpractice/Wrongful Death

Injuries alleged: Death of 51-year-old husband of 19 years and father of two sons

Name of case: Rhonda Johnson, Administrator of the Estate of William Johnson v. Anesthesiologist and CRNA

Court: Fairfax Circuit Court

Case no.: CL 2016-16113

Tried before: Jury

Name of judge or mediator: Judge Brett Kassabian

Date resolved: Jan. 31, 2018

Special damages: $1,958,041 – $2,310,776 in lost wages; $526,264 – $808,252 in lost retirement benefits; $453,261 in lost household services

Demand: $7,000,000.00

Verdict or settlement: Defense Verdict

Attorneys for defendant: Byron J. Mitchell and Jodi B. Simopoulos, Fredericksburg

Attorneys for plaintiff: Laurie Amell and Andrew Waghorn, Washington, D.C.

Defendant’s experts: David Metro, M.D. – anesthesia (Pittsburgh); Bruce Spiess, M.D. – anesthesia (Florida); Peter Mofrad, MD – electrophysiology (Maryland)

Plaintiff’s experts: James Pepple, MD – anesthesiologist (Baltimore); Ronald Pearl, MD – Anesthesiologist (Stanford); David Martin, MD – electrophysiologist (Boston); Nils Guttenplan, MD – electrophysiologist (New York); Ceres Artico, Ph.D. – psychotherapist (Gainesville, Va); Colin Linsley, Ph.D. – economist (Washington, DC)

Insurance carrier: Coverys

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