On Feb. 18, 2015, plaintiff’s decedent, a 28-year-old male with history of “slipped” laparoscopic gastric band presented to Inova Fairfax Hospital’s emergency department for symptoms consisted with band complications. The patient was worked up by the emergency department staff, had a surgery consult and had a work-up by bariatric surgery service. Despite efforts to deflate the band and alleviate the symptoms, those non-surgical efforts were not successful so a revision/removal surgery was scheduled for Feb. 20, 2015. The patient’s condition was stable throughout the course at the hospital and he was doing well going into surgery. At the time of induction of anesthesia, the patient unexpectedly vomited and aspirated an undetermined amount of gastric content, despite significant efforts of the anesthesiology team. Following the short band removal surgery, the patient was taken to the trauma intensive care unit and received several weeks of care there, but he ultimately did not recover from the sequelae of the aspiration and died from the effects of Acute Respiratory Distress Syndrome.
Plaintiff filed suit against the bariatric surgeon and his practice group, the anesthesiologist and her practice group, and the hospital, alleging failures to properly protect the patient from aspiration and failure to properly respond to the aspiration that occurred. Plaintiff’s experts alleged that the defendant bariatric surgeon breached the standard of care by failing to decompress the patient’s stomach and esophagus via nasogastric tube prior to the induction of anesthesia. Plaintiff’s experts also alleged the same breach against the co-defendant anesthesiologist, but added breaches related to post-aspiration patient management. Defense experts for the surgeon testified that bariatric surgeons working a patient up prior to surgery to remove a laparoscopic gastric band do not place, or have placed, nasogastric tubes to decompress the stomach, because it was not indicated and the risks outweighed the potential benefits. Defense experts also testified that this patient’s dilated esophagus placed the patient at heightened risk for esophageal perforation, which further militated against placing a pre-surgical nasogastric tube.
After an eight-day trial, the jury deliberated for a day and a half and returned a verdict for the defendant bariatric surgeon, but against the co-defendant anesthesiologist.[19-T-008]
Type of action: Medical Malpractice
Injuries alleged: Wrongful Death
Court: Fairfax Circuit Court
Tried before: Jury
Name of judge or mediator: Judge Michael F. Devine
Date resolved: Jan. 23, 2019
Verdict or settlement: Defense Verdict
Attorneys for defendant: Michael E. Olszewski and James N. Knaack, Fairfax
Plaintiff’s experts: Lloyd Stegemann, M.D., bariatric surgery, Corpus Christi, TX; James Maher, M.D., bariatric surgery, Richmond, and James Earls, M.D. radiology, Washington, DC
Insurance carrier: The Doctors Company