Defense Verdict In New York County
Following two weeks of trial, HPM&B obtained a unanimous defense verdict in New York County Supreme Court in a wrongful death case brought by the estate of a local nephrologist against a urological surgeon.
Plaintiff’s counsel claimed that during a Retroperitoneal Lymph Node Dissection (RPLND) to address Transitional Cell Carcinoma of the upper urinary tract, the urologist negligently transected the right renal artery supplying the patient’s only remaining kidney, causing acute blood loss of 2,500 cc’s or one-half of the patient’s blood volume. The patient was a 61 year old nephrologist who died of a massive myocardial infarction two days after this surgical complication.
Plaintiffs alleged that the surgical incision was improper, the renal artery should have been identified and protected and the fact the right renal artery was found to be 75% transected by the vascular surgeon called in to perform an emergency repair proved that our client had “lost control” of the surgical field and carelessly caused this complication which resulted in massive blood loss and plaintiff’s death. Plaintiffs claimed that the patient’s cancer was cured by prior surgery and chemotherapy and sought over $1 million in damages on behalf of his surviving spouse and two daughters
Representing the surgeon at trial, HPM&B senior partner Charles L. Bach, Jr. argued that the patient had already undergone a left nephroureterectomy with the removal of 21 lymph nodes in the paraaortic region and he was diagnosed with a rare, aggressive cancer. Performed seven months earlier, that surgery caused a great deal of fibrosis or scar tissue and the subsequent administration of chemotherapy created additional adhesions in the retroperitoneal lymph node area distorting tissue planes and obscuring blood vessels. The RPLND was an experimental, high risk procedure approved by the Tumor Board of the Medical Center because it has produced good results in patients with TCC of the bladder.
The urologist who performed the initial surgery removing this patient’s left kidney, ureter and lymph nodes attempted to perform this RPLND laparoscopically but he couldn’t move the colon out of the way secondary to adhesions. The defendant urologist and his team performed a midline incision and painstaking dissected around the great vessels to remove paraaortic, periaortic and interaortocaval lymph nodes. Unfortunately, the right renal artery could not be identified secondary to adhesions and the dermoplastic affect of chemotherapy but the lead surgeon recognized the vascular injury immediately and called for vascular assistance. It was demonstrated that the large blood loss was addressed with blood and volume replacement, the patient’s right renal artery was successfully repaired with a graft and the patient was stable after surgery. It was further proven at trial that this patient failed to disclose a significant cardiac history and that he was improperly cleared for this surgery by his own internist.
Mr. Bach successfully proved that a transection of the renal artery was a known and unpreventable complication of this post chemotherapy RPLND, that the complication was promptly recognized, timely addressed and the patient’s right kidney was producing urine. By calling as witnesses one of the foremost urological surgeons in post-chemo RPLNDs, an expert in cardiology and the patient’s treating urologist, Mr. Bach convinced the jury that the plaintiff’s wrongful death claims lacked merit. On June 11, 2013, a defense verdict was returned following twenty minutes of deliberations.