Surgical Errors Cause Sacramento Patient’s Death, Part 3 of 10

The following blog entry is written from a defendant’s position as trial approaches. Reviewing this kind of briefing should help potential plaintiffs and clients better understand how parties in personal injury cases present such issues to the court.

It is worth noting that situations similar to those described in this medical malpractice case could just as easily occur at any of the healthcare facilities in the area, such as Kaiser Permanente, U.C. Davis Medical Center, Mercy, Sutter, or any skilled nursing facility.

(Please also note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this wrongful death case and its proceedings.)


Plaintiffs’ decedent, Kim Smith, was admitted to Memorial Medical Center on November 7, 2008, by Dr. Phillip White for replacement of a cardiac-resynchronation implantable defibrillator (CRT-D) pulse generator that had reached the battery’s elective replacement indicator. Insertion of a coronary sinus lead for left-ventricular pacing was also planned. The previously implanted system consisted of a Medtronic Model 7277 InSync Marquis pulse generator, Model 5076 transvenous atrial lead, Model 6947 transvenous right-ventricular lead, and Model 5071 epicardial left-ventricular lead. For more information you are welcome to contact Sacramento personal injury lawyer, Moseley Collins.

On November 8, 2008, Dr. White performed a CRT-D generator replacement (with a Medtronic Model C154DWK Concerto generator), pocket revision, and removal of lipoma. The coronary sinus was cannulated, but no lead was deployed because the target vessels were too small. No complications were noted. Postoperatively, Ms. Smith did not exhibit any signs or symptoms of infection. She was discharged home on November 10, 2008.

Subsequent to her discharge from Memorial Medical Center, Ms. Smith was seen in office for a follow-up by her general practitioner, Dr. Hernandez. On November 15, 2008, Dr. Hernandez diagnosed Ms. Smith with left chest wall wound infection and prescribed her Rocephin and Keflex. Dr. Hernandez continued to follow Ms. Smith in his office on November 18, November 25, November 27, November 30, and December 7, 2008. On December 20, 2008, Ms. Smith presented to the Emergency Room at Memorial Medical Center with complaints of redness and pain at the site of the CRT-D pulse generator. She was diagnosed with an infected CRT-D pocket and cellulitis.

On December 22, 2008, wound culture results showed that Ms. Smith suffered from a Pseudomonas infection. She was placed on antibiotics and discharged with a plan to be admitted to University Memorial Hospital in one week for CRT-D removal and replacement of the transvenous components of her CRT-D system, including pulse generator, atrial lead, and right-ventricular leads. Ms. Smith was admitted to University Memorial Hospital on January 19, 2009 for explant of the infected CRT-D system. Surgery was performed that day by Dr. David Hall, Dr. Stephen Lee, Dr. Robert Jones, and Dr. Melinda Li. Representatives from Spectranetics and Medtronic corporations were present at surgery for technical support. During the procedure, Ms. Smith developed hypotension refractory to epinephrine. A sternotomy revealed right hemothorax. Exploration revealed extensive injury to the right subclavian vein, innominate vein and the superior vena cava. The surgeons were unable to control the bleeding, rapid infusion of blood and fluids and other resuscitation efforts failed to keep up with her blood loss, and Ms. Smith was pronounced dead at or about 1603 hours on January 19, 2009. (See Part 4 of 10.)

For more information you are welcome to contact Sacramento personal injury lawyer, Moseley Collins.

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