Bell v. Mt. Sinai Medical Center

643 N.E.2d 151, 95 Ohio App. 3d 590, 1994 Ohio App. LEXIS 2389
CourtOhio Court of Appeals
DecidedJune 13, 1994
DocketNo. 63424.
StatusPublished
Cited by13 cases

This text of 643 N.E.2d 151 (Bell v. Mt. Sinai Medical Center) is published on Counsel Stack Legal Research, covering Ohio Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bell v. Mt. Sinai Medical Center, 643 N.E.2d 151, 95 Ohio App. 3d 590, 1994 Ohio App. LEXIS 2389 (Ohio Ct. App. 1994).

Opinion

Harper, Presiding Judge.

Plaintiff-appellant, James A. Bell, Administrator of the Estate of Vivian Bell, instituted this wrongful death action in the Court of Common Pleas of Cuyahoga County on March 31, 1989. Mt. Sinai Medical Center (“Mt. Sinai”), Thomas Santoscoy, M.D., and Terry King, M.D., were named as defendants. Appellant alleged that Drs. Santoscoy and King performed negligently during Mrs. Bell’s coronary bypass surgery at Mt. Sinai, and thereby proximately caused her death.

The case proceeded to trial on March 5, 1991, and the jury began deliberations on March 14, 1991. On March 19, 1991, the jury found in favor of Drs. Santoscoy and King, but was unable to enter a verdict with regard to Mt. Sinai’s liability. The trial court, therefore, entered verdicts in favor of the physicians based upon interrogatory answers, and ordered a new trial on appellant’s claims against Mt. Sinai.

*592 Appellant filed a motion for judgment notwithstanding the verdict or in the alternative for new trial. The trial court overruled the motion on May 9, 1991.

Appellant filed a notice of appeal in this court on May 23, 1991 from the verdicts rendered in favor of defendants-appellees, Drs. Santoscoy and King. We dismissed the appeal pursuant to Civ.R. 54(B) on July 19, 1991.

The new trial on appellant’s claims against Mt. Sinai commenced on November 18, 1991. The jury rendered a verdict in favor of appellant and against Mt. Sinai in the amount of $3,078,000 on November 27, 1991. The trial court denied Mt. Sinai’s motions for new trial and/or a remittitur on February 20, 1992.

Mt. Sinai appealed from the verdict rendered against it on March 10, 1992. 1 Appellant filed a second notice of appeal from the verdicts rendered in favor of Drs. King and Santoscoy on March 18, 1992, the present appeal. 2

I

Mrs. Bell, on September 28, 1987, underwent coronary artery bypass graft (“CABG”) surgery at Mt. Sinai. She was sixty-nine years old. Mrs. Bell’s attending physician and surgeon was Dr. Santoscoy, a board-certified cardiothoracic surgeon. Dr. Santoscoy routinely had a resident in the operating room at Mt. Sinai during the performance of heart surgery. Dr. Scott Comp, a fifth year general surgery resident, assisted in Mrs. Bell’s surgery.

Dr. Comp initiated the surgery by performing a median sternotomy, the operative procedure to open the chest. Residents at Mt. Sinai routinely performed this procedure. After Dr. Comp opened the skin down to the sternum, he used an electric Bovie cauterization device to divide the sternal ligament which lies under the sternum. Dr. Comp burned a hole in Mrs. Bell’s innominate artery while performing the procedure. The innominate artery provides blood to the brain, head, neck and face.

Dr. Santoscoy testified that he was trained to use electric cautery to divide the sternal ligament during the sternotomy. Moreover, Dr. John Kratz, an expert witness for Dr. Santoscoy who is a cardiac surgeon at the Medical University of South Carolina, testified that he trains residents to divide the sternal ligament with electric cautery. He testified further that 99.9 percent of all heart surgeons conceive the use of the electric cautery as the proper way to divide the ligament.

*593 According to Dr. Comp and Dr. Santoscoy, the Bovie cautery was correctly placed at the sternal notch during Mrs. Bell’s surgery. However, only minutes into the surgery, significant bleeding developed, arising from the sternal notch. Drs. Santoscoy and Comp first applied digital compression in order to find the source of the bleeding in an area above the suprasternal notch. Dr. Santoscoy next attempted to repair a hole discovered in the innominate artery with sutures. One-half hour after the surgery began, the bleeding and Mrs. Bell’s blood pressure were under control. Dr. Santoscoy nonetheless found that repairing the innominate artery was not easy; Mrs. Bell was, therefore, placed on bypass 3 at approximately 9:51 a.m. The repair was purportedly completed, and Dr. Santos-coy proceeded with the heart surgery at about 11:00 a.m.

Mrs. Bell was taken off bypass and Dr. Santoscoy observed that the innominate artery was oozing blood and appeared stenotic or obstructed. He called in Dr. King, a board-certified vascular surgeon.

Dr. Santoscoy and Dr. King decided that the best method to repair Mrs. Bell’s innominate artery was to use a patch on the artery. They used a partial occluding clamp to close off the artery to effectuate the repair. Dr. Santoscoy and Dr. Comp continued with the heart surgery after the repair.

Mrs. Bell was taken to the recovery room and her blood pressure was stable. Dr. Santoscoy inspected her eyes and found the right eye to be large and fixed. He related to Mrs. Bell’s family that she suffered a stroke as a result of the surgery. Mrs. Bell never regained consciousness and she died on October 6, 1987.

Appellant presented Dr. Sheldon Burman, a board-certified cardiothoracic surgeon from Chicago, as his expert witness. Dr. Burman testified that burning a hole in the innominate artery amounted to a failure to adhere to acceptable standards of care on behalf of Mt. Sinai and Drs. Santoscoy and King through the actions of Dr. Comp. This failure to adhere to acceptable standards contributed to Mrs. Bell’s death. Dr. Burman was also critical of Dr. Santoscoy’s initial suture repair attempts without placing Mrs. Bell on bypass. With regard to the clamping of the innominate artery during the patch repair, he opined that the artery should not have been totally occluded; rather, a shunt 4 should have been used to preserve circulation. Since Mrs. Bell’s artery was clamped, her brain was deprived of blood and oxygen, according to the doctor.

*594 At the time of trial, Dr. Burman, however, had not performed either a median sternotomy or any cardiothoracic surgery in ten years. His area of practice was currently limited to penile revascularization. Additionally, Dr. Burman never performed an innominate artery repair.

John Hower, M.D., a vascular surgeon, and John Kratz, M.D., a cardiothoracic surgeon, were called as expert witnesses for the defense. Both testified that the innominate artery was abnormally positioned in Mrs. Bell. Specifically, Dr. Kratz testified that in patients who suffer from cardiovascular disease and have had longstanding hypertension, such as Mrs. Bell, arteries may become elongated and buckle as a result of these conditions. In this case, Mrs. Bell’s artery buckled underneath her sternum, and according to Drs. Hower and Kratz, its position led to the injury. Dr. Hower, therefore, testified that Dr. Comp met acceptable standards of care in performing the sternotomy, and Dr. Kratz testified that all of the physicians involved in the surgery met accepted standards of care.

Dr. Norman Hertzer, a board-certified surgeon, joined in the opinion that Mrs. Bell’s innominate artery was abnormally placed, while testifying as an expert witness for Dr. King. Regarding the repair procedure, Dr.

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Bluebook (online)
643 N.E.2d 151, 95 Ohio App. 3d 590, 1994 Ohio App. LEXIS 2389, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bell-v-mt-sinai-medical-center-ohioctapp-1994.