Fanguy v. Patwardhan

136 So. 3d 998, 2014 WL 1386306, 2014 La. App. LEXIS 983
CourtLouisiana Court of Appeal
DecidedApril 9, 2014
DocketNo. 48,773-CA
StatusPublished
Cited by3 cases

This text of 136 So. 3d 998 (Fanguy v. Patwardhan) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Fanguy v. Patwardhan, 136 So. 3d 998, 2014 WL 1386306, 2014 La. App. LEXIS 983 (La. Ct. App. 2014).

Opinion

WILLIAMS, J.

pin this medical malpractice action, the trial court rendered a judgment, in accordance with the jury’s verdict, in favor of defendant, Dr. Ravish V. Patwardhan. The court also denied a motion for a judgment notwithstanding the verdict (“JNOV”), or in the alternative, a new trial, filed by plaintiff, Robin Fanguy. For the following reasons, we affirm.

FACTS

On May 22, 2007, Robin Fanguy, presented to defendant, Dr. Ravish V. Pat-wardhan, a neurosurgeon, for treatment. Ms. Fanguy, who had been referred to Dr. Patwardhan by her primary physician, Dr. Carl Hines, complained of low back pain, numbness, pain and tingling in her left leg and pain in her left hip.1 A subsequent MRI revealed a dessication of the disc at L5-S1; a discogram revealed concordant back pain at L4-5 and L5-S1. As a result of the radiological findings, Dr. Patwar-dhan recommended that Ms. Fanguy undergo a two-level transforaminal lumbar interbody fusion (“TLIF”) at L4-5 and L5-S1.

Dr. Patwardhan performed the TLIF on July 9, 2007. According to Dr. Patwar-dhan’s testimony, throughout the surgery, he monitored Ms. Fanguy’s electromyo-graphic (“EMG”) status and he performed the surgery with the use of a fluoroscope. In his postoperative dictation, Dr. Patwar-dhan stated that the rods, screws and cages were properly placed. Dr. Patwar-dhan also testified that he verified the placement of the hardware via fluoroscopy during the surgery; however, he did not print any fluoroscopic images and 12did not obtain postoperative radiographic studies.

On July 24, 2007, Ms. Fanguy returned to Dr. Patwardhan’s office for her first postoperative examination. She reported that she continued to experience back pain. Again, Dr. Patwardhan did not obtain any radiographic studies. Instead, he assured Ms. Fanguy that postoperative pain and inflammation were common and instructed her to continue to take her medication.

Thereafter, on August 28, 2007, Ms. Fanguy called Dr. Patwardhan’s office and reported pain in her left hip. Dr. Patwardhan referred her to Dr. Cambize Shahrdar, an orthopaedic surgeon, who evaluated her on September 21, 2007, and February 5, 2008.2 Dr. Patwardhan did not schedule any appointments with Ms. Fanguy between August 2007 and February 2008. He testified that he instructed her “to call me if there was a problem. She never called me saying there was a new problem[.]”

On February 12, 2008, Ms. Fanguy returned to Dr. Patwardhan’s office, complaining of low back pain radiating into her left leg, numbness and tingling in her left [1001]*1001leg and “constant pain in [her left] leg [and left] foot.” Dr. Patwardhan ordered x-rays, which revealed that one of the cages he had inserted during the TLIF was displaced. He opted to treat Ms. Fanguy conservatively and referred her to a pain management specialist.

On March 20, 2008, Ms. Fanguy was evaluated by Dr. Rebecca Posner, a pain specialist. During this visit, Ms. Fanguy reported numbness, tingling and weakness in her left leg. Thereafter, she was referred to Dr. |sMilan Mody, an orthopaedic spine specialist.

Dr. Mody evaluated Ms. Fanguy on April 16, 2008. According to the records from that visit, Ms. Fanguy reported that she had fallen from a ladder at home. Dr. Mody ordered x-rays which revealed that the spacers that had been inserted by Dr. Patwardhan were protruding posteriorly into Ms. Fanguy’s spinal canal. Initially, Dr. Mody opted to treat Ms. Fanguy conservatively; he ordered a nerve conduction study and CT myleogram and instructed Ms. Fanguy to perform home exercises. On June 12, 2008, Ms. Fanguy returned to Dr. Mody with continued complaints of back pain. Dr. Mody recommended a revision of the TLIF.

On June 24, 2008, Ms. Fanguy obtained a second opinion from Dr. Euby Kerr, an orthopaedic spine surgeon. Dr. Kerr reviewed the x-rays and opined that the cage Dr. Patwardhan had inserted at L4-5 was compressing Ms. Fanguy’s L5 nerve root. After unsuccessfully treating Ms. Fanguy conservatively, Dr. Kerr performed a revi-

sion of the TLIF on September 8, 2008. Thereafter, Ms. Fanguy reported to Dr. Kerr that her condition had improved and she only experienced minor complaints of numbness and tingling in her left leg and foot.3

On October 30, 2008, Ms. Fanguy filed a complaint against Dr. Patwardhan with the Patient’s Compensation Fund, and a medical review panel was convened. The panel concluded that Dr. Patwardhan failed to meet the applicable standard of care in providing postoperative care to Ms. Fan-guy and that the failure “was a factor in reducing the patient’s chance for |4a better outcome.”4 The panel stated:

Dr. Patwardhan made a contemporaneous statement at the time of [the] procedure that the rods, screws and cages were properly placed. There is no objective evidence to establish that they were not properly placed. Displacement of the cages is a known risk following this procedure, although the risk is relatively low.
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The standard of care required that x-rays should have been done immediately following the procedure and at the time of her follow-up visit, but certainly sooner than February 12, 2008, for this patient. The follow-up care and failure to obtain these x-rays was a breach of the applicable standard of care.
The delay in follow-up treatment and addressing the displaced cage was a factor in reducing the patient’s chance for a better outcome.

[1002]*1002On June 22, 2011, Ms. Fanguy filed this lawsuit against Dr. Patwardhan, alleging that his conduct caused her to sustain “extensive nerve damage — causing partial (yet permanent) paralyzation, and intense permanent pain[J” She also alleged that her condition was “gravely aggravated” by Dr. Patwardhan’s “failure to perform the necessary and expected follow-up treatment dictated by the applicable postoperative standard of care[.]”

A jury trial was held on January 28-February 1, 2013, during which Ms. Fanguy, Dr. Patwardhan and numerous medical experts testified. Ms. Fanguy’s voluminous medical records were also introduced into evidence.

Ms. Fanguy testified at trial as follows: she began experiencing “back ^problems” in 2001, and they gradually worsened; Dr. Hines began treating her for back pain in 2006; initial treatment was unsuccessful; eventually, Dr. Hines referred her to Dr. Patwardhan, who obtained multiple diagnostic tests before informing her that surgery was her “only option”; after surgery, the pain in her back was “worse than before”; she told Dr. Patwardhan about her pain, and he advised her that the pain was caused by inflammation and would improve “over time”; on her first postoperative follow-up visit, she informed Dr. Patwardhan she was “still in intense pain”; Dr. Patwardhan told her the pain was related to the surgery and would improve; between September 2007 and February 2008, she made multiple telephone calls to Dr. Patwardhan’s office with complaints of pain; Dr. Patwardhan’s nurse attributed her pain to inflammation and instructed her to continue taking her pain medications; she asked Dr. Patwardhan to order x-rays; he instructed her to remain on bed rest, take her medication and follow up with her pain management doctor; at the February 2008 visit to Dr.

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Bluebook (online)
136 So. 3d 998, 2014 WL 1386306, 2014 La. App. LEXIS 983, Counsel Stack Legal Research, https://law.counselstack.com/opinion/fanguy-v-patwardhan-lactapp-2014.