Fountain v. Ochsner Clinic Foundation Westbank Campus

194 So. 3d 728, 2015 La.App. 4 Cir. 1048, 2016 WL 2736180, 2016 La. App. LEXIS 905
CourtLouisiana Court of Appeal
DecidedMay 11, 2016
DocketNo. 2015-CA-1048
StatusPublished
Cited by1 cases

This text of 194 So. 3d 728 (Fountain v. Ochsner Clinic Foundation Westbank Campus) 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
Fountain v. Ochsner Clinic Foundation Westbank Campus, 194 So. 3d 728, 2015 La.App. 4 Cir. 1048, 2016 WL 2736180, 2016 La. App. LEXIS 905 (La. Ct. App. 2016).

Opinion

MAX N. TOBIAS, Jr., Judge.

hThe plaintiff, Latanya Fountain, sued the defendant, Dr. Washington Bryan, alleging that he breached the applicable standard of care when he failed to obtain her informed consent to perform a bilateral tubal ligation and ventral hernia repair by laparotomy leaving her with a large, disfiguring abdominal scar.1 Ms. Fountain also alleged that Dr. Bryan’s negligence was the proximate cause of the pain, suffering, and loss of enjoyment of life that she suffered as a result of the disfiguring scar. Following a trial by jury, Dr. Bryan was found liable to Ms. Fountain for damages in the amount of $150,000.00, Thereafter, the trial court denied Dr. Bryan’s motion for judgment notwithstanding the verdict (“JNOV”) from which Dr. Bryan [731]*731has appealed. Finding the jury’s verdict is supported by the record evidence, and ' thus, is neither manifestly erroneous nor clearly wrong, we affirm.

Factual Background and Procedural History

Ms. Fountain first presented to Dr. Bryan, a physician practicing obstetrics and gynecology, for pre-natal care in October 2008, when she was approximately height weeks pregnant. Subsequently, Dr. Bryan delivered Ms. Fountain’s baby naturally on 5 May 2009. . During the course of . her pregnancy, based upon Ms. Fountain’s complaints of significant abdominal pain when full after eating, Dr. Bryan suspected she was suffering from a hernia, but chose not to address the issue at that time due to her pregnancy.

On 2 June 2009, during her six-week post-partum check-up, Ms. Fountain and Dr. Bryan discussed various birth control options, including a tubal • ligation as a means of permanently preventing future pregnancies. At that time, Ms. Fountain signed a state-mandated form consenting to a tubal ligation.2 In a follow-up appointment on 30 June 2009, Ms. Fountain confirmed her desire to undergo the contemplated procedure. During this appointment, Ms. Fountain also complained of continued abdominal pain suggestive of a hernia, which Dr. Bryan advised he could surgically address at the time he performed the tubal ligation; ie., both surgeries could be accomplished in the same surgical setting. In order to confirm the existence of the suspected hernia, Dr. Bryan ordered a CT scan that day.3 Additionally, according to Dr. Bryan, he preliminarily scheduled Ms. Fountain for a “mini laparotomy and ventral hernia repair” at Ochsner Foundation Clinic West-bank Campus (“Ochsner Hospital”) solely for purposes of reserving a firm day to perform the surgical procedures.

| sMs. Fountain returned to Dr. Bryan’s office on 6 August. 2009 for the pre-opera-tive consultation. According to Dr. Bryan, during .this consultation, he explained the different surgical options available in detail to Ms. Fountain and the risks associated with each one. Specifically, Dr. Bryan testified that he presented Ms. Fountain with two options. The first option involved making two separate incisions: one at the site of the lower abdomen near the fallopian tubes to allow tubal ligation by mini laparotomy, and the other at the navel to excise the hernia sac by laparotomy. The second option involved making only one incision at the navel site, where he could use a laparoscope instrument to destroy the fallopian tubes and also through which he could then extract the hernia sac. Having expressed her concerns to him about wanting only one incision, Dr. Bryan testified that he suggested to Ms. Fountain that rather than a laparotomy, he would attempt to perform the surgery laparo-scopically.4

[732]*732Based on her understanding that Dr. Bryan would be able, barring any emergency complications, to accomplish the procedures by laparoscopy through one relatively small incision, Ms. Fountain testified that she executed the written consent form during that consultation. The consent form informed Ms. Fountain that the procedures she would be undergoing included a “laparoscopic tubal ligation and ventral hernia repair.” The purpose of the laparoscopic procedures was described on the form as follows: “to cut into [her] belly, destroy [her] tubes in|4an attempt to keep [her] from getting pregnant and also to repair the defect in [her] belly.”5 Ms. Fountain testified that while she understood Dr. Bryan was going to have to “cut into [her] belly” and that doing so would result in a scar, it' was her understanding and expectation, based on Dr, Bryan’s representations, that the laparoscopic procedure would be minimally invasive and that the single scar to her abdomen would be no more than two inches in length. According 'to Ms. Fountain, Dr.' Bryan' never discussed with her the ■ possibility of his performing the tubal ligation and hernia repair by laparotomy nor did he disclose-to her the risk of additional scarring associated with a laparotomy.

Five days later, on the morning of 11 August 2009, Ms. Fountain arrived at Ochsner Hospital for her scheduled surgery. Despite her written consent to undergo a tubal ligation and ventral hernia repair by laparoscopy, Dr. Bryan actually performed a bilateral tubal ligation and ventral hernia repair by laparotomy. As a result, instead of the two-inch scar Ms. Fountain was expecting and to which she claims she consented, she woke up from surgery to discover an approximate 15 centimeter (roughly six inches), T-shaped disfiguring scar on her abdomen.6

In 2010, Ms. Fountain filed a medical malpractice complaint against Dr. Bryan alleging that he breached the standard of care in failing to properly perform a ventral herniorrhaphy,7 bilateral tubal ligation, and mini laparotomy resulting in the large, disfiguring abdominal scar, which sear caused her physical; mental, and | ^emotional damages. In November 2012, Ms. Fountain’s complaint was submitted to a medical review panel composed of Drs. Kathryn G. Wild, Charles Rene, and Richard D. Marino, who unanimously found that -the evidence supported the conclusion that Dr. Bryan failed to comply with the appropriate standard of care as charged by Ms. Fountain in her complaint.8 The medical review panel issued the following reasons in support of their conclusion:

1. There is a lack of adequate documentation of informed consent for the procedure scheduled and performed. The patient was consented for laparo- ' scopic tubal ligation and ventral hernia repair, and the procedure scheduled was [733]*733a laparotomy with tubal ligation and ventral hernia repair. There is no evidence in the operative report that the procedure was started with laparoscopy and converted to laparotomy.
2. However, the procedure was appropriately performed, and post-operative management was appropriate.
3. We do not believe the patient suffered an injury due to the above.9

According to Dr. Bryan, because Ms. Fountain did not raise the issue of informed consent in the complaint that she filed with the medical review panel, he did not address the issue in his original submission. However,’ after the panel released its opinion finding a lack of adequate, documentation to support informed consent for the procedure scheduled and performed, Dr.

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194 So. 3d 728, 2015 La.App. 4 Cir. 1048, 2016 WL 2736180, 2016 La. App. LEXIS 905, Counsel Stack Legal Research, https://law.counselstack.com/opinion/fountain-v-ochsner-clinic-foundation-westbank-campus-lactapp-2016.