Mahfouz v. Xanar, Inc.

646 So. 2d 1152, 94 La.App. 3 Cir. 305, 1994 La. App. LEXIS 3050, 1994 WL 643166
CourtLouisiana Court of Appeal
DecidedNovember 16, 1994
Docket94-305
StatusPublished

This text of 646 So. 2d 1152 (Mahfouz v. Xanar, Inc.) 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
Mahfouz v. Xanar, Inc., 646 So. 2d 1152, 94 La.App. 3 Cir. 305, 1994 La. App. LEXIS 3050, 1994 WL 643166 (La. Ct. App. 1994).

Opinion

646 So.2d 1152 (1994)

Michael MAHFOUZ, Plaintiff-Appellee,
v.
XANAR, INC., et al., Defendant-Appellant.

No. 94-305.

Court of Appeal of Louisiana, Third Circuit.

November 16, 1994.
Rehearing Denied January 18, 1995.

*1154 Anthony Fazzio, for Michael Mahfouz.

Gary McGoffin, Lafayette, for John Robichaux M.D.

Peter T. Dazzio, for Iberia Gen. Hosp.

Paul Joseph Hebert, for Hebert Sonnier Hebert.

Before DOUCET and PETERS, JJ., and BERTRAND, J. Pro Tem.[*]

PETERS, Judge.

The plaintiff, Michael Mahfouz, brought suit against a number of defendants to recover damages for a burn he received on September 12, 1988, while undergoing laser surgery at the Iberia General Hospital in New Iberia, Louisiana. Dr. John Robichaux, the defendant-appellant, removed a plantar wart from the ball of Michael Mahfouz's left foot with a Xanar XA-20 Carbon Dioxide Surgical Laser. As a result of the procedure, Mahfouz suffered a non-contiguous, unintended burn to the arch of his foot several centimeters from the surgery site.

Mahfouz brought suit against Xanar, Inc., Johnson & Johnson Company, and Coherent, Inc. as the manufacturers and sellers of the laser; St. Paul Fire & Marine Insurance Company, the liability insurer of Xanar, Inc. and/or Coherent, Inc.; Iberia General Hospital, the owner of the laser and the site of the surgical procedure; and Dr. Robichaux and his professional liability insurer, Louisiana Medical Mutual Insurance Company. The manufacturers were made cross-claim and third-party defendants by Dr. Robichaux and Iberia General Hospital. By trial, all claims had been either settled or dismissed except that of Michael Mahfouz against Dr. Robichaux and his professional liability insurer.

A bench trial was held on December 7 and 8, 1992, on the claim against Dr. Robichaux. After completion of the evidence, Mahfouz was awarded $470,837.51 in damages by the trial court which apportioned 25% fault to Dr. Robichaux, 35% fault to Iberia General Hospital, and 40% fault to Xanar, Inc. Dr. Robichaux appeals the finding of fault on his part and the award of damages.

FACTS

Michael Mahfouz saw Dr. Robichaux, who is a physician specializing in dermatology, because he was having pain associated with a plantar wart located on the ball of his left *1155 foot. After conservative treatment was not effective, Dr. Robichaux recommended surgical removal by use of a laser. The nature of the procedure required that it be performed in a hospital subject to either local or general anesthesia.

Mahfouz agreed to Dr. Robichaux's recommendation, and the laser surgery was performed on September 12, 1988, at the Iberia General Hospital in New Iberia, Louisiana. Iberia General made available to Dr. Robichaux its laser equipment which was the Xanar XA-20 Carbon Dioxide Laser. Additionally, the staff assisting in the procedure, Lorette Pittman, the circulating nurse, and Joyce Green, the surgery technician, were both employees of Iberia General Hospital.

The Xanar XA-20 Carbon Dioxide Laser functions by sending a carbon dioxide (CO2) laser beam through a series of tubes and mirrors referred to as an "articulated arm" to the target surface. The laser beam travels through the tubes and is reflected along its path by the mirrors to the "handpiece" where the beam is emitted. The CO2 beam vaporizes tissue at a focused spot without injury to adjacent tissue, but with immediate effect. The diameter of the beam and the amount of energy released is controlled by the operator of the laser, who thereby controls the diameter and depth of tissue removed.

Because the CO2 beam is invisible, the laser is equipped with a visible helium-neon guide beam to be used in conjunction with the CO2 beam. This guide beam, referred to as an "HeNe" beam, is aligned with the CO2 beam thereby giving the operator a visual sighting of the otherwise invisible CO2 beam. The alignment is accomplished by test firing the laser and using two adjustment knobs to coordinate the CO2 beam with the HeNe beam on an X-Y plane. Once the beams are aligned, an X-Y ring is locked down to maintain alignment.

The manufactures of the Xanar XA-20 Carbon Dioxide Surgical Laser provide purchasers of the system with an operation manual which provides in its introductory information that "THIS MANUAL SHOULD BE READ CAREFULLY AND IN ITS ENTIRETY BY ALL PERSONNEL ASSIGNED TO THE LASER OPERATING AREA" and that "THIS CARBON DIOXIDE LASER SYSTEM SHOULD ONLY BE OPERATED BY A TRAINED, QUALIFIED, AND LICENSED PHYSICIAN." When Iberia General Hospital acquired the laser, it held an in-service instruction seminar for the local physicians who might use the instrument. However, according to Dr. Robichaux who attended the seminar, the instruction was limited to detection of misalignment of the laser and not how to realign it. In fact, Dr. Robichaux never read the operation manual of this instrument.

At Iberia General Hospital, the standard procedure is for the surgery technician to bring all necessary equipment into the operating theater. The circulating nurse is then responsible for setting up and testing the laser. Once everything is in place, the patient is brought into the surgery room and the doctor is notified that everything is in order. Until the procedure begins the circulating nurse is in control. Thereafter, the doctor has all authority within the surgery theater.

The procedure itself is basically simple. The laser beam is directed at the designated area and the physician activates it by the use of a foot peddle. Visual contact is afforded the physician by various means. The Iberia General Hospital laser is equipped with a microscope which gives the physician detailed access to the area associated with the procedure but limits his field of vision as to the area around the surgery point. The depth and width of tissue vaporization is determined by the amount of energy released through the laser and the size of the beam. The narrower the beam, the greater the energy concentration is at that point. The physician combines these factors and the time of exposure to determine the degree of surgical intervention necessary to obtain a particular result.

To remove a plantar wart, the physician directs the laser at the wart and destroys some tissue. He then stops and curettes, or scrapes away, the burned tissue and examines the spot to determine if additional tissue should be removed. When curetting the surgical *1156 wound, the physician is not looking through the microscope or other vision limiting devise, but the entire area around the surgical site is visible. He continues to alternate the laser and curette activity until he is satisfied that the offending wart is completely removed. The physician then terminates the procedure and the nursing staff cleans and dresses the affected area.

Dr. Robichaux had used the laser at Iberia General Hospital on numerous other occasions before Mahfouz's procedure and was aware it was not trouble free. On at least two other occasions, he had experienced alignment difficulties during a procedure, and on one occasion, had to cancel a procedure because the HeNe beam would not function. However, all prior difficulties with the equipment were in no way similar to that which occurred on September 12, 1988.

On September 12, 1988, Ms. Green, as surgery technician, assimilated the laser, a microscope, a smoke evacuator, and all other equipment necessary for the procedure. She then assisted Ms. Pittman in setting up the equipment. She recalled that when it was initially test-fired by Ms.

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Bluebook (online)
646 So. 2d 1152, 94 La.App. 3 Cir. 305, 1994 La. App. LEXIS 3050, 1994 WL 643166, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mahfouz-v-xanar-inc-lactapp-1994.