Thomas v. Intermedics Orthopedics, Inc.

47 Cal. App. 4th 957, 55 Cal. Rptr. 2d 197, 96 Cal. Daily Op. Serv. 5489, 96 Daily Journal DAR 8939, 1996 Cal. App. LEXIS 702
CourtCalifornia Court of Appeal
DecidedJuly 24, 1996
DocketB096811
StatusPublished
Cited by3 cases

This text of 47 Cal. App. 4th 957 (Thomas v. Intermedics Orthopedics, Inc.) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Thomas v. Intermedics Orthopedics, Inc., 47 Cal. App. 4th 957, 55 Cal. Rptr. 2d 197, 96 Cal. Daily Op. Serv. 5489, 96 Daily Journal DAR 8939, 1996 Cal. App. LEXIS 702 (Cal. Ct. App. 1996).

Opinion

Opinion

JOHNSON, J.

The underlying action was for personal injuries arising from both medical malpractice and general negligence. By special verdict a jury found both the orthopedic surgeon and prosthetic supplier negligent and assessed liability at 50 percent each for the plaintiffs’ injuries.

The prosthetic supplier appeals from the judgment, claiming the trial court prejudicially erred in withdrawing the “captain of the ship” instruction in response to a jury question. We conclude the supplier’s special instruction was erroneous under the law and facts of this case. Therefore, we hold the trial court did not err in withdrawing the instruction from the jury’s consideration during deliberations.

Facts and Proceedings Below

In 1984 respondent G. Russell Thomas had a total hip replacement. Defendant Dr. John Thompson performed the surgery. Thomas continued to lead a very active life. Among other activities, he sailed his own boat to the South Pacific. He and his wife, respondent Marjorie Elizabeth Thomas took an extensive European vacation during which he walked several miles every day.

In November 1991, Thomas lost his balance while cleaning his Jacuzzi. He leapt to the other side of the Jacuzzi to avoid falling in. He landed hard *960 on his feet and in an awkward manner. He heard a sound and felt a popping sensation in his hip.

A few days later he consulted with Dr. Thompson. From an examination and X-rays Dr. Thompson determined Thomas would have to undergo hip revision surgery to replace a broken component of the hip prosthesis. This particular component is commonly referred to as the plastic acetabular insert.

Dr. Thompson scheduled Thomas’s surgery at Goleta Valley Hospital. This hospital did not keep an inventory of orthopedic prosthetic devices. Each component part costs thousands of dollars and a typical surgery could require having tens of thousands of dollars worth of parts immediately available, depending on what the sturgeon found necessary to use or replace during a given operation. Industry custom when using a hospital which did not keep an inventory was to meet with representatives of suppliers of prosthetic devices to order a variety of prosthetic devices, components and instruments for a scheduled surgery to ensure all the necessary parts would be available to meet any contingency once surgery began.

Prior to Thomas’s surgery Dr. Thompson met with John Gainor, a representative of appellant, Intermedies Orthopedics, Inc. (Intermedies). The purpose of the meeting was to discuss Thomas’s upcoming surgery and to determine which prosthetic devices and components would likely be necessary to complete the surgery.

At trial Dr. Thompson testified he had a distinct recollection of this meeting. He and Gainor reviewed X-rays of Thomas’s damaged hip using templates provided by Intermedies to determine the size of the required replacement parts. At the conclusion of the meeting Dr. Thompson advised Gainor of two potential procedures, depending on the condition of the existing femoral portion of the prosthetic. First, if the femoral component of the prosthetic was not damaged, it was Dr. Thompson’s intention to only replace the existing plastic acetabular cup and insert. In this scenario, a complete series of 32-millimeter cups and inserts would be needed. Dr. Thompson preferred modular units to ensure a precise fit, as well as so-called “hooded” units which would lend stability and reduce the likelihood of dislocation. Alternatively, if the femoral component was damaged, Dr. Thompson would need a complete hip prosthetic. Due to improvements in medical technology since Thomas’s initial surgery using a 32-millimeter head, Dr. Thompson requested a 28-millimeter femoral head with all the corresponding component parts. The smaller femoral head had become state *961 of the art in the orthopedic field and presented the advantage of greater stability.

Gainor, on the other hand, testified he did not recall any specifics of this meeting with Dr. Thompson. Gainor testified he did not recall exactly what Dr. Thompson ordered. Gainor said he did not take any notes during the meeting or fill out any order form for the equipment Dr. Thompson ordered. Gainor testified that after his meeting with Dr. Thompson he used his car phone to orally place Dr. Thompson’s order with Intermedies’s main office in Texas.

Gainor testified Intermedies had an error rate of between 15 and 20 percent. Thus, prior to the surgery he went to Goleta Valley Hospital to inspect the parts which Intermedies shipped for Thomas’s surgery. At trial Gainor said he assumed Dr. Thompson had only ordered 28-millimeter size cups and inserts because that was the size shipped by Intermedies.

At trial the parties stipulated Gainor was an agent of Intermedies for purposes of the case.

As noted, each prosthetic device or component part costs thousands of dollars. Each part is packaged in sterile protective packaging. Once removed from its sterile environment the part can never be reused. To guard against waste, a representative of the prosthetic supplier is generally present during the surgery. He or she stays nearby in a nonsterile area and produces the part or instrument as the surgeon requires during surgery. The surgeon gives the order to the assisting nurse or technician who, in turn, gives the order to a circulating nurse in a quasi-sterile area, who then requests the part from the supplier’s representative. The representative finds the box containing the requested part, removes the outer packaging and hands the contents to the circulating nurse who then passes it on to the surgeon.

The next day Thomas’s surgery began as scheduled. Dr. Thompson ordered Thomas be placed under general anesthesia. Dr. Thompson then made an incision, cut aside the soft tissue structure and reamed a hole in Thomas’s hip for a 32-millimeter acetabular cup. When ready, Dr. Thompson requested a 32-millimeter cup. Gainor advised there were no 32-milli-meter cups present.

Gainor called hospitals in the Santa Barbara area to locate 32-millimeter cups. He was able to locate a prosthetic of the same size but none of the modular, “hooded” variety Dr. Thompson requested. It took Gainor approximately 30 minutes to drive to the other hospital to pick up the parts and *962 return to the operating room. All the while Thomas remained under general anesthesia.

After surgery Dr. Thompson tested Thomas’s hip in the operating room. He noted it was unstable. The doctor concluded the leg was shorter than the other because the hip was not seated properly. In addition, the hip was more unstable than it otherwise would have been had a “hooded” cup been inserted.

Thereafter, Thomas’s hip dislocated several times a day causing him pain, inconvenience and annoyance. It required multiple surgeries to correct the problem. However, the several surgeries caused a weakening of the muscles necessary to hold the prosthesis in place. At the time of trial Thomas required a crutch or cane to walk.

The jury found both Dr. Thompson and Intermedies negligent and apportioned liability 50 percent to each. The jury awarded a total of $775,000, including a small amount for Mrs. Thomas’s claim for loss of consortium.

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47 Cal. App. 4th 957, 55 Cal. Rptr. 2d 197, 96 Cal. Daily Op. Serv. 5489, 96 Daily Journal DAR 8939, 1996 Cal. App. LEXIS 702, Counsel Stack Legal Research, https://law.counselstack.com/opinion/thomas-v-intermedics-orthopedics-inc-calctapp-1996.