June 8, 2019

In its Decision rendered on May 23, 2019, the Court of Appeals of Ohio Tenth Appellate District (“Ohio Appellate Court”) affirmed an Ohio medical malpractice jury’s verdict in favor of the plaintiff in the amount of $308,620.74 (the jury returned its verdict in the amount of $300,000.00 in non-economic damages that was subsequently reduced by the trial judge to $250,000.00, and $58,620.74 in economic damages) against the defendant breast surgeon.

The Underlying Facts

TRAM Flap Procedure

A TRAM flap procedure (a transverse rectus abdominis myocutaneous flap procedure) fashions the reconstructed breast from a piece of the patient’s abdominal muscle. The plaintiff, who had had a mastectomy due to breast cancer, agreed to have the defendant breast surgeon perform a pedicle TRAM flap, which involves cutting half of the abdominal muscle and bringing it up to the patient’s chest under the skin to reconstruct the breast. The surgeon leaves one vein and one artery attached to maintain blood flow to the abdominal flap. (A free flap procedure, which was not performed on the plaintiff, requires a complete disconnection of the abdominal flap and the use of microsurgery to reattach the veins and arteries, thereby reconnecting the blood supply to the flap.)

Sometime during the next evening following the plaintiff’s TRAM flap procedure, she noticed the breast tissue had started to swell and was turning purplish in color. A nurse contacted the defendant breast surgeon who ordered that leeches be applied to the plaintiff’s breast. The leech therapy was discontinued the next morning after the defendant breast surgeon examined the plaintiff and determined that there was no change to the condition of the breast. Shortly afterwards, the plaintiff’s breast became cool and she was brought back into surgery by the same surgeon. The surgeon reopened the TRAM flap, removed non-viable tissue, and reset the pedicle, which appeared to restore the blood supply to the breast. Subsequently, it was determined that the flap could not be salvaged and the tissue was removed the next morning during an outpatient procedure at the hospital. The plaintiff spent a total of four months in a nursing home undergoing wound therapy, but the wound did not completely close until the following summer.

The plaintiff filed her Ohio medical malpractice lawsuit, alleging that the defendant breast surgeon was negligent in deciding to perform only the leech therapy and not timely operating on her TRAM flap after the venous congestion had occurred (i.e., failure to promptly have microsurgery performed once the complication of venous congestion occurred).

The defendant breast surgeon appealed and raised eight alleged errors committed by the trial judge that she argued entitled her to a new trial. The Ohio Appellate Court discussed each of the alleged errors raised by the defendant on appeal, overruled each, and stated: “Having overruled all eight of appellants’ assignments of error, we affirm the judgment of the Franklin County Court of Common Pleas.”

Source Jenkins v. Grawe, 2019-Ohio-2013.

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