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$7.5 Million Verdict for Undiagnosed Common Surgical Complication

Melode Dickerson and Gregory Dickerson v. Florias Andrew Morfesis, M.D., Kelly Marie Van Fossen, D.O., and Owen Drive Surgical Clinic of Fayetteville, PLLC

(13-CvS-3475, Cumberland County, NC)

 

Melode Dickerson, a 50-year-old woman, underwent a routine colonoscopy that revealed a suspicious-looking polyp that could not be completely excised during the colonoscopy procedure.  Melode was referred to Dr. Florias Morfesis for performance of a partial colectomy (removal of a portion of the colon) at the location of the polyp.  Melode underwent this surgical procedure without event at Cape Fear Valley Hospital, and was discharged from the hospital one day after the procedure despite laboratory signs trending in the wrong direction and difficulty urinating.

Melode returned to the hospital approximately 8 hours after her discharge and complained of severe abdominal pain, nausea, vomiting and inability to urinate.  Melode was directly admitted to the hospital by Dr. Morfesis’ colleague, Dr. Van Fossen with a diagnosis of urinary retention.   Over the next three days under Dr. Van Fossen’s care, Melode’s clinical picture further deteriorated.  Upon admission and thereafter, Melode met the hospital’s written criteria for severe sepsis; however, Dr. Van Fossen never diagnosed sepsis nor entered orders which would seek to find the source of Melode’s sepsis.  After three days under Dr. Van Fossen’s care, Dr. Morfesis returned and assumed care of Melode.  By the time of Dr. Morfesis’s return, Melode had been diagnosed with sepsis through positive blood cultures ordered by a consultant.

Plaintiffs contended that Drs. Morfesis and Van Fossen did not render appropriate care by seeking to find the source of Melode’s sepsis.  Plaintiffs contended the source of the sepsis was a bowel leak at the place where the colon had been surgically reattached to the small intestine after the partial colectomy procedure.  Plaintiffs introduced undisputed evidence that a leak of such a nature happens to one out of every 20 patients who undergo this procedure.  Plaintiffs obtained testimony from all expert physicians for both parties that the “gold standard” for diagnosing this known and potentially deadly complication is a CT scan with contrast dye.  This was never provided to the plaintiff.

Defendants contended that other radiologic studies, including an ultrasound, multiple x-rays and a CT scan without contrast dye failed to show the amount of free air in Melode’s abdomen that would be consistent with a leak at the surgical site.  Defendants also contended that the defendant surgeons went back in surgically two separate times and found no evidence of a leak.  Plaintiffs contended that the two subsequent surgeries were inadequate to locate a leak.  The second subsequent surgery undertaken by the defendant surgeons involved an ileostomy designed to prevent any further leaking which might occur at the original surgical site.

After two weeks of hospitalization, Melode was transferred to the N.C.  Memorial Hospital at the University of North Carolina-Chapel Hill while on life support.  After several months, Melode had recovered enough for surgeons to attempt a take-down of the ileostomy and reconnect the small intestine to the colon.  During this procedure, surgeons discovered a 3-mm hole at the original surgical site.  Defendants contended this hole had developed after Melode’s transfer to UNC-Chapel Hill as a result of friability of the intestinal wall.  Defendants supported this argument by pointing to the timing of development of an abscess as shown in radiology films taken of Melode’s abdomen throughout her entire ordeal.  Plaintiffs used an article produced by one of Defendants’ experts to show that most patients who suffer a leak of this nature develop peritonitis, rather than an abscess.  Plaintiffs showed that Melode had been diagnosed with peritonitis by the original defendant surgeons.

Plaintiffs’ Attorneys:  R. Kent Brown, Jon R. Moore and Paige L. Pahlke; Brown Moore & Associates, PLLC; Charlotte, NC

Defendants’ Attorneys:  John W. Minier and Maria Wood; Yates, McLamb & Weyher, L.L.P.; Raleigh, NC

Plaintiffs’ Experts:

  • Edward Hall, M.D., board-certified general surgeon, Thomasville, GA
  • Robert Bailey, M.D., board-certified general surgeon, Miami, FL
  • Stanley Nasraway, M.D., Director, Surgical Intensive Care, Tufts University, board-certified Critical Care specialist, Boston, MA
  • Richard Bonfiglio, M.D., board-certified Physical Medicine & Rehabilitation physician, Export, PA
  • Cynthia Wilhelm, Ph.D., Chapel Hill, NC (Life Care Planning expert)
  • Carl Poindexter, Ph.D., Norfolk, VA (Economist)

Defendants’ Experts:

  • Gary Robinson, M.D., board-certified general surgeon, Statesville, NC
  • Lisa Nelson-Robinson, M.D., board-certified general surgeon, Rocky Mount, NC
  • Alan D. Proia, M.D., Ph.D., board-certified pathologist, Durham, NC
  • Alan L. Rosen, M.D., board-certified radiologist, Durham, NC

Trial Length:  2 weeks, 1 day

Jury Deliberations:  1.75 days

Judge:  Hon. Gale M. Adams

Highest Pre-Trial Offer:  $0

Verdict:

Economic Damages — $3,242,554.00

Non-Economic Damages — $4,000,000.00

Loss of Consortium — $300,000.00