What do you guys think about this?

[HomerSimpson]

I just read this the other day. Thought it might warrant a little discussion.


Jury awards record $30 million in doctor’s death
By JOHN MONK
[email protected]
A Lexington County jury has awarded $30 million to the family of a doctor who died in 2002 after having what was supposed to be routine surgery.

The jury in the civil trial found Lexington Medical Center and anesthesiologist Dr. Gail Capell responsible in the death of Dr. Asif Sheikh, 58.

Sheikh was a prominent physician who died unexpectedly 17 hours after double knee-replacement surgery at Lexington Medical Center in 2002.

The $30 million is actual damages. The jury awarded no punitive damages. The jury did not find the surgeon in the case, Dr. Tom Gross and his medical group, Midlands Orthopedics, responsible for Sheikh’s death.

Longtime 11th Circuit Solicitor Donnie Myers of Lexington said the $30 million is likely the largest ever awarded by a Lexington County jury.

The award will not be reduced because the case was filed before the passage of new tort reform laws that limit jury awards, according to Geoffrey Fieger, the lead attorney for Sheikh’s family.

The hospital is expected to be liable for $270,000 of the $30 million; Capell will be expected to pay the remainder, Fieger said. The defendants could appeal.

The six-man, six-woman jury heard more than three weeks of testimony and arguments. Jurors returned a verdict at about 11:30 a.m. after deliberating since Wednesday afternoon.


That's the largest award against an individual physician I've ever heard of.

Be careful out there

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[Sevo]

Fieger brings high profile to Lexington County malpractice trial

By RICK BRUNDRETT
[email protected]

The story comes courtesy of The State newspaper.

Geoffrey Fieger talks with his team of lawyers Wednesday in Lexington.Geoffrey Fieger is a lawyer who tends to draw a crowd.

The attorney, best known for defending assisted-suicide advocate Dr. Jack Kevorkian, is the lead plaintiff’s lawyer in an unusual medical malpractice trial under way in Lexington County.

The civil jury trial, which pits the widow of a doctor against Lexington Medical Center and two other doctors, is expected to last about three weeks. Millions of dollars are at stake.

Fieger is an animated lawyer, often using hand motions and smiling at jurors after grilling witnesses.

The Detroit-area attorney gravitates toward big-award cases. His law firm Web site boasts he has won “more multimillion dollar awards than any other attorney in the country.”

He cites, for example, a $25million verdict he won in a lawsuit alleging “The Jenny Jones Show” was negligent in the death of a man who was killed after revealing a crush on another man.

Although reared in Michigan, Fieger said he has ties to South Carolina, including a place at Hilton Head. The Lexington County trial is his first in the Columbia area, he said.

“If it were 30 degrees cooler, this would be a very, very nice place,” he joked during a break in the trial.

Fieger said he took the Lexington County case after being contacted by his client, Margaret Sheikh.

“I determined she had a valid case that needed to be brought.”

But he declined to discuss specifics, citing South Carolina ethical rules for lawyers.

In her lawsuit, Sheikh alleges her husband, Dr. Asif Sheikh, 58, had a heart problem and was not properly monitored while he was on painkiller drugs after his double knee-replacement surgery Dec. 31, 2001, at Lexington Medical Center.

Her husband, an orthopedic surgeon who had served on the center’s board of trustees and also as chief of the hospital’s orthopedics board, died of cardiac arrest about 17 hours after the surgery, the lawsuit said.

The lawsuit contends the doctors involved with his surgery were “reckless and careless” by failing to “obtain a cardiology consult” before operating on Sheikh, failing to “properly administer” anesthesia to him during the surgery, and failing to monitor his condition afterward.

The surgery was performed by Dr. Thomas Gross, a partner of Sheikh at Midlands Orthopaedics, the lawsuit said. Gross is a defendant in the lawsuit, along with Dr. Gail Capell, an anesthesiologist.

The hospital, Gross and Capell in court papers deny liability. Capell’s answer to the lawsuit said Sheikh’s death stemmed from his “physical infirmities and a natural disease process.”

Jurors will hear a barrage of medical terminology during the trial before Circuit Judge Diane Goodstein in the Marc H. Westbrook Courthouse. Fieger has used large charts and computer screen presentations this week to make his points.

Fieger’s high-profile cases and penchant for the media spotlight have helped make him well-known nationwide. He even has his own fan club, with a Web site dubbed “Fans of Fieger.”

In 1998, Fieger tried to capitalize on his name recognition, making an unsuccessful run for governor of Michigan.

But he is best known for obtaining several acquittals for Kevorkian, the Michigan pathologist who claimed he had assisted in more than 130 suicides. Fieger didn’t represent Kevorkian when the doctor was convicted in 1999 of second-degree murder in the assisted suicide of a terminally ill man with Lou Gehrig’s disease.

Fieger isn’t licensed to practice law in the Palmetto State. But he was allowed to take the Sheikh case after applying in 2003 under a special state court rule allowing an out-of-state attorney to handle an in-state case.

Fieger is being assisted by Columbia attorney Ken Suggs, a longtime medical malpractice lawyer.

Reach Brundrett at (803) 771-8484.

 

[UTSouthwestern]

The sound you hear is Dr. Gail Capell getting thrown under the train.

 

[militarymd]

Asset protection.....

 

[VA Hopeful Dr]

Being from this area, I find it someone bothersome that any out-of-state lawyer can just come in and argue a case simply because he/she was hired to do it.

Kinda takes the fun out of the bar exam, but I guess when this much $$$ is involved, lawyers can be persuaded to ignore their own rules...

 

[VentdependenT]

Ughhhhhhhhhhhhhhhhhh

 

[meddog1]

The sound you hear is Dr. Gail Capell getting thrown under the train.

I agree. Seventeen hours out and going after the "anesthesiologist" for not geting a pre-op cards consult? That's weak.

Funny how the wife doesn't go after the ortho docs (probably her husband's cronies) who did the case. I guess all they need to know are bones, right?

The only thing I can see is if the pt had a HX/o a recent MI or had bad CHF and wasn't tuned-up pre-op and the anesthesiologist missed it or blew it off.

 

[Laryngospasm]

Asset protection.....

Agree with that..

 

[thegasman]

I agree. Seventeen hours out and going after the "anesthesiologist" for not geting a pre-op cards consult? That's weak.

Funny how the wife doesn't go after the ortho docs (probably her husband's cronies) who did the case. I guess all they need to know are bones, right?

The only thing I can see is if the pt had a HX/o a recent MI or had bad CHF and wasn't tuned-up pre-op and the anesthesiologist missed it or blew it off.

Exactly, the orthopod who did the case was the patients partner.

 

[Laryngospasm]

Exactly, the orthopod who did the case was the patients partner.

If my wife did something like that Id roll over in my grave

 

[Idiopathic]

Wouldnt you guys like to know a few more specifics about this case? We hear a lot of talk about whether or not pre-op cards consults are necessary, but it sure would have been nice to have one here. If this guy really had such significant "physical infirmities and disease", then maybe he needed some extra attention? Im sure much less worthy consults were ordered that day.

And thats why our specialty is 'perioperative medicine' right? Everything we do and debate is intended to protect the patient, but also to protect ourselves.

Its so easy to write "blah-blah-blah dilaudid PCA blah-blah-blah lopressor PRN blah-blah-blah fluids TKO" but every once in a while, something nibbles your ass.

 

[UTSouthwestern]

A rebuttal letter written to the author of the story:

A friend e-mailed me the link to your story about Dr.
Sheikh and I find it to be a story that does not make
sense from a medical perspective.

Dr. Sheikh undergoes a routine double knee replacement
surgery. He has a heart condition, as alleged by his
wife, yet no cardiac workup is attained.

Guess what: Dr. Sheikh is a physician and must have
known about this heart condition and relayed this to
Dr. Capell. If not, then this condition was either
not known preoperatively, or else not relayed to the
anesthesiologist.

Regardless, anesthesiologists do not routinely consult
cardiologists unless there is a clear indication to do
so (recent heart attack, evidence of worsening of a
preexisting heart condition, unexplained physical
findings suggestive of cardiac failure/involvement,
etc.). Even with the consult, the recommendations
almost invariably clear the patient for surgery unless
the patient is in clear heart failure or severely
compromised by a weak heart. With that clearance
comes the standard recommendations: Don't let the
heart rate go above 60-80, avoid hypotension (low
blood pressure), avoid fluid overload.

A patient dying 17 hours after completion of surgery
and being blamed on pain medications indicates to me
that Dr. Sheikh received too much pain medication
after the surgery, which either slowed/stopped his
breathing leading to hypoxia and cardiac arrest or
directly lowered his blood pressure to an unsafe level
and again caused cardiac arrest, possibly attributed
to an underlying heart condition. Seventeen hours
after surgery, on a person without clear evidence of a
heart condition fails to make me suspicious of the
anesthesiologist, unless he/she prescribed overwhelming
doses of pain medications. It makes me think that some over
exhuberant administration of pain medication in a short
period of time led to this tragedy, yet the hospital, which
covers the liability of its providers, gets slapped with only
1% of the verdict.

Did you know that after one hour in the recovery room
of almost all surgery centers/small hospitals,
responsibility of the care of the patient reverts back
to the surgeon? So one should ask why after 16 hours
of uncomplicated postop care, why the
anesthesiologists' name is even being brought up.
Also in most surgery centers, the surgeon shares
responsiblity of obtaining preoperative clearance by
cardiologists, internists, etc. as the anesthesiologist
typically is not notified of the case until the day
before or day of surgery.

What I see is a hospital owned by Dr. Sheikh, Dr.
Ross, and partners throwing Dr. Capell under the train
as a sacrifical lamb and skating off into the sunset
minus a small judgement and a respected colleague. Is
it any wonder why tort reform is being pushed across
the country and why it is so difficult to get
physicians to practice in certain areas when you can
get sued even if you do everything right.

Now I cannot claim that this is the case with Dr.
Capell, but a patient dying 17 hours after surgery
from complications of administration of pain
medications indicates to me that Dr. Capell is being
railroaded into this verdict. What a shame for the
people of your county, that additional culpable parties
in this tragedy have escaped unscathed and
unrepentant.

 

[hokie]

I wonder if he had an epidural for post-op pain management and there was a dosing error with it?

 

[sallyjoe]

edit

 

[lakerjock]

Look at how crazy this is. Fieger made a deal with the hospital that they would only be liable for $270,000 if they were found guilty. SO the jury found that the hospital was 98% guilty, and the anesthesiologist was 2% guilty...for $30million total. Since the hospital is capped at $270,000, Fieger says the anesthesiologist is on the hook for the rest, eventhough she is only 2% guilty. UNBELIEVABLE the crap these lawyers get away with. Apparently the crooked judge went along with all of this. Narcotic and poor nursing combination seems to be the cause.

Doctor died after knee surgery at Lexington Medical Center

Lawyers expect an appeal in the award to the estate of Dr. Asif Sheikh, who died in January 2002.

A Lexington County jury Friday awarded $30 million to the estate of Dr. Asif Sheikh, who died in 2002 in unusual circumstances at Lexington Medical Center hours after he was operated on.

The jury deliberated three days before deciding that Lexington Medical Center -- the county's largest hospital system, with 4,000 employees -- was responsible for Sheikh's death, along with Dr. Gail Capell, the anesthesiologist for his operation.

The $30 million was one of the highest, if not the highest, jury awards in Lexington County within memory and one of the highest ever for medical malpractice in the state, lawyers said.

But the award is sure to be appealed, lawyers said.

Lexington Medical Center lawyer Weldon Johnson said that although the hospital on occasion has settled cases, "In my 25 years of representing the hospital, this is the first jury verdict ever against it."

During the civil trial, Sheikh family lawyer Geoffrey Fieger of Detroit said a lethal cocktail of narcotics delivered to Sheikh during what was supposed to be a routine operation killed him instead. Defendants argued Sheikh, 58, died of an undetected heart problem or from the stress of recovering from double knee-replacement surgery.

Fieger also alleged what he called a "massive cover-up" by the hospital. He repeatedly called the jury's attention to the disappearance of original hospital records such as X-rays and a medical chart of Sheikh's last hours.

The hospital disputed the allegations, saying records had been inadvertently lost. A computer-scanned copy of Sheikh's chart available to the jury had the same data as the original, hospital officials said.

But in instructions to the jury earlier this week, Judge Diane Goodstein charged that, "Where evidence is lost or destroyed by a party, you may infer ... that the evidence that is lost or destroyed would have been adverse to that party."

The $30 million award was for actual damages, including the loss of Sheikh's income (said during trial to be about $470,000 a year), and loss of his companionship and role as a father. During the four-week trial, Sheikh's widow, Maggie, and their four children testified about what a wonderful husband and father he had been. Fieger asked the jury to levy $50 million in punitive damages to punish and serve as a warning against negligence. But the jury only awarded actual damages.

The jury of six men and six women found no liability against defendant Midlands Orthopedics or against Midlands surgeon Dr. Tom Gross.

Sheikh had been a member of the hospital's board of trustees and chief of the hospital orthopedics board and belonged to the Midlands Orthopedics group.

Fieger, known nationally for his high jury awards and as a legal television commentator, was pleased with the award.

"The jury got things right," he said Friday by telephone. "They showed, contrary to the beliefs of doctors and the Lexington hospital, that Lexington County jurors are determined to have the best medical care possible, and they will not put up with anything less."

During final jury arguments this week, Fieger said the Lexington hospital was counting on a long tradition of penny-pinching county juries giving low awards.

"They believe that juries in Lexington County hate lawyers, hate lawsuits, more than they like the truth!" Fieger shouted Wednesday morning in a final argument. "You have an opportunity to say, 'Never again.' You have an opportunity to ring a bell for justice ... to make it hurt."

Not only had the hospital destroyed original records of what happened, Fieger said, Sheikh had been given doses of narcotics that caused him to stop breathing. Even so, Fieger said, Sheikh could have been saved if hospital staffers had monitored him better. Sheikh died 17 hours after surgery.

Hospital and physician witnesses strongly denied the allegations. They said Sheikh was given appropriate medicine and post-operation care and likely died from a fatal heart arrhythmia.

The $30 million award is already an object of dispute among opposing lawyers.

The jury found that Lexington Medical Center bears 98 percent of the responsibility for the $30 million award and Capell, the anesthesiologist, 2 percent.

But because of the complicated legal framework in which the trial was held, the hospital -- or rather, its insurer -- won't pay anywhere near that amount.

First, the hospital's attorney, Johnson, and Fieger reached an agreement early in the trial that limited the hospital's exposure to $270,000 if the jury found hospital nurses, and not doctors, were liable. Friday, the jury ruled that hospital nurses and other nonphysician staffers bore responsibility for Sheikh's death.

Secondly, no matter what the jury had ruled, under state law regarding liability of public hospitals, the county-operated hospital is only liable for a maximum of $1.2 million in damages.

In making the agreement, Johnson limited his client's potential exposure. But he also agreed not to present a robust defense for the hospital. For example, he agreed to limit his closing argument to 10 minutes. The agreement was kept from the jury but approved by the judge.

After the jury verdict, Fieger said that under state law, Capell's insurance carrier is obligated -- because the hospital will not have to pay its 98 percent of the jury award -- to cover the balance of the $30 million award.

However, Capell's lawyer, former circuit judge John Hamilton Smith, said his client's liability was only $600,000. That amount is two percent of $30 million -- the jury's assessment of Capell's share of the responsibility for Sheikh's death, Smith said.

Fieger had saved his most scathing jury remarks for Capell, who he said had "killed" Sheikh and then "lied" in her testimony.

Smith defended Capell after the verdict. "Dr. Capell did not do anything that would constitute negligence in any way whatsoever."

Opposing lawyers are expected to make post-trial motions before the judge by month's end. The size of the jury award, and who should pay it, are sure to be among the motions, lawyers said.

Goodstein will then rule on the motions, setting the stage for an appeal to the S.C. Court of Appeals, then possibly the state Supreme Court.

George Beighley, attorney for Gross, the surgeon, issued a statement Friday on behalf of his client and Midlands Orthopedics, which said in part, "... patient care was never compromised by our practice or by the surgeon in this case. We continue to express sympathy to the family of Dr. Sheikh. ..."

The $30 million award astonished South Carolina lawyers who make their living taking big corporations to court on behalf of individuals who claim they have been wronged.

"Getting a Lexington County jury to give a $30 million verdict is a once-in-a-century happening against a hospital," Columbia trial attorney Dick Harpootlian said. "Even if the award is reduced, it's a huge black eye for the hospital."

Hospital spokeswoman Margaret Gregory said Friday hospital officials were "disappointed and disagreed with the jury verdict. We are proud of the excellent care that our physicians and nurses provide for our patients."

Following the verdict, Judge Goodstein shook hands with some jury members and hugged others. She thanked the jury for their four weeks' service: "You are where the rubber meets the road as long as we have a democracy."

Earlier in the week, in charging the jury, Goodstein said, "When a hospital treats a patient, the law does not require perfection, but reasonable care that meets good medical standards."

In recent years, the state General Assembly, in efforts to limit the amount of money businesses and hospitals pay to their victims, has capped certain jury awards. However, Sheikh's death happened before the most recent caps were passed into law.