A well-planned and well-executed demonstration of a surgical procedure by the defendant surgeon in a recent med mal case, assisted by his attorney, may have been a key factor in the jury’s verdict. The surgeon, Dr. J. Eduardo Corso, had been sued in DeKalb County State Court by the family of Arlene Bailey after Bailey’s death resulting from complications arising during a catheterization procedure performed by Dr. Corso. Larry Bailey et al. v. J. Eduardo Corso, MD et al. (12A45372).
On August 12, 2011, Dr. Corso performed a procedure to insert a catheter in Arlene Bailey to enable her to receive dialysis treatments. This type of catheter placement is routinely used with dialysis patients, and Dr. Corso had successfully performed the operation several hundred times previously. In fact, he had inserted another catheter in Bailey three days earlier on August 9, but the earlier catheter did not function properly and needed to be replaced.
As part of the operation, Dr. Corso inserted a wire in Bailey’s neck and into her jugular vein, then advanced the wire through her circulatory system so it could help guide the end of the catheter to its permanent location in the heart area. However, during the operation, Bailey’s heart was punctured and she bled internally, resulting in a loss of oxygen to the brain. As a result, Bailey went into a vegetative state and died a few days later.
Although the parties agreed that Bailey’s ventricle had been perforated during the 30-minute procedure, they differed sharply as to the timing of the fatal injury. Plaintiff’s expert witness, Dr. Russell Samson, believed the the puncture occurred while the wire was being advanced through Bailey’s veins and that Dr. Corso was not sufficiently careful while advancing the wire. In his view, Dr. Corso should have monitored what he was doing with a fluoroscope at all times while the wire was being inserted.
Dr. Corso testified that he had indeed been watching the wire with a fluoroscope and that the wire did not enter her heart while he was advancing it. Instead, in the opinion of Dr. Corso and the two expert witnesses called by the defense, the injury occurred while the wire was being removed at a time when accidental random movement of the wire might have occurred that Dr. Corso could not control.
During the trial, both Dr. Samson and Dr. Corso showed the jury the various devices used in the operation and demonstrated how the procedure is performed. However, Dr. Samson’s demonstration consisted of his holding the catheter and wire in front of one of plaintiff’s attorneys who was standing before the jury and describing how the wire and catheter were moved inside a patient’s body.
During his testimony, Dr. Corso, with the assistance of his attorney Daniel Huff, used various visual aids to assist his demonstration. He first demonstrated how the operation is normally performed, using a diagram showing the anatomy of a patient’s upper torso and circulatory system. Dr. Corso showed where the wire is inserted in the body and the path through which it advances towards the heart. During this demonstration, Huff helped Dr. Corso manipulate the catheter and wire to show the jury how they moved. Huff also pointed out for the jury the areas on the diagram that Dr. Corso was describing.
Once Dr. Corso finished describing how he normally performed the procedure, he testified that he had discovered during the earlier August 9 catheterization that Bailey had a somewhat unusual physical condition in which the vein through which the wire was advanced was abnormally curved. He described Bailey’s case as “more extreme” than most patients but noted that about three percent of patients had similar anatomies. Huff then removed the first anatomical diagram and replaced it with a second diagram showing Bailey’s actual anatomy and vein curvature. Dr. Corso then described and demonstrated how he performed the operation somewhat differently to account for Bailey’s condition.
With Huff’s assistance, Dr. Corso spent about 20 minutes describing the entire procedure at length to the jury. During his testimony, he disagreed several times with specific statements made by Dr. Samson regarding the standard of care for these operations and how the operation should be conducted and explained in detail why he performed the procedure differently than the method recommended by Dr. Samson.
Dr. Corso’s detailed demonstration gave the jury an opportunity to judge his credibility and competence both as a subject matter expert and as an actual witness to the operation. After hearing from all four expert medical witnesses in the case, the jury found in favor of Dr. Corso.
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