Kalitan Perforated Esophagus MedMal Trial Begins

Posted by msch on May 31, 2011 2:35:00 PM

Crane Johnstone and Robert CousinsKalitan v. Alexander (Fort Lauderdale, Florida)

Dental assistant Susan Kalitan developed an injury common to those in her profession: carpal tunnel syndrome. However, unlike others who undergo surgery to eradicate the pain and discomfort associated with this condition, Ms. Kalitan ended up in a drug-induced coma and sustained a spinal cord injury in the course of what should have been a minor wrist surgery. How did Ms. Kalitan get here?

Ms. Kalitan’s attorney, Crane Johnstone (Schelesinger Firm), said that the anesthesiologist made a mistake during the procedure, and punched a hole in Ms. Kalitan's esophagus.  The records showed that Ms. Kalitan complained of severe chest and back pain after the surgery. But instead of determining the cause of the pain, the hospital gave Ms. Kalitan pain medication and discharged her.

As a result of the hole in Ms. Kalitan’s esophagus, any food ingested risked entering not her stomach but her chest — and much of the food she consumed after being discharged did in fact end up in her chest. This led to sepsis, which brought her quickly back to the emergency room, where she underwent multiple major surgeries, eventually ended up in a drug-induced coma.

As a result of this carpal tunnel syndrome surgery gone horribly wrong, Ms. Kalitan brought this suit against the anesthesiologist, Dr. Rob Alexander, and several other defendants associated with the hospital.

Mr. Johnstone emphasized in his opening statement the damage sustained by the plaintiff over the course of the incident and since. He stated, “She was left with a feeding tube for months … She’s got major scarring all over her body. She could not eat or drink for months. To this day food hangs up in her throat. When she was lying in that hospital bed, she never got any physical therapy for the surgery on her wrist … she has been left with very serious and permanent pain in her neck and shoulders and hands.” He added that in addition to these physical injuries, as a result of the incident NAME suffered from depression and PTSD, had chronic fatigue, and could not afford to pay her debts. 

"This perforation, the evidence will show, should never have happened," said Mr. Johnstone. "She wasn't morbidly obese with a short neck, which makes intubation difficult. She didn't have trauma where the airway was obstructed and there was a lot of blood you couldn't see. There was no excuse for what happened here," and Ms. Kalitan was never told that an anesthesiology student in her first semester of training would be practicing on her.

Defense attorney Robert Cousins (Quintairos, Preito, Wood, & Boyer)  demonstrated for the jury using tools and plastic throat models the steps involved in a rapid endotracheal intubation, concluding that it was successfully completed, and it was "extremely unlikely" that the soft, pliable tip of the endotracheal tube caused any injury or harm to the esophagus. The medical records showed that Dr. Alexander passed the tube successfully into the endotracheal area on the first attempt. If there had been an esophageal intubation it would have been noted on the records, which it was not.

An oro-gastric tube was placed through the mouth and esophagus and into Ms. Kalitan's stomach, probably by a student, but also had a soft, flexible tube. A temperature probe was also inserted into the esophagus. The temperature probe had a more rigid tip, but was also soft and flexible. None of the devices when removed showed any signs of blood or trauma, so there was no reason for any of the caregivers to have believed that an injury had occurred.

“He was there … he supervised the case appropriately, and then he moved on to another procedure,” Mr. Cousins said. Further, even while Dr. Alexander was not present, the anesthesiologists and the certified registered nurse anesthetists followed proper hospital protocol.

Mr. Cousins told the jury that an injury during such "blind" procedures in which it was not possible to see past the vocal chords was unfortunate, but not negligent. Dr. Alexander acted reasonably, said Mr. Cousins, because Ms. Kalitan seemed fine after the procedure, and Dr. Alexander had no reason to believe that anything bad had happened.

Perforated Esophagus Trial Exhibit

CVN is covering Susan Kalitan v. Rob Alexander trial live.

Topics: Negligence, Kalitan v. Alexander, Malpractice