Decatur, GA—A DeKalb County State Court jury issued a verdict in favor of a surgeon who punctured a woman’s heart with a wire during supposedly routine catheterization surgery. Larry Bailey et al. v. J. Eduardo Corso, MD et al. (12A45372).
On August 12, 2011, Arlene Bailey underwent surgery at Emory University Hospital to insert a catheter to enable her to receive dialysis treatment. According to testimony in the case, her surgeon, Dr. J. Eduardo Corso, inserted a wire into Bailey’s neck and then used the wire to guide the catheter through her circulatory system into the proper position. At some time during the operation, the wire caused a pinhole sized perforation Bailey’s in ventricle, and she bled internally, resulting in a loss of oxygen to her brain. She went into a vegetative state and died a few days later. Bailey’s brother and sister filed a malpractice action against Dr. Corso and his practice group, Peachtree Vascular Associates, seeking over $7 million in damages.
At the trial, the parties’ expert witnesses disagreed as to the timing and cause of Bailey’s injury and the applicable standard of care. Plaintiff’s expert witness, Dr. Russell Samson, testified that a heart perforation was a recognized complication of the catheterization procedure that was performed but that he believed it was preventable in Bailey’s case. Dr. Samson stated that the standard of care required a surgeon to use a fluoroscope while inserting a wire in a patient’s body to see what was happening. However, the fluoroscope has a limited range and cannot produce images of a patient’s entire body at one time. Therefore, in Dr. Samson’s opinion, the standard of care requires a surgeon to use the fluoroscope at all times to look at the device that is closest to the patient’s heart, in this case the tip of the wire being inserted.
Dr. Samson noted that Dr. Corso had stated in a deposition prior to the trial that, at the critical time during the operation, the fluoroscope was pointed at Bailey’s neck area, where the catheter was, instead of her chest, where the tip of the wire was. Dr. Samson believed that, while Dr. Corso was trying to move the catheter into position, the wire advanced into Bailey’s ventricle and perforated the heart. Based on when Bailey’s blood pressure dropped as a result of the perforation, Dr. Samson believed that the perforation occurred five to ten minutes after the procedure started.
Dr. Samson added that he was “100 percent” certain that the heart perforation occurred while the catheter was being inserted in Bailey and not while the wire was being removed. Dr. Samson stated that the catheter wire was designed to be easily removable without the tip of the wire moving sufficiently to cause a heart perforation in the area where Bailey’s injury occurred. However, if Dr. Corso did experience significant resistance while removing the wire, the standard of care required that he use the fluoroscope while doing so.
Under cross examination, Dr. Samson acknowledged that the catheter was placed in a position that allowed Bailey to successfully receive dialysis. Also, in his view, an experienced surgeon who was watching the wire through the fluoroscope would be able to see whenever the wire moved.
Dr. Corso testified that he used the fluoroscope and was watching where the wire was going during surgery. He stated that the wire never entered Bailey’s heart while he was advancing it. Dr. Corso disagreed with Dr. Samson’s testimony that the standard of care required him to look at the tip of the wire at all times during the surgery. In his view, he needed to look at the catheter when he was advancing it because of the risk that the wire could kink in the area of the catheter and tear a vein.
Dr. Corso said that when he was removing the wire, there was considerable friction in Bailey’s circulatory system and that the friction probably caused the wire to move around, causing the perforation. He did not use the fluoroscope at that because he felt the friction was not unusual. Dr. Corso also felt that the injury could not have occurred the way Dr. Samson opined. If the wire had entered the heart while it was being inserted, it would have remained there for a significant length of time, and there would have been a noticeable change in Bailey’s vital signs.
Two other vascular surgeons, Dr. Peter h’Doubler and Dr. Anthony Avino, also testified as experts for the defense and essentially corroborated Dr. Corso’s testimony regarding the standard of care and the causation of Bailey’s injury.
In his closing statement, plaintiff’s attorney Keishan Davis set out three different theories of liability for the jury. First, they could find that Dr. Corso breached the standard of care by failing to closely monitor the wire while inserting it in Bailey’s body. Alternatively, if the jury did believe the injury occurred when the wire was removed, they could find that Dr. Corso violated the standard of care by failing to use the fluoroscope when he encountered significant resistance. Finally, they could find that Dr. Corso failed to recognize and investigate the possibility of a heart perforation quickly enough following the surgery.
In regard to the timing of the injury Bailey suffered, Davis said, “The dispute is about where in the procedure the injury had to happen. So I asked everybody how long before the missing blood pressure would the injury had to have happened. You have Dr. Samson. This is his window, 20-25 minutes. Then you have [the defense witnesses]… They’re telling you it happened after the procedure was over. That’s impossible… Why do you think they said it? They have to do anything they can to take it from when Dr. Samson said because everyone knows if it happened when he said, [Dr. Corso] should have been watching.”
In his closing statement, Dr. Corso’s attorney Daniel Huff reminded the jury that Dr. Corso is presumed to have acted with reasonable care. In addition, they should not apply hindsight to determine whether the steps that were taken during and after the procedure were reasonable.
Huff continued, “Developing a known complication of medical treatment is not proof of negligence. That’s the law in Georgia… When you’re deliberating, if somebody says, ‘You know… I just don’t feel that should happen in this kind of surgery. It’s a short surgery and it just shouldn’t happen.’ The law does not allow you to reach that conclusion. Simply because the outcome was not what it should be, if that outcome was a known complication, and every expert in this case said that this is a known complication, then that’s not enough. You have to find that Dr. Corso was negligent and committed malpractice in how he did this surgery.”
After the trial, Huff commented to CVN that the case was very hotly contested on the evidence. He praised opposing counsel for a well tried case and the jury for sorting through the evidence and coming to the right conclusion. Attorneys for the plaintiffs could not be reached for comment prior to this article.
Attorneys in this case include Keishan Davis of Townes, Davis & Associates of Tucker and Alphonso Craig of the Craig Firm of Atlanta for the plaintiffs, and Daniel Huff of Huff Powell Bailey of Atlanta for the defense.
Watch on-demand video of the trial as soon as it becomes available.
Not a Subscriber? Learn more about CVN's unparalleled coverage of top Georgia trialsAlphonso Craig of the Craig Firm of Atlanta