As Med Mal Stroke Trial Opens, Attorneys Spar Over Alleged Alterations to Medical Documents

Posted by Arlin Crisco on Apr 20, 2015 7:22:00 PM

Grant Kuvin details what he claims were alterations to the medical records of his client, Jorgina Araujo, after her 2011 hysterectomy. Araujo is suing Dr. Tatiana Eisner and Heidi Aleman-Ortega, claiming they failed to take action on a tell-tale warning sign of an embolism that caused her stroke.

Fort Lauderdale, FL—The cause of the stroke that blinded Jorgina Araujo, and whether vital sign measurements had been altered by medical staff, took center stage as trial opened Friday in Araujo’s suit against the anesthesia team she claims committed malpractice during her hysterectomy. Araujo v. Eisner, CACE13012999.

Click Here FREE Florida Trial Video Samples “There are three important things to keep a patient asleep, safe, and stable,” Morgan & Morgan’s Grant Kuvin, representing Araujo, told jurors in openings Friday. “This anesthetic team broke all three of those rules.”

Araujo is suing anesthesiologist Dr. Tatiana Eisner and nurse-anesthetist Heidi Aleman-Ortega, claiming they failed to notice tell-tale warning signs of an air embolism, or air entering Araujo’s veins during her 2011 hysterectomy. Araujo contends she suffered a stroke from the embolism, which led to her left-side blindness and the inability for her brain to understand what she is seeing.  

A key point of dispute in the case is whether Araujo’s end-tidal C02 measurement during surgery had dropped, signaling that air had entered her veins. End-tidal C02, or ETCO2, is the measurement of the carbon dioxide remaining in a person’s lungs after an exhale, with a lower number indicating potential pulmonary problems. During openings, Kuvin told the jury that Araujo’s ETC02 fell to a critically low 22 as the embolism made its way through to her brain, but defendants failed to act.   

Kuvin argued that evidence, including testimony from a documents examiner, would prove Ortega's ETCO2 entry during Araujo's surgery had been altered from a 22 to a 32. “You don’t need to be an anesthesiologist, and you don’t need to be a (certified registered nurse anesthetist) to appreciate the addition on that number,” Kuvin said.

Kuvin contended that the alleged change in the entry did not necessarily signal any ill intent. Instead, he argued that Ortega may have changed the number after surgery in the mistaken belief that the reading was inaccurate because there had been no other symptoms of an air embolism. “But the fact is, and the medicine will show… you can have this event happen without the phenomenon of (other venous air embolism symptoms) happening,” Kuvin said.

The defense countered that their own documents examiner and copies of Araujo's surgical records would show the ETCO2 entry was never altered. Instead, the defense contends the unusual looking entry was the result of poor handwriting under the stress of an operating room environment. “Minute by minute, second by second, she’s evaluating this patient, her vital signs, her responses, the oxygen levels, the medications, and she’s making notes. Boom, boom, boom, boom,” Chimpoulis, Hunter & Lynn’s Jay Chimpoulis said. “All this stuff she’s charting, as it’s going in real time, with one hand. This is not calligraphy. She’s not looking to put it on a birthday card.”

Chimpoulis acknowledged that Araujo suffered a stroke, but argued that it was caused by a blood clot for which defendants are not responsible. Chimpoulis told jurors that nothing in the medical records established that Araujo suffered a venous air embolism. “The only person who is going to say it’s a venous air embolism are the people that (Araujo’s attorneys) hired,” Chimpoulis said.  “Guess what you don’t see in those first two (post-operative) nursing notes?” Chimpoulis asked. “You don’t see any complaints of ‘I can’t see,’ when we know if that’s a venous embolism (blindness) would be immediate.”

Trial is expected to last two weeks.

Attorneys for the parties did not immediately respond to requests for comment. 

Arlin Crisco can be reached at

Related information

Attorneys include Morgan & Morgan's Grant Kuvin and John W. Dill, representing Jorgina Araujo, and Chimpoulis, Hunter & Lynn's Jay Chimpoulis and Barbara Paige, representing Dr. Tatiana Eisner and Heidi Aleman-Ortega. 

Read a copy of the pre-trial stipulation here. 

Watch Araujo v. Eisner.

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Topics: Florida, araujo v. eisner