Atlanta, GA—A Fulton County Superior Court jury found in favor of a surgeon whose patient died following supposedly routine hernia surgery that led to several subsequent hospitalizations over the next few three months. Eric Morgan et al. v. Dr. Clarence Hixon et al. (2012CV224094).
According to testimony and documents in the case, on December 12, 2011, Dr. Clarence Hixon performed surgery on Letha Johnson at Atlanta Medical Center to repair a hernia and alleviate her acid reflux. Johnson was acknowledged by the parties to be in generally frail health at the time of the surgery. Afterwards, Johnson complained of shortness of breath and considerable discomfort. She received a blood transfusion, and a CT scan revealed blood in her abdomen. Dr. Hixon did not drain the blood at that time, and, as Johnson’s attending physician, he discharged her from the hospital on December 24.
Johnson was readmitted to Atlanta Medical Center on December 27 after complaining of shortness of breath. A CT scan then revealed a substantial amount of fluid in Johnson’s abdomen. On December 30, a drain was inserted in Johnson’s abdomen and over a liter of infected fluid was removed. Another physician removed the drain on January 6, 2012, and Dr. Hixon discharged Johnson a day later.
Johnson was admitted to Atlanta Medical Center a third time on January 15, 2012. She was unresponsive and in critical condition. Johnson was diagnosed with sepsis, and the infection was again drained. On February 14, Johnson was transferred to a long term care facility, for continued treatment. Johnson’s condition deteriorated, and she was admitted to Emory Hospital for further surgery. She later developed septic shock and was transferred to a hospice, where she died on March 2, 2012. Her death certificate indicated the cause of death was sepsis and respiratory failure.
Johnson’s relatives later filed the current wrongful death malpractice action against Dr. Hixon and his practice, Peachtree Surgical Specialists. According to the plaintiffs, Dr. Hixon’s alleged malpractice occurred during Johnson’s first two admissions to Atlanta Medical Center.
Dr. Eugene Meyer, a general surgeon, testified as the plaintiffs’ expert witness. He believed that Johnson suffered an injury to her pancreas or spleen during the initial surgery that resulted in significant bleeding and the eventual formation of a hematoma. Dr. Meyer stated that, instead of discharging Johnson on December 24, Dr. Hixon should have drained the fluid at that time and investigated further to determine the cause of her bleeding.
When Johnson was admitted to the hospital the second time, Dr. Meyer again believed that Johnson should not have been discharged until the cause of the infection could be determined and treated. He added that he believed the infection originated in Johnson’s pancreas and that the fluids drained should have been tested for pancreatic enzymes. In Dr. Meyer’s view, if Johnson had been properly diagnosed and treated during her first two admissions to the hospital, the infection would have been resolved and she would likely not have subsequently developed sepsis and died.
Dr. Hixon testified that he believed his treatment of Johnson at all times was proper and within the standard of care. He did not drain the blood from Johnson’s abdomen during her first hospitalization because the hematoma was resolving and, considering her overall frail condition, the risks of doing so outweighed the benefit. Based on all of Johnson’s clinical signs, he believed discharging her on December 24 was warranted.
When Johnson was readmitted, Dr. Hixon noted that her condition had deteriorated and, at that time, he decided to drain the fluid from her abdomen. However, he felt that there was no reason to suspect a pancreas injury as the cause of her infection. As with the first discharge, Dr. Hixon believed that the January 7 discharge was warranted due to her medical condition at the time.
Dr. Hixon acknowledged that Johnson was in very serious condition at the time of her third admission. However, he believed that she had responded to treatment during that admission and was not critically ill at the time she left Atlanta Medical Center for the last time.
Dr. Courtney Shelton, Johnson’s longtime personal care physician, and Dr. William Crossland, a pulmonary specialist, both assisted in the treatment of Johnson during her hospitalizations. Both indicated that there was no reason to keep Johnson in the hospital at the time of each discharge, and that there was no indication at the time of her final discharge that she was likely to die.
Dr. Jeffrey Schwab, a general surgeon, also testified as an expert witness for Dr. Hixon. He stated that, at the time Johnson was initially discharged from the hospital, draining the hematoma was not warranted because of the potential risks involved in the procedure. Instead, he believed that, according to Johnson’s records at the time of discharge, Dr. Hixon acted properly. He also agreed with Dr. Hixon that there was no indication of pancreatitis at the time of her second hospitalization and that her second discharge was also warranted. Finally, he indicated that there was no reason to suspect at the time Johnson was discharged from Atlanta Medical Center the last time that she would die in the near future.
In his closing statement, the plaintiffs’ attorney Michael Harper rejected any suggestion that he was asking the jury to base its verdict on hindsight. Instead, he stated that Dr. Hixon “has all this objective clinical data, beforehand not hindsight, before she goes home here… Now he testified ‘she seemed fine to us.’ That is because he failed to diagnose the problem… This is beforehand. This is not hindsight. He had all of this information in front of him before he sent her home both times.”
In his closing statement, Dr. Hixon’s attorney Mark Meliski reminded the jury that the only medical witness who criticized Dr. Hixon’s treatment of Johnson was Dr. Meyer. “It’s funny to me that Dr. Meyer came in here, and I felt a little bit sorry for him because he’s on an island in every opinion that he has. For every opinion that he has in terms of criticizing Dr. Hixon, he is the only physician in the room that has that opinion. Everybody else that you heard from has a different opinion.”
Meliski also reminded the jury that, in order to find for the plaintiffs, they would need to find that Dr. Hixon’s negligence caused Johnson’s death. He pointed out that at the time she left Atlanta Medical Center the last time, all the doctors who treated Johnson believed her condition was treatable and that she was not going to die.
After the trial, plaintiffs’ attorney Michael Harper told Courtroom View Network that the case was hard fought on both sides. In his view, the key to the jury’s verdict was that they believed he had not presented sufficient proof that Dr. Hixon’s actions caused Johnson’s death. Representatives for the defense were unavailable for comment before this article was published.
Related information:
Attorneys involved in the case include Michael Harper of Atlanta's Michael Harper & Associates for the plaintiffs, and Mark Meliski of Atlanta'a Owen, Gleaton, Egan, Jones & Sweeney for the defense.
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