Retained Catheter Causing Need for Liver Transplant

Filed under Surgical Errors

The Stupar Case

In this case, we represented Jeff Stupar and his wife in a lawsuit against a Hospital and cardiologist based on a retained instrument that was left in Mr. Stupar’s inferior vena cava during a heart catheterization. Suit was filed 15-years after the procedure. As a result of the retained instrument, which was a 7-9 inch long catheter, Mr. Stupar suffered from a condition called Budd-Chiari Syndrome which badly damaged his right heart and his liver to the point that he was placed on a liver transplant list.

The facts:

In 1993, when Jeff Stupar was 31-years old, he underwent a heart catheterization performed by the Defendant cardiologist at the Defendant Hospital. During this procedure, a guide wire and catheter are inserted from the groin into a blood vessel and guided to the heart. During Mr. Stupar’s procedure, the Defendant cardiologist inserted the guide wire and catheter into the blood vessel in Mr. Stupar’s groin. When the procedure was over, the Defendant cardiologist was supposed to remove the entire guide wire and catheter and inspect it to insure that it was removed intact. Additionally, a nurse was supposed to verify that the guide wire and catheter were removed intact. Mr. Stupar had no reason to believe this wasn’t done.

In 2008, Mr. Stupar began experiencing swelling and bleeding in his legs. A CT scan showed that there was a 7-9 inch long instrument stuck in the blood vessel running from Mr. Stupar’s groin up to his heart (the inferior vena cava). This instrument, which we later determined to be a retained catheter, caused Mr. Stupar to experience something called Budd-Chiari Syndrome, a liver condition, caused by an occlusion of the hepatic veins, which will require him to undergo a liver transplant. At the time of trial, Mr. Stupar was on the liver transplant list, and can expect to have numerous health problems in the future, outrageous medical expenses, and a decreased life expectancy, all as result of the retained instrument.

The lawsuit:

We filed suit against the cardiologist and the Hospital (the nurse was employed by the Hospital) in 2008, 15-years after the original procedure. We were permitted to file suit years after the standard 2-year statute of limitations because Mr. Stupar did not have the ability to know of the negligence until the 2008 CT scan (commonly referred to as the “discovery rule”).

The defenses:

The lawyers for the cardiologist and their experts took the position that the retained instrument was not a “catheter” but instead a “guide wire” from a different procedure performed by a different doctor (this is the classic “empty chair” defense in which a defendant and his experts point the finger at other health care providers that have not been sued).

To do this, the Defense had to either point to a cardiothoracic surgeon who did an aortic valve replacement that day after the catheterization in 1993 or to some procedure that Mr. Stupar had as a child in Children’s Hospital. The Defense had to claim it was not a catheter because: (1) a catheter was not used in the aortic valve replacement procedure, only a guidewire was used, (although the guidewire was placed through the neck, not through the groin); and (2) the size of the catheter that would’ve been used on Mr. Stupar as a child did not match the size of the retained catheter. To support the defense, the Defense experts provided various nonsensical opinions including: the cardiologist could not have left a catheter in Mr. Stupar because the cardiologist would just never do that (even though someone obviously did it); it was probably from some procedure that Mr. Stupar had in which the medical records were destroyed; etc.

The cardiologist’s expert also claimed: Mr. Stupar’s heart damage, which was going to require open heart surgery, was not as severe as his treaters think it is; that Mr. Stupar’s liver damage was alcohol consumption (even though the liver pathology contradicted this argument and indicated that the damage was not alcohol related); that Mr. Stupars liver damage was caused by his heart damage which was unrelated to the retained instrument; that Mr. Stupar does not have Budd-Chiari Syndrome - his treating liver specialists at The Cleveland Clinic and in Pittsburgh misdiagnosed him; etc.

Additionally, although it was the Hospital’s position, and that of its experts, that the retained instrument was not a catheter but instead a wire fragment from an aortic valve replacement that a different doctor performed that day after the cardiologist’s catheterization 1993, the Hospital’s experts later changed their opinions and agreed that it was a retained catheter fragment. However, they then claimed that the catheter was from a procedure that Mr. Stupar received as a child in the 1970’s at Children’s Hospital (even though the catheter used on a child would not be the size as the catheter left in Mr. Stupar).

As a catch all, the Hospital’s experts then opined that the Hospital is not responsible regardless of when the catheter was left in Mr. Stupar because they claimed that the nurse did not have a duty to verify that the catheter was removed fully intact; it was the responsibility of the cardiologist.

The result:

On the morning of jury selection, we reached a multi-million dollar settlement with each party contributing to the settlement.

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Publisher: Harry S. Cohen and Associates, P.C.