Lawrence doctor on trial for surgery error / LJWorld.com

Archive for Friday, November 3, 2006

November 3, 2006

Closing arguments are expected today in a medical malpractice trial involving a Eudora woman whose doctor removed the wrong ovary in a 2002 surgery.

Amy C. Miller, 32, is seeking more than $750,000 in damages in her lawsuit against Lawrence physician Carolyn Johnson, who specializes in obstetrics and gynecology.

It's not disputed that Johnson accidentally removed Miller's left ovary instead of the right one on Oct. 18, 2002, when Miller came in for surgery to relieve severe pain on the right side of her pelvis.

"I thought it was the right ovary. I don't have an explanation for how that happened. : I made a mistake," Johnson testified Thursday in Douglas County District Court.

The question for jurors to decide is whether Johnson is legally at fault, and if so, how much Miller should receive in damages and expenses.

Such mistakes are common nationwide but underreported, according to a September article in the medical journal Archives of Surgery. The authors estimated there are from 1,200 to 2,700 surgeries per year that involve the wrong site on the body, wrong procedure or wrong patient.

"Despite a significant number of cases, reporting of (the cases) is virtually nonexistent, with reports in the lay press far more common than reports in the medical literature," an abstract of the article states. "Wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events, although rare, are more common than health care providers and patients appreciate."

Attorneys for Johnson admit the doctor fell below the "standard of care" for physicians, but they claim the mistake didn't change the course of Miller's treatment. Given her medical history and circumstances, they said, the left ovary would have required removal at some point.

They also deny that Miller suffered the kinds of damages she's claiming. Three weeks prior to the surgery, they argue, Miller told a doctor that she and her husband didn't want to have any more children. They've also called expert witnesses, including a psychologist who testified that Miller's diagnosed anxiety disorder can't be attributed to any specific incident.

After the surgery, Miller's pain on her right side didn't go away, and it wasn't until a sonogram that a doctor discovered she still had her right ovary. It was removed in a 2004 surgery.

Prevention of "wrong side" mistakes, the authors of the September medical journal article wrote, "requires new and innovative technologies, reporting of case occurrence, and learning from successful safety initiatives : while reducing the shame associated with these events."

At the time of the surgery, Johnson worked at Lawrence OB-GYN Specialists. She now works for Student Health Services at Kansas University's Watkins Memorial Health Center.

Miller is represented by attorneys William Skepnek and Trey Meyer. Johnson is represented by Bruce Keplinger and John Hicks of Overland Park.

Discussion

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3 November 2006
at 6:26 a.m.

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lunacydetector (Anonymous) says…

so, let's say the jury awards some astronomical figure because they think this person deserves it, isn't the cap on medical malpractice in kansas only $250,000? a drop in the bucket. so in essence, the judge will reduce the amount awarded (if there is any amount awarded) to what the maximum cap is by law.
3 November 2006
at 6:38 a.m.

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Ragingbear (Anonymous) says…

There are ALWAYS ways around that, that is why lawsuits are still producing judgments of 3 bazillion gajillion dollars to somebody that didn't think coffee would be hot.
3 November 2006
at 7:50 a.m.

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lawrence_citizen (Anonymous) says…

Let's see, is it my right or your right.
3 November 2006
at 7:57 a.m.

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consumer1 (Anonymous) says…

If I ever have to have surgury, I am gonna write on my body with a marker, which proceedure should be done, with my name right beside it.
“Joe Blow, remove gall bladder”.
3 November 2006
at 8:09 a.m.

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jranderson (Anonymous) says…

This happened to a friend of mine as well, (emergency surgery for ectopic pregnancy) and she said it was because the doctors wouldn't listen to her let alone speak to her. They whisper things to the nurses or discuss weekend plans as they botch your lifesaving procedure. As patients we must demand better care than this! Ask questions and be educated. Doctors are not superior beings that we can blindly trust. Unfortunately lawsuits only seem to make the system worse. Where is a real check and balance system?
3 November 2006
at 8:25 a.m.

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mom_of_three (Anonymous) says…

And everyone is assuming your organs are where they are supposed to be. No excuses for doctors, though.
Dr. Johnson is a good doctor, and it's a shame something like this happened.
3 November 2006
at 8:55 a.m.

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kmat (Anonymous) says…

These things aren't rare and it's because we run our hospitals poorly. My mother was to have a small, non-cancerous tumor removed from her breast 5 years ago. The Dr. did the surgery, but removed other material instead of the tumor. When the mistake was found almost three months later, the tumor was then stage III cancer which required more surgeries (not only remove the breast, but also all lymph nodes on that side), radiation treatments and years and years on multiple meds.

Dr.'s make plenty of mistakes. We are all human, but when they are dealing with someone's lives, they'd better be 100% sure they're doing the procedure correctly. I'm very lucky that my mother made it through her cancer and have always hoped that the first surgeon that botched the job felt plenty of guilt for causing this cancer to develop.

Moral of the story - all Dr.'s are only “practicing” medicine and you should check into the background of anyone that will doing any kind of surgery on you or a loved one.

3 November 2006
at 9:02 a.m.

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missmagoo (Anonymous) says…

go figure they sent her to watkins.
3 November 2006
at 9:07 a.m.

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stbaker (Anonymous) says…

Dr Johnson is a fantastic doctor! And just as the article states, these incidents are very much under-reported, so you can bet yourself that she is not the first one in Lawrence to make the mistake.

jranderson: May I ask what you might talk about at work with your co-workers? I'm sure that there is some “smalltalk” throughout the day, as well as relevant-to-work discussion. And I can guarantee (being a nurse) that the physicians, nurses, and ancillary staff that I work with do not “whisper things” to one another in front of patients during a procedure. I am sorry for your friends' situation.

In her defense, Dr Johnson has performed hundreds life-saving procedures successfully, and delivered thousands of babies in her time, many of which were emergent and required great skill and quick thinking.
3 November 2006
at 9:29 a.m.

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consumer1 (Anonymous) says…

Uhhmmm, just wondering since health insurance seems to be the primary focus when seeing a dr. could this mistake be related to the type of or lack of health insurance? For example, do dr.'s do less for patients with medicare? than they do for someone with Blue Cross? My thought are Heck yes. From Rx to surgury the poor folks get less quality care. Go figure????
3 November 2006
at 9:30 a.m.

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Jamesaust (Anonymous) says…

“isn't the cap on medical malpractice in kansas only $250,000?”

No. K.S.A.Â§ 60-19a02 limits recovery to $250k for non-economic damages ('pain & suffering' or 'loss of consortium' or financial loss to an heir in a wrongful death case, etc.).

The Kansas Supreme Court held back in 1988 (correctly) that it was unconstitutional to cap recovery for ACTUAL damages to the victim; if your loss is actually a million dollars, capping recovery at a lesser amount is the equivalent of stealing the money in the first place.

No statute, however, can determine the actual amount of damage when there is a dispute such as here. That's what we pay courts to do.
3 November 2006
at 9:33 a.m.

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kmat (Anonymous) says…

stbaker - just because you work in a medical office, don't assume that you know how all doctors and staff in all facilities are. I can tell you that they do whisper things in front of patients. I really pissed off the second dr. that my mom had do her cancer surgeries because I went off about how if they have something to say about my mom's condition, speak up or get the hell out of the room. They kept disturbing my mom because they weren't telling her what was going on and just kept saying it wasn't important. I've also had doctors doing very routine things whisper to the nurse in front of me. It is very disturbing to have a dr do this.

It is absurd to compare co-workers in an office making small talk to medical staff in charge of someone's life making small talk around a patient. the patient is what matters, no matter what you think!

You are obviously overprotective about this because you work in the medical field.

Dr. Johnson may be a good dr in general, but if she is such a good dr I'd think she could figure out which side is left and which side is right. Do they need diagrams on the walls of the operating rooms to remind dr's of this? If she had read all of the patient information before hand and was focusing on only the patient at hand, I don't see how she could confuse right and left. Maybe she needs to hold a rock in one hand so she can keep it straight.
3 November 2006
at 9:35 a.m.

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towniejj (Anonymous) says…

The question here is why hasn't her insurance company just paid this? $750,000 isn't that much for an ovary. This woman now cannot have any more children b/c her one good ovary was removed b/c of the doctor's error. Obviously the doctor is at fault, now we will see how much a jury thinks the ability to have children is worth.

I think the doctor's insurance company should just pay this small amount. They are probably spending well over $200,000 to defend the case.
3 November 2006
at 9:37 a.m.

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mom_of_three (Anonymous) says…

My daughter had her appendix removed last year, but it took 4 days to diagnose it, and then the surgery took 3 times as long as normal, because her appendix was not where it was supposed to be. It was actually next to her ovaries, and in a sonogram, it was mistaken for one. Some things are not as they seem in a human body.
Dr. Johnson was my ob for two of my kids, although she didn't deliver either of them. She was great. I wish her the best.
I also feel for the patient, and hope everything turns out for the best for both of them.
3 November 2006
at 10:12 a.m.

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bearded_gnome (Anonymous) says…

dr. johnson is one of the most caring and giving doctors I've seen in practice (she's cared for mrs. gnome and I've sometimes gone along). I'm sure that dr. johnson feels a great deal of emotional pain over this mistake.

***
the idea of mutilating doctors for such mistakes [above] is rather midieval and represents some viscious retalliation. sad.
in every profession, there cannot be perfection for we are human after all.

3 November 2006
at 10:13 a.m.

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crazyks (Anonymous) says…

While I don' think it's an excuse for this kind of error, it would be possible to get confused, I guess, if no one was clear on whether it was the right side from the patient's view or the doctor's.

Didn't the patient know immediately, after she woke up, that they had cut the wrong side?? Or do they make the incision somewhere in the middle and grope for whatever ovary they want?

Plastic surgeons use some kind of pen to mark the areas they are going to modify. Can't regular surgeons use this as well?

I've seen medical horror stories on TV about all the blunders that happen in the operating room, and it's chilling. And a good lot of the errors occur because the doctor has been on duty for far too many hours, and their judgement is impaired because they're sleep deprived.

They've lowered the amount of hours per week that a med student has to work, but it's still too high. You'd think people in the medical profession would be intelligent enough to realize that sleep deprivation can cause mistakes.

I had an uncle who complained of pain on his left side, and they did numerous tests before they discovered that it was his gallbladder, and it was on the left, instead of on the right as it is with most people. But at least they discovered this BEFORE surgery.

And stbaker, I'm sorry, but some doctors and nurses DO talk and whisper in front of patients and family members. I have even heard some of them GOSSIP and JOKE about patients, and joke about the procedure being done. Don't say it never happens. Too many people have had the same experiences.

My daughter had to have surgery done at KU Med when she was an infant. While I was there one day, right after her surgery, there was a little boy down the hall, about 10, and his family was all there, basically waiting for him to die. There was no hope left.

During rounds that morning, the doctor and all the interns went trooping into this boy's room and discussed his case in a very clinical manner, as if he wasn't really a PERSON, even in front of all the grieving family members that were gathered. His mother started sobbing and begged them to leave them alone. They wouldn't do it. They stayed until the doctor decided it was damn well time to go.

I know KU is a teaching hospital, but this was going way too far. Doctors aren't gods, and they shouldn't think they're better than anyone else.

Consumer1, you're right. Look at the death rates and types of treatment done for women with breast cancer (or anything else). Poor women are far more likely to die from breast cancer.
3 November 2006
at 12:26 p.m.

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Celeste (Anonymous) says…

That is so, so sad. Suffice it to be said that some doctors do lose sight of what is important, but I believe the vast majority really care about their patients. They really carry a heavy burden, because if they make any mistakes at all, then the patient is the one who suffers. It takes a really strong person to take that risk. I worked at a veterinary office for several years, and that was what kept me from going into vet school-it was the thought that if I made any mistakes, the animal would be the one to pay, and I just couldn't handle it.

I don't know what I would do in this doctor's situation-I feel terrible for both parties in this.
3 November 2006
at 1:20 p.m.

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hockmano (Anonymous) says…

to lunacy detector : That was said like a true man. If you are not a man you must be a childless woman. There is no consolation to losing your ovaries. No amount of money could make up for that.
3 November 2006
at 1:43 p.m.

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context (Anonymous) says…

In case you think you know it all after reading this article — a mere snapshot of the story, consider:
- insurer may well be in the driver's seat of what may have been offered by Dr. Johnson in settlement;
- insurer/Dr. have likely already offered the $250K cap plus;
- you don't know what other kind of claims may have been made by Plaintiff as a vehicle for seeking economic damages (so as to avoid statutory cap);
- you don't likely know Dr. Johnson or the plaintiff or whether the plaintiff had intended to have a child later; and
- you don't likely know what happened prior to or during the surgery.
3 November 2006
at 1:43 p.m.

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Katara (Anonymous) says…

From the article…

“Three weeks prior to the surgery, they argue, Miller told a doctor that she and her husband didn't want to have any more children. ”

“Given her medical history and circumstances, they said, the left ovary would have required removal at some point.”

I take this to mean that she was not planning to have children even if she could so I don't see where she could collect damages for not being able to have children

I'm guessing that this woman suffered from PCOS based on my own experience with it.

This article is interesting because I had a similar surgery a little bit over a month prior to this woman. Dr. Johnson was the surgeon. My right ovary + a giant tumor were removed.

You can't tell from the incisions because this type of surgery is usually done laproscopically. There are 4-5 small incisions (including one in your belly button) made.

In my case the tumor grow so large so quick, the laproscope surgery became a lapro-otomy (sic) and I now have a scar the same size & 1/16” above my c-section scar.

I was pretty unhappy with the decision to remove the right ovary but I was unconscious at the time.

I still get pretty severe pain on my right side even though that ovary is gone so you can't base it on where the pain is (just like others have said).
3 November 2006
at 1:45 p.m.

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Katara (Anonymous) says…

Oops. I guess she does have children since she mentioned to a doctor that they didn't want any more.
3 November 2006
at 2:37 p.m.

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concernedparent (Anonymous) says…

It'd be nice if they'd write a story about Dr J doing all the good things she did in her many fantastic years as an Ob/Gyn, but they decide to just write about the bad things. Lets hear all the good stories about all the babie's and mothers lives she's saved. Anyone who knows Dr J (either personally or as a patient) knows she must just feel horrible about this. And they didn't get rid of her Missmagoo, she chose to go to Watkins for her own personal reasons. I'm sure Lawrence Ob/Gyn would still be thrilled to have her around.
3 November 2006
at 2:53 p.m.

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kugrad (Anonymous) says…

Hang in there Dr. Johnson! We all make mistakes!
You are certainly a good doctor and helped my family a great deal!

3 November 2006
at 4:44 p.m.

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Baille (Anonymous) says…

Ragingbear:

One can recover whatever economic losses one suffered due to another's negligence, e.g. reasonable medical expenses associated with fixing the damage caused by medical negligence or wages lost while undergoing reparative procedures. These are not capped.

Non-economic damages are capped at $250,000.00 in Kansas. This has not changed in AGES. Essentially these damages compensate a victim of negligence for the intangible losses caused by another's negligence. These are the damages that have no market value, e.g. grief, bereavement, chronic or acute pain. This is hard cap. There is no way around it.

Let's take the case of a baby whose intubator fails and the nursing staff ignore the warning lights and alarms. The lining of the baby's lungs literally melt due to the heat and humidity of the incubator. The baby survives but is disabled and suffers excruciating pain every time she breathes.

The negligence of the nurses has caused a variety of damages and losses. Under the theory that one must take responsibility for the harm one causes (you break it, you buy it), the nurses - or more accurately the nurses' insurance company - owes the baby for harm caused.

Medical expenses to stabilize the child will be very high. The insurance company needs to pay for that. Future medical expenses are likely if only to ease the excruciating pain that baby must live with. The insurance company needs to pay for that, too. Most likely the baby has lost the ability to earn what she would have been able to earn. This is harder to prove, but the evidence will be there and the jury must reach a decision on the value. The insurance company must pay for these losses even though they may be difficult to figure out. In any case, these are all examples of economic losses. No cap.

However, the insurance company also must pain for the pain this person will suffer for the rest of his/her life. This loss is enormous, but it is hard to calculate. In some jurisdiction, the loss could be valued at a million dollars, maybe 2, maybe 10. If we operate under the theory that the compensation would equal the loss, one must ask oneself for how much money would they trade their lung lining. A million dollars? Every breath you take is taken in agony. You can't sleep. You can't work. You can't flirt. You can't travel. Would you take a million dollars for that? 2 million? If not, then you have not been compensated for your loss. You have not been made whole. But then maybe you never could be. Maybe no amount of money is enough. Well, it doesn't matter. Because in Kansas you can recover $250,000.00. That's it. Dead kid? Dead parent? Enormously negligent defendant? $250,000.00. There is no way around it. It is a hard cap. It doesn't hardly seem fair, but that's the way it is.
3 November 2006
at 5 p.m.

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bevy (Anonymous) says…

Just a note - I had shoulder surgery last year and I was asked by the nurse (and then the doctor confirmed it) to sign my name in Sharpie across the shoulder they were operating on. The purple ink looked really neat under my stitches…they also asked me multiple times what I was there for, what side the injury was on, etc. etc.
3 November 2006
at 5:31 p.m.

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lristh1230 (Anonymous) says…

i heard about this and the demand for that amount of money if outrageous she didnt lose her life and there was no baby that lost its life, and other children werent in the future. I hope the jury goes down in the amount a whole lot. What happened to marking the site for surgery?? Looks like publicity and greediness took over!!! Party tonight it looks like and early retirement.
3 November 2006
at 6:19 p.m.

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person184 (Anonymous) says…

I'm glad I'm not a doctor. I make these types of mistakes (not on body parts) all the time. It is a shame but the other ovary had to come out anyway!
3 November 2006
at 6:34 p.m.

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Lynn731 (Anonymous) says…

Everyone makes mistakes. My brother is a pediatric surgeon, and he always listens to the parents of his patients. I am not aware of any mistakes he has made, but it could happen. What worries me most about this is when the patient said the doctors would not listen to her. That is very, very serious. If I go to a physician that won't listen to me, most especially a surgeon, I would go into warp out of there and find a doctor who will listen. If this is true, had the surgeon listened to the patient, if most likely would never have happened. Listening to patients is paramount for a doctor. I feel so sorry for both the patient, and the physician that has a reputation as being an excellent doctor. How sad. Thank you, Lynn
3 November 2006
at 6:36 p.m.

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Lynn731 (Anonymous) says…

P.S. I would have no problem sending my wife to Doctor Johnson. Thank you, Lynn
3 November 2006
at 6:49 p.m.

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just_another_bozo_on_this_bus (Anonymous) says…

An eye for an eye, and an ovary for an ovary.

Sounds like a good “christian” solution to me.
3 November 2006
at 9:20 p.m.

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redneckgirl1 (Anonymous) says…

She is the worst Dr. ever…I would never refer anyone to her…not even my worst enemy !!!!

3 November 2006
at 10:23 p.m.

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jayhawk909 (Anonymous) says…

Baille-

A simple counter point, what is it worth when a Physician, Nurse, or other health care provider performs a procedure that saves a life, perhaps, saves a baby from having excruciating pain when he/she breathes, or saves any other life…isn't that worth significantly more than the meager sum they will receive from their health insurance.

Point being, those in the medical profession, across all specialties, are not compensated appropriately for the risk they take. Maybe that explains why enrollment in medical schools are on the decline, doctors are retiring early, or going to work in the private sector, and many hospitals are having to reduce services due to lack of on-call physicians.

I for one appreciate what they do, and am damn glad I don't have to bear the burden they face everyday they go to work. Perhaps, you should go to medical school and make the world a better place.
3 November 2006
at 10:47 p.m.

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yellowrose (Anonymous) says…

Dr. Johnson is a wonderful, conscientious and very caring physician and was my doctor for several years. I don't know why she is no longer with Lawrence ObGyn but, I can say with certainty that if she were still in the practice there, I would continue to be her patient. She performed surgeries and was with my husband and I throughout our intire struggle in our unsuccessful attempts to have children. Dr. Johnson rejoiced with us when I took each pregnancy test, and comforted us as our tears fell with each negative result. At a point when most doctor's would have given up on us because of the difficulties of our situation, she did just the opposite. Doctor Johnson didn't try to play God as some physician's would have. She made sure that I got excellent treatment by a specialist and that we had every chance that our finances would permit us at having the family we so desperately wanted. It takes a big person to realize when a situation she is dealing with is out of her area of expertise and to ask for help. It takes an even bigger one to publicly admit their mistake but, you see, that is the kind of person that Doctor Carolyn Johnson is. Carolyn Johnson, I'm proud of you for having the courage and personal integrity to do what is right. You may think I'm crazy but, I trust someone who honestly admits they have made a mistake much more than I would trust someone who hides it in secrecy or tries to cover it up.
4 November 2006
at 10:45 a.m.

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Baille (Anonymous) says…

Jayhawk99,

I will ignore your personal jabs and focus on the substance of what you wrote.

Every profession has some risk of causing harm. Physicians are in the precarious position of being able to inflict great harm quickly or allowing great harm to occur by not preventing it. However, they are allowed to use their judgment and they are allowed to make mistakes. Poor decisions - so long as they meet the standard of care which is defined by others in their profession - do not bring liability for harm caused. Negligence does.

What is the Spiderman line? “With great power…”

Physicians often do great things. Many of them are in the position of saving lives everyday. For this they are compensated well. Look at the average salary of a general surgeon or an orthopod. But along with the power to do great and miraculous things comes along the great risk of doing great damage. If a physician is negligent, he or she just doesn't lose a sale or screw up a string of code. They can cost people limbs. They can cause irreparable pain and suffering. They can actually kill someone. Just because they are a doctor does not mean that they do not have to take responsibility for their negligence.

However, I agree that doctors can not be expected to shoulder that burden alone. That is why they have insurance. Now there are problems with the insurance model of sharing risk. Ad there are plenty of proposals on how to improve that system of risk-sharing in the medical profession. It is too complex an issue to discuss in the forum but it is interesting.

Three observations:

1. Medical negligence cases are notoriously hard to prove. The system favors the doctors. The laws favor the doctors. The Pattern Instructions of Kansas favor the doctors. Doctors have great protection under the law while their patients have relatively few. The very nature of the suits are such that the normal person can not bring most medical negligence cases. They cost so much to litigate that the patient has to be greatly damaged simply to break even on the costs of litigation. We have legislated most victims of medical negligence out of the courtroom.

2. Most doctors don't get sued. A relatively small percentage of doctors get sued a lot. The medical profession does a very poor job of investigating and disciplining these doctors.

3. Most cases of medical negligence could be resolved by the doctor explaining to the patient and family what went wrong and apologizing, and the doctor's insurance company paying to fix the damage caused. Neither of these things usually happens prior to an attorney getting involved. That is a sad.
13 November 2006
at 1:03 a.m.

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scardicats (Anonymous) says…

I have read most of the prior comments made and I can't believe what I read! Obviously, those who wrote the mean comments do not know Dr. Johnson. She is a wonderful doctor! She was my OB-Gyn for both of my pregnancies and performed both of my c-section deliveries. My youngest daughter was born right before SHE made the decision to go to Watkins. And I was very sad to lose her as my doctor. She was the most compassionate and caring doctor that I have ever had in my life. I would go back to her in a minute! Dr. Johnson, please know that you and your family are in my thoughts and prayers.