The 55-year-old plaintiff and her spouse contended that defendant’s failures to properly counsel her about her risk of vitamin deficiencies, obtain appropriate blood-vitamin level testing at appropriate intervals, and more aggressively administer vitamin supplementation, notably B1 (thiamine), in the presence of persistent vomiting, frothing, excessive postoperative weight loss and weakness, caused her to develop a severe thiamine deficiency and Wernicke’s encephalopathy, with permanent injuries including impaired vision, inability to focus, and gait imbalance and weakness.   Plaintiff underwent a sleeve gastrectomy by the defendant in April 2018.  Thereafter, she developed vomiting, frothing and dehydration, for which she was administered intravenous fluids in the office twice, and once in the hospital, within three months of the surgery.  The plaintiff was not maintaining adequate hydration as she had been educated about before surgery, and after.  She also was not taking her post-operative vitamins as directed, although she and her spouse denied that at trial.  Ultimately, the jury found that the defendant had met the standard of care in all respects, including the timing of the blood- vitamin level and vitamin supplementation.  The defense was supported by the impressive trial testimony of the defendant herself, and another board-certified bariatric surgeon.   The jury returned its verdict within three hours of beginning its deliberations.

The plaintiff–mother brought suit against her deceased daughter’s neurosurgeon, alleging that his failure to promptly perform surgery to revise her malfunctioning ventricular–peritoneal (VP) shunt caused her death just a few days before her third birthday.  The girl’s prematurity at birth and brain hemorrhage had necessitated the placement of the shunt.  The defendant had remained her doctor thereafter, monitoring the shunt’s function during office visits and emergency department admissions with head CT imaging.   In November 2014, the child was admitted to the pediatric intensive care unit under his care, with concern to rule out malfunction of the shunt.  Serial CT imaging was obtained, and did not appear to show any dangerous accumulation of cerebral spinal fluid within the brain.  However, the girl’s lethargy, headache, and elevated blood pressure and heart rate persisted, prompting her neurologist and intensivists to recommend revision of the shunt.  The defendant scheduled, but then canceled surgery to revise the shunt when her symptoms improved. Overnight, her condition deteriorated and she developed persistent seizure activity; by the next day, she had evidence of brain death.  Defendant took her to the OR where he placed a new shunt.  The child passed away several days later.   Plaintiffs’ expert contended that defendant was negligent in delaying performance of what would have been life-saving surgery.  He contended that the child was experiencing “pressure waves” from intermittent increased intracranial pressure as a result of shunt malfunction.  The defendant, and another neurosurgeon involved in the infant’s care until just prior to the canceled surgery, testified that there was no evidence of shunt malfunction.  Defendant identified the cause of death as seizures which were not treated appropriately by the hospital staff intensivists.  The defense was supported by the testimony of an expert pediatric neurologist, who testified that the autopsy, and head CT imaging, showed no evidence of brainstem herniation as would have occurred had the death been caused by increased intracranial pressure.  He dismissed plaintiffs’ expert pediatric neurosurgeon’s testimony regarding “pressure waves,” and identified seizure activity as a possible cause of the death.   The jury returned a unanimous verdict in favor of the defendant after deliberating for two days.

In April 2011, the defendant performed weight loss surgery (a duodenal switch with sleeve gastrectomy) on the morbidly obese patient, a single mother of two children.  She subsequently developed persistent micronutrient deficiencies and abdominal pain, prompting him to take her back to the operating room in January 2015.  His intention was to perform exploratory surgery with possible revision of the common channel, anatomy he had revised during the first surgery, in the hope of curing her malabsorption issues.   During his insertion of a 12 mm Optiview trocar, the aorta and inferior vena cava were lacerated.  The patient died on the operating table despite the intervention of a vascular surgeon and trauma team.   The action was filed by the decedent’s niece and the father of the younger child, the co-administrators of the Estate and guardians of the two children.  Plaintiffs alleged that the defendant committed malpractice by carelessly using excessive force in his insertion of the trocar, and by misdirecting it toward the aorta.  Our defense, that the injury to the aorta was the unfortunate consequence of the patient’s massive weight loss and changes in her tissues, the result of her malnourishment, was supported by the testimony of the defendant and a second well-credentialed bariatric surgeon expert.  The jury returned its verdict in favor of my client in just under 50 minutes.  Keys to the successful outcome included “surgical” cross-examinations of plaintiffs’ bariatric and economics experts, and sensitive yet probative questioning of the decedent’s family, including the surviving son and his father, and the daughter’s guardian.