Femoral Angioplasty Errors Results in $17M Plaintiff Award

Case Overview

Case Name: Kathleen J. Bashore v. Sparrow Health System, Sparrow Medical Group, Edward W. Sparrow Hospital Association, Ara Pridjian, Thoracic and Cardiovascular Institute, Sparrow Hospital, Sparrow Heart and Vascular Center, Sparrow Thoracic and Cardiovascular Institute and Sparrow Cardiovascular and Thoracic Surgery

Case Type: Medical Malpractice – Delayed Treatment; Wrong Site/Procedure

Injury:

Leg – fracture, leg; fracture, femur
Other – sepsis; ischemia; necrosis; catheterization
Cardiac – aorta, rupture
Epidermis – gangrene; bedsore/decubitus ulcer/pressure sore
Leg amputation
Urological – neurogenic bowel; neurogenic bladder; urinary tract infection
Arterial/Vascular – artery; acidosis; hemorrhage; hypotension; hypovolemic shock; internal bleeding; artery, severed/tear
Surgeries/Treatment – colostomy; debridement; open reduction; internal fixation
Pulmonary/Respiratory – pneumonia
Paralysis; paraplegia

Plaintiff Attorney(s):

Stephen B. Goethel; Goethel Engelhardt, PLLC
Jennifer Engelhardt; Goethel Engelhardt, PLLC
Chad D. Engelhardt; Goethel Engelhardt, PLLC

Defense Attorney:

Richard J. Suhrheinrich; Kitch, Drutchas, Wagner, Valitutti & Sherbrook

Case Outcome: Verdict – Plaintiff

Award Amount: $17,000,000

What Happened?

On March 3, 2015, doctors at Sparrow Hospital in Michigan performed a femoral angioplasty on a 70-year-old woman, Kathleen Bashore. Within a few days of the procedure, Kathleen suffered a blood clot, internal bleeding, and a spiral of ensuing medical problems that culminated in Bashore becoming a paraplegic and an amputee.

Femoral Angioplasty

A person needs a femoral angioplasty when the arteries that supply blood to their legs become clogged or narrowed. In this procedure, surgeons place a medical “balloon” inside the artery. Then, surgeons inflate the medical “balloon” to widen the blocked blood vessel to allow blood flow. The procedure can also include the insertion of mesh stents that remain in the artery to keep it open.

During the surgery, doctors may put a sheath—a protective encasement—into the artery to help them insert the balloon and stent. The sheath often stays in for several hours to minimize bleeding. Medical teams monitor a sheath inserted during an angioplasty and determine when to remove it, paying close attention to the anticoagulant or thrombolytic blood thinning medication given to the patient. These medications thin the blood and put patients at risk for bleeding.

An Angioplasty Gone Wrong

The Sparrow Hospital surgical team implanted surgical sheaths into Bashore’s legs when they did the femoral angioplasty. These sheaths remained in her legs for an extended period after the procedure, causing a blood clot in Bashore’s left leg. On March 4, the day after her surgery, vascular surgeon Ara Pridjian, M.D. began treating Bashore for her clot. Dr. Pridjian also went in and inflated the balloons and stents from the original femoral angioplasty. Two days later, Dr. Pridjian performed a bypass on Kathleen. In a femoral bypass procedure, a medical team builds a detour around an artery blockage using a vein from another area of a patient’s leg or a man-made graft.

A few days after the bypass surgery, doctors discovered that Bashore could not move her lower extremities. Massive hemorrhaging after Dr. Pridjian’s surgery on March 4 had deprived Kathleen’s spinal cord of blood. The internal bleeding had compressed her blood vessels, which impeded blood flow to her spinal cord. Doctors diagnosed her with an ischemic spinal cord injury—an injury to the spine from a stoppage of blood supply. The injury resulted in Kathleen suffering below-the-waist paralysis and loss of bladder and bowel function.

Amputation and A Litany of More Complications

A month after the hospital discharged Bashore to an inpatient rehabilitation facility, she was re-hospitalized for treatment of a sepsis infection. Sepsis occurs when an existing infection triggers a chain reaction throughout the body that can rapidly cause tissue damage, organ failure, and death. Afterward, Kathleen developed colitis—inflammation of the colon’s inner lining—and a urinary tract infection. She also contracted hospital-acquired pneumonia.

Gangrene Took Her Left Leg

While back at a long-term care facility, a CT angiogram revealed that Kathleen was suffering from a reduced circulatory condition called “critical limb ischemia.” The tissue in Bashore’s left leg continued to die from a lack of blood supply, eventually becoming gangrenous and requiring amputation on July 30, 2015.

Debilitating Wounds and Surgeries

A wound also developed at the site of the bypass surgery as well as a decubitus ulcer on her sacrum—a wound from excessive pressure on a bony prominence such as the sacrum. Kathleen endured over 30 surgeries to clean and remove infected or dead tissues from her wounds before the trial. The sacral wound was still there at the time of the trial. The surgical site had healed.

Three Major Surgeries

Bashore underwent three major surgeries after the left leg amputation. First, there was the colostomy bag surgery in October 2017. Then, a broken right femur from a fall from her wheelchair required surgical repair the same month. In December 2018, she underwent a suprapubic catheter procedure.

Allegations and Testimony

Following these medical experiences, Kathleen Bashore sued Dr. Ara Pridjian, Sparrow Hospital, and related entities for negligence. In her lawsuit, Bashore claimed that Pridjian had been negligent in her treatment and that this negligence amounted to malpractice. She asserted the hospital was vicariously liable for the doctor’s actions.

The Plaintiff’s Case

Bashore’s lawyer alleged that since March 4, Dr. Pridjian made a string of medical errors in treating Bashore. Counsel first alleged that the right thing for Pridjian to have done was to perform immediate emergency surgery to remove the clot in Bashore’s leg. Instead, treating Bashore’s procedure as elective surgery, the doctor scheduled it for the end of the day on March 4. Kathleen’s lawyer also called out that when Pridjian finally did take Bashore into surgery, he failed to remove the clot.

Bashore’s counsel emphasized that a March 3 CT angiography showed that a calcium buildup was blocking Kathleen’s blood flow. A March 4 angiography that Dr. Pridjian ordered showed similar findings. With the March 4 CT findings, Bashore’s counsel contended that Pridjian should have performed a bypass on that date rather than inflate the balloons and stents from the March 3 surgery. Counsel commented further that the surgeon who performed Bashore’s March 3 femoral angioplasty testified that he had inflated the balloons and stents to their maximum capacity. Bashore’s lawyer alleged that in his March 4 procedure on Kathleen, the doctor had overinflated the devices. This action resulted in a ruptured aorta and a crack in the iliac artery.

The Resulting Complications

A failure to timely address Kathleen’s medical issues also formed the basis for Bashore’s claims against Dr. Pridjian. Counsel asserted that the arterial rupture and crack led to Kathleen’s massive internal hemorrhaging. In the day and a half after the device reinflation surgery, physician assistants and other doctors caring for Bashore observed that she had a condition where a lack of oxygen was making her blood acidic, said counsel. Bashore’s mental status also changed in this period, along with a decrease in her hemoglobin level. She entered into hypovolemic shock. Bashore’s lawyer maintained that Dr. Pridjian was aware that Kathleen was experiencing these conditions. However, Pridjian delayed the bypass surgery for 37 hours. The plaintiff’s counsel asserted that the calcium perforated Bashore’s aorta and vena cava during the delay.

The plaintiff provided a life care plan that included ongoing skilled nursing assistance, wheelchair home modifications, the purchase of a wheelchair-accessible vehicle, and continuing wound care. Bashore sought $5 million in damages for past and future medical expenses and $10 million for past and future pain and suffering.

The Defense’s Argument

Dr. Pridjian stated at the trial that it was not necessary to take Bashore to surgery right away because he alleged that she was not experiencing a vascular emergency on March 4. In the doctor’s view, it was simpler and safer to re-inflate the angioplasty balloons on March 4 rather than perform bypass surgery. The defendant asserted that Kathleen Bashore’s subsequent medical issues were known angioplasty complications.

Pridjian also disagreed with the other doctors’ findings concerning Kathleen’s medical condition prior to him performing the bypass. The doctor further disputed a perforation of the vena cava before he did the bypass. In his view, the vena cava ruptured during the bypass—a known complication of the procedure.

Who Won the Case?

After a three-week trial and two days of deliberations, the jury determined that Dr. Ara Pridjian had been negligent. The triers-of-fact awarded Kathleen Bashore $17 million dollars in damages. Here’s how the damages broke down:

$3,900,000 for future non-economic damages
$1,500,000 for past economic damages
$6,000,000 for future economic damages
$5,600,000 for past non-economic damages

Expert Specialities

The plaintiff retained expert witnesses in

The defendants retained expert witnesses in

Key Takeaways

The Bashore case reinforces that capable medical experts with a nuanced understanding of vascular surgery standards can overcome doctors’ claims of “known complications.” In addition, it is clear that a doctor cannot get away with negligence based on the excuse of “disagreeing” with the findings of other attending doctors.

Vascular Surgeon’s Medical Errors Results in $17M Award for Paraplegic Patient