A woman who was injected with the wrong medicine during nasal surgery has been awarded $5.1 million compensation for a cardiac arrest due to medical negligence by a jury in Philadelphia.
The jury at Montgomery County Court heard how Jacqueline DiTore had attended the Abington Surgical Centre in Pennsylvania on 7th June 2010 for an outpatients procedure on her nose.
Prior to starting the procedure, Dr Warren Zager had asked a nurse to prepare an injection of 1 percent lidocaine with epinephrine for a local anaesthesia, and to soak cotton wall balls in Afrin (a brand of decongestant nasal spray) to control the bleeding during surgery.
According to the testimony presented at court, the nurse poured the Afrin into an unmarked cup in order to soak the cotton wool balls; but this was mistaken by a second nurse to be lidocaine, which she drew up into a syringe and handed to the doctor. Dr Zager injected the Afrin into Jacqueline´s nose and then attended to other pre-surgery procedures.
Jacqueline´s heart rate dropped to 36 soon after, and an anaesthetist – not realising that Jacqueline had been injected with Afrin – administered glycopyrrolate (an anticholinergic) which had the result of bringing Jacqueline´s heart rate back up to 80.
When Dr Zager returned to his patient, he asked for more 1 percent lidocaine but was told that only 2 percent lidocaine was available. The doctor then asked what had been put into the syringe that he use to inject Jacqueline and the error was discovered.
According to a medical expert who gave evidence at the hearing, the injection of 6-7cc of Afrin caused a 100-fold increase in vasoconstrictive activity (the narrowing of the blood vessels) but, unaware of this, Dr Zager decided to continue with the surgery and used the 2 percent lidocaine to anaesthetise Jacqueline´s nose.
Following the second injection, Jacqueline´s heart rate jumped to 140 with a blood pressure of 260/150. At that point labetalol was administered (a drug used to lower high blood pressure), but Jacqueline´s blood pressure then bottomed out and she went into cardiac arrest. Jacqueline was rushed to Abington Memorial Hospital where she was resuscitated.
As a result of going into cardiac arrest due to medical negligence, Jacqueline suffered brain damage, and now has impaired cognitive abilities, and problems with her speech, vision and memory – issues her doctors say are going to deteriorate as she gets older.
After seeking legal advice, Jacqueline claimed compensation for a cardiac arrest due to medical negligence against the Abington Surgical Centre and Dr Zager – claiming that the doctor should not have proceeded with the surgery once the original error had been identified, and that the Surgical Centre was liable because it was aware that Dr Zager and those in his practice were not following safe medical procedures.
Both defendant´s denied their liability for Jacqueline´s injury – contesting that Dr Zager was correct to continue with the surgery, as the lidocaine that was administered in the second injection did not compound the effect that the Afrin had on Jacqueline, and therefore did not contribute to her reaction. It was also alleged that Jacqueline´s injuries were not as severe as had been presented and that she was “high-functioning” – restricted only by limitations she had imposed upon herself.
However, after several days of testimony and deliberations, the jury at Montgomery County Court found in favour of Jacqueline and awarded her $5.1 million compensation for a cardiac arrest due to medical negligence – allocating 38.5 percent negligence to Dr Zager and 61.5 percent negligence to the Abington Surgical Centre.