Robert R. Sappe successfully defended a vascular surgeon and two vascular surgery physician assistants (PAs) against charges of medical malpractice in Orange County Supreme Court. The plaintiff alleged that the surgeon and the PAs failed to recognize ischemic steal syndrome in her hand after the surgeon created an arterio-venous graft (AVG) in her arm. The AVG is a connection created between the artery and the vein using synthetic graft material. Once connected, some of the blood flow in the artery is diverted to the vein through the graft. The graft, which is designed to be used as an access point for administering hemodialysis, was needed in the plaintiff who suffered from end stage renal disease and was dialysis dependent.
After the AVG surgery, the plaintiff complained of severe pain and numbness in her hand which she alleged was the result of ischemia caused by the diversion of too much blood through the graft and away from the hand. She alleged that Feldman, Kleidman, Collins & Sappe LLP’s (FKC&S) clients were negligent for not timely responding to the signs and symptoms of steal syndrome ischemia, and that they should have taken her back to the operating room to tie off or remove the graft which would have restored the blood supply to the hand. FKC&S’s clients contended that pain and a sensation of numbness can be expected post-operatively and can resolve over time, and, further, that their physical exams of the plaintiff did not show evidence of ischemia.
Ultimately, the surgeon did reverse the graft eight days later. However, the surgeon contended that he reversed the graft only because the plaintiff insisted on it, not because there was any ischemia from steal syndrome. The plaintiff alleged that the eight-day delay was unreasonable. She further alleged that her hand was suffering from ischemia for eight days which resulted in permanent nerve damage, leaving her hand non-functional.
After a one-and-a-half-week trial, the jury returned a verdict in favor of FKC&S’s clients in 45 minutes.