Tracy L. Zuckett Successfully Defends OB-Gyn in Alleged Unnecessary Pelvic Surgery Case

Ms. Tracy L. Zuckett, a principal with Moser & Marsalek, P.C. and a member of the Medical & Health Care Litigation group obtained a defense verdict on behalf of Dr. Dossu Chanduwadia (Dr. Wadia), an obstetrician/gynecologist, in a medical malpractice action recently tried in the Jefferson County Court in Hillsboro, MO. Plaintiff, Annette Davies, brought this action claiming she underwent unnecessary exploratory laparotomy performed by Dr. Wadia as a result of his alleged failure to rule out other potential causes and non-surgical interventions for her pelvic pain.

Plaintiff, Annette Davies presented to the Jefferson Memorial Hospital radiology department on August 5, 1999 complaining of right-sided pelvic pain and underwent ultrasound evaluation of the pelvis to rule out appendicitis. The ultrasound report prepared by defendant, Dr. John Crotty, indicated a clinical history given by the patient of hysterectomy (removal of uterus) and bilateral oopherectomy (removal of ovaries) and reported total surgical absence of the uterus and both ovaries. She had continued complaints of pain and multiple ER and doctor visits over the following two plus years and on January 1, 2002 presented to the ER at St. Anthony’s Medical Center complaining of lower left pelvic pain. She was examined and underwent CT scan, blood tests and urinalysis. All testing was normal and no source for her pain was identified. She was sent to Jefferson Memorial Hospital the following day for an ultrasound and was to follow up with her Ob-Gyn, Dr. Chanduwadia. The ultrasound completed on January 2, 2002, also read by Dr. Crotty, was normal and revealed a left ovary. There was a clinical history given by the patient of hysterectomy and questionable right salpingo-oopherectomy (removal of fallopian tube and ovary). Dr. Crotty recommended correlation with the patient’s operative records.

Ms. Davies presented first to a family doctor on January 7, 2002 who stated she may need an exploratory laparotomy. She then presented the same day to defendant, Dr. Dossu Chanduwadia. After examination, speaking with Ms. Davies and reviewing her test results from the St. Anthony’s ER and the ultrasound from Jefferson Memorial Hospital, Dr. Chanduwadia suggested exploratory laparotomy, an open pelvic surgery, to find the source of her pain. He stated he would remove the left ovary and scar tissue, or adhesions, if encountered. The surgery was scheduled for January 23, 2002.

Ms. Davies underwent the exploratory laparotomy on January 23, 2002, during which time Dr. Chanduwadia found and broke down adhesions binding the bowel to the pelvic wall, however, there was no ovary. He sought intraoperative consultation from Dr. Alfred Shaplin, one of Dr. Crotty’s partners, and was told the appearance on the ultrasound could be caused by shadows from the adhesions, a loop of bowel or other soft tissue in the pelvis. The procedure was concluded and Ms. Davies sent to recovery.

The trial of this case took place in the Jefferson County Court in Hillsboro, Missouri before Judge Gary Kramer and lasted three days.

Plaintiff’s allegations against Dr. Chanduwadia were that he failed to rule out other potential causes for her pain before proceeding to surgery and failed to investigate the reported left ovary and consider the past surgical history of removal of both ovaries. Against Dr. Crotty, the radiologist who read the two ultrasound films, plaintiff alleged Dr. Crotty should have alerted the ordering physician to the discrepancy in the histories given by the patient and the findings related to the left ovary, and he should have recommended further evaluation by repeat ultrasound and/or transvaginal ultrasound. Plaintiff also claimed Dr. Crotty was an agent of Jefferson Memorial Hospital. Plaintiff claimed the negligence of both Dr. Chanduwadia and Dr. Crotty caused her to undergo unnecessary surgery.

Plaintiff’s radiology expert, Dr. Orestes Sanchez, from Newark, New Jersey, whose deposition was read to the jury in lieu of live testimony set forth the criticisms of Dr. Crotty outlined above. Plaintiff’s obstetrics and gynecology expert, Dr. David Levine, from St. Louis, testified live and set forth the criticisms of Dr. Chanduwadia outlined above.

The case against Jefferson Memorial Hospital was limited to an agency theory on behalf of Dr. Crotty. Plaintiff attempted to establish such by reading portions of the hospital’s interrogatory answers, portions of the depositions of Dr. Crotty and Dr. Alfred Shaplin, (Dr. Crotty’s partner at Scott Radiological Group) and portions of the by-laws of the hospital. However, at the close of plaintiffs’ case, defendant Jefferson Memorial Hospital’s motion for directed verdict was granted.

The remaining defendants argued that Ms. Davies had a long history of pain without a known cause. She had been seen recently in the emergency room where all testing was negative and her only complaints were related to the left lower pelvic pain. In addition, although Dr. Chanduwadia was aware Ms. Davies had a history of having both her ovaries removed, ovarian tissue can be left behind, particularly in patients with pelvic adhesions, which she had. Further, ovarian remnants can regrow, therefore, the ultrasound report of left ovary was not a surprising finding. The defense further argued through the live testimony of Dr. Chanduwadia and defense expert, Dr. Thomas Hanley, an obstetrician/gynecologist from St. Louis, that further gastroenterology testing (which was ultimately completed post-operatively and was normal) would not have changed Dr. Chanduwadia’s decision to proceed with exploratory laparotomy. On behalf of Dr. Crotty, the defense argued through the live testimony of expert radiologist Dr. Gary Omell, also from St. Louis, that the report prepared by Dr. Crotty was complete, accurate and appropriate, and that Dr. Chanduwadia was aware of the conflict between the two ultrasounds without requiring indication from Dr. Crotty on the second report. Further, similarly, even if there had been mention on the second report of a discrepancy from the prior report, Dr. Chanduwadia would have proceeded with the exploratory laparotomy in an effort to determine the source of Ms. Davies’ pain.

Plaintiffs asked the jury to return a verdict for nearly $14,000 in economic damages and an unstated amount for non-economic damages for the stress and anxiety of undergoing an unnecessary procedure and scarring and continued numbness in the area of her incision. In addition, the plaintiffs asked the jury to return an unstated amount for the loss of consortium of Ms. Davies husband, Todd Davies.

The jury of eight men and four women deliberated for three and one half hours before returning a verdict in favor of defendants Dr. Chanduwadia, Dr. Crotty and Scott Radiological Group.

Facts of the case: