Our client needed heart and kidney transplants following complications from a specialized cardiac catheterization procedure called an ablation. We reached a $9.25 million settlement of her Jackson County medical negligence case against the cardiologist and hospital where the procedure was performed. The identities of the parties are subject to a confidentiality agreement.
The plaintiff first presented to the cardiologist and hospital in 2003. She as diagnosed with an irregular heart rhythm called a ventricular tachycardia. The cardiologist decided to surgically correct the arrhythmia by performing a radio frequency ablation – a procedure using energy, or heat, to kill the area of the heart tissue causing the arrhythmia.
The cardiologist actually performed two radio frequency ablation procedures on the plaintiff. The first procedure was done on January 29, 2003 using a traditional approach from just below plaintiff’s aortic valve. Part of the procedure involved “mapping” the heart to find the exact location in the heart causing the arrhythmia. The doctor noted that when the catheter passed through the space just below the aortic valve, the arrhythmia stopped. He thought he had located the tissue causing the arrhythmia and ablated it.The plaintiff’s irregular heart rhythm temporarily stopped but later started up again.
The plaintiff’s arrhythmia was managed the next 18 months conservatively with drugs. The drug therapy was working well and the doctor noted the patient could continue on the medication for several years if necessary.
During this time, the doctor attended a cardiology symposium where he learned a new ablation technique approaching the tissue from above the aortic valve. This technique had apparently been used on another cardiac patient with a history and symptoms similar to plaintiff’s. The doctor suggested to plaintiff that this new technique might work for her.
The second radio frequency ablation was performed on June 9, 2004. Initially, the doctor again used the traditional approach from below the aortic valve. Following this attempt the irregular rhythm was still present. The doctor then used the new approach to the site from above the aortic valve from an area called the left coronary cusp. This potentially placed the ablation catheter closer to the coronary artery. The doctor had never used this approach before.
Our experts testified that the cardinal rule of this procedure, regardless of approach, is to not burn the coronary artery. There are several precautions a physician can use to prevent injuring the coronary artery, including using a low temperature to limit the area of tissue destroyed. Our experts testified that the physician used too high a temperature for too long a period of time.
Immediately after the ablation procedure, the plaintiff suffered a total occlusion of the left main coronary artery system causing a massive heart attack. Our experts testified that the cardiologist had actually applied heat directly to plaintiff’s coronary artery rather than to the spot in the heart that was causing the arrhythmia.
After plaintiff’s heart attack, a full code was called, and a cardiopulmonary bypass procedure of damaged coronary artery was performed. The plaintiff was kept alive on an artificial bypass machine for several months until a heart transplant later became available. During this time, plaintiff suffered irreversible kidney damage necessitating a kidney transplant. She also developed compartment syndrome in the right leg that required multiple surgeries and fasciotomies. The plaintiff now must use a brace or walker most of the time.
This was a complicated an interesting case. We had several nationally recognized experts in ablation involved in this case. Settlement was reached in a mediation held several months before trial.