During an operation on January 29, 2001, it was discovered that the titanium rods the patient, Arturo Iturralde, was to have inserted in his back were “missing.â€
Despite strong warnings from one of the surgical nurses and an assurance from the supplier (Medtronic Sofamor Danek) that new titanium rods could be delivered within 90 minutes, the surgeon, Robert Ricketson, decided that he would use the shaft of a stainless steel medical screwdriver instead.
Although Ricketson’s decision that it would be a good idea to substitute part of a stainless steel screwdriver for a titanium implant would, by itself, probably have justified the verdict, the remainder of the facts make the case even more astonishing.
As it turns out, the hospital, Hilo Medical Center, issued credentials to Ricketson despite the fact that he had been suspended from practicing medicine in Texas and Oklahoma for alleged drug use.
Ricketson had no malpractice insurance and acted as his own attorney at trial. He will probably never be able to pay the judgment against him.
The implanted screwdriver shaft lasted only a week before breaking in Mr. Iturralde’s back. A second (and then a third) operation was required to correct the problem created by Ricketson’s creative carpentry work.
Iturralde, who was 73 and in poor health, never recovered from the complications of the botched surgery. His condition deteriorated and he died in 2003 at 75.
The jury found Ricketson 65% liable and Hilo Medical Center 35% responsible. The verdict of $5.6 million was made up of $307,000 for “special damages’ (medical bills), $1.87 million general damages (conscious pain and suffering), and $3.4 million in punitive damages (100% against Ricketson since Hawaiian law precludes punitive damages against hospitals).
Although Medtronic was also sued, the jury did not find it liable. The company claimed it had sent the original rods (the hospital denied receiving them). Medtronic also argued the surgical team should have checked if the rods were in the operating room before the surgery was started. There was also the fact that it offered to rush replacements to the hospital during the surgery.
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