Case Overview
Case Name: Suzanne Czerepinski Margaret A. Parr v. Medhat Allam M.D. Eastern Long Island Surgery, P.C. Lawrence Tarasuk D.O. John/Jane Doe, M.D. Southampton Hospital, No. 64199/14
Case Type:
- Medical Malpractice – Surgeon; Failure to Consult; Failure to Monitor; Premature Discharge
- Wrongful Death – Survival Damages
Injury:
- other – death; ischemia; necrosis
- arterial/vascular – thrombosis/thrombus
- gastrointestinal/digestive – pancreas
Plaintiff Attorney(s):
- Clifford S. Argintar; trial counsel, Duffy & Duffy, PLLC; for Suzanne Czerepinski, Margaret A. Parr
Defense Attorney(s):
- Nicholas J. Marotta; Aaronson Rappaport Feinstein and Deutsch, LLP; New York, NY for Medhat Allam, Eastern Long Island Surgery, P.C.
- None reported for Lawrence Tarasuk, Southampton Hospital
Case Outcome: Verdict-Plaintiff
Award Amount: $2,500,000.00
What Happened?
Margaret Parr, a 68-year-old retiree, had surgery to repair a hiatal hernia on February 28, 2013 at Southampton Hospital in Southampton, New York. Dr. Hedhat Allam performed the surgery, assisted by Dr. Lawrence Tarasuk. Within hours Ms. Parr was home after her discharge from the hospital following the procedure.
That evening her spouse Suzanne Czerepinski said Margaret began experiencing severe, uncontrollable pain. By morning, the pain had worsened. Ms. Parr was transported to another hospital the morning of March 1, 2013. Exploratory surgery at this hospital revealed necrosis of Margaret’s gallbladder, intestines, pancreas, and stomach. Doctors use the term necrosis to describe body tissue that is dead. A lack of blood flow is one way body tissue can die. Sadly, doctors could not reverse Ms. Parr’s condition. She passed away the evening of March 1.
Notably, in a May 2012 surgery, Parr had stents implanted in her celiac and mesenteric arteries. Stent implants help open blocked or partially blocked arteries.
The mesenteric artery provides blood flow to the small intestine, large intestine, and the pancreas. The role of the celiac artery is to get blood to the gut, liver, gallbladder, spleen, pancreas, and both the greater and lesser omentum ( fatty tissue that covers and supports the intestines and lower abdominal organs).
After the stent procedure, Margaret was taking anticoagulant and antiplatelet medications to lower the risk of blood clots. Without these treatments, clots can block blood flow and lead to heart attacks or strokes. As a precaution, her doctor had Ms. Parr stop taking the anti-clot meds the week before her hernia surgery.
Allegations and Testimony
Parr’s spouse and estate administrator, Suzanne Czerepinski, filed a lawsuit against Dr. Allam, his employer, Eastern Long Island Surgery, P.C, Dr. Tarasuk, and Southampton Hospital. The plaintiffs asserted that Allam and Tarasuk failed to properly treat Margaret Parr and that these two doctors and the staff at the hospital did not properly monitor her condition. Ms. Czerepinski alleges that these failures amount to malpractice.
The plaintiff also sought to hold the Southampton Hospital vicariously liable for the actions of its employee’ Dr. Tarasuk and the hospital staff. Likewise, Czerepinski also intended to hold Eastern Long Island Surgery vicariously liable for Dr. Allam’s failures.
Ms. Parr’s estate wanted wrongful-death damages, including damages for 20 hours of pain and suffering, and damages for the loss of parental guidance her daughter suffered.
Before trial, the estate’s counsel discontinued the claims against Dr. Tarasuk. The claims against Southampton Hospital were dismissed by a summary judgment. The case went to trial against defendants Allam and Eastern Long Island Surgery.
Allegations of Blood Supply Loss Due to Compromised Stents
Counsel for the estate alleged that Margaret Parr died from a stroke caused by clot(s) that compromised the stents in her celiac and or mesenteric arteries. In medical terms, they maintain that Margaret developed thrombosis – the presence of clots in blood vessels. The clots inhibited her stent(s) to a degree where they no longer kept the arteries open and blood flowing. Plaintiffs say the blocked arteries resulted in an ischemic stroke where Parr’s brain was denied adequate blood flow and oxygen.
Counsel also asserted that the diminished blood supply (ischemia) resulted in the tissue death of her gallbladder, intestines, pancreas and stomach.
Defense counsel, however, maintained that counsel for the estate could not prove the specific cause of Parr’s death because an autopsy was not done.
No Vascular Surgeon Consultation
The lawyer for the estate faulted Dr. Allam for failing to consult a vascular surgeon before performing surgery on Ms. Parr. Plaintiff also said Dr. Allam should have ordered and reviewed a radiological study of the stents in her arteries before the hernia surgery.
Defense counsel contended that a vascular surgeon clearance was not required. He added that Ms. Parr’s own primary doctor and a cardiologist had given the green light for the hernia procedure.
Anti-Clotting Medications
The vascular-surgery expert for the estate stated that after a stent-implantation procedure, the patient must take antiplatelets for the following 12 months. Defense counsel asserted that Dr. Allam had appropriately deferred to Ms. Parr’s doctors who discontinued her use of the anti-clotting medications leading up to the hernia surgery.
Ill-advised Hospital Discharge
The estate’s counsel maintained that Margaret should not have been discharged the same day as the hernia surgery. Given that her stents presented a significant risk of post-surgery complications, counsel asserted she should have been discharged the day after the surgery.
In contrast, defense counsel argued that it was appropriate to discharge Ms. Parr once the surgery was done. He pointed to the facts that after the surgery Margaret was drinking and urinating, was adequately hydrated, and her heart’s functions were normal, as indicators that she was ready for discharge. In addition, according to the defense, Parr did not exhibit ischemia symptoms or any other complication before she was sent home.
Outcome
After a two-week trial, the jury said that Dr. Allam should have consulted a vascular surgeon. The six-person jury also found that Parr’s discharge from Southampton Hospital was premature.
The jury awarded Ms. Parr’s estate’s damages totaling $2.5 million. The award broke out as follows:
Estate of Margaret Parr
- $ 2,200,000 survival (20 hours)
- $ 300,000 loss of parental guidance
Key Takeaways
With dueling views on the need for a vascular surgeon consultation and the appropriateness of the same-day discharge, counsel was able to convince the jury of that Dr. Allam had committed malpractice. Counsels arguments and the quality of plaintiffs’ experts surely played a strong role in this success.
