Case Overview
Case Name: Amy M. McGouirk and Allen K. McGouirk v. Tamica E. White, M.D. and Wellstar Medical Group, LLC
Case Type: Medical Malpractice – Surgical Error; Failure to Test; Failure to Detect; Unnecessary Procedure
Injury:
- Other – fever; sepsis; infection; hernia, ventral
- Abdomen
- Cardiac – heart; tachycardia
- Mental/Psychological – depression; emotional distress
- Respiratory arrest
- Gastrointestinal/Digestive – diarrhea; bile duct; gastrointestinal complications; nausea
Plaintiff Attorneys:
- Jay Sadd; Slappey & Sadd LLC
- Daniel M. Epstein, M.D.; Slappey & Sadd LLC
- D. Chad Nuce; Pasley, Nuce, Mallory & Davis, LLC
- Audrey M. Tolson; The Tolson Firm LLC
Defense Attorney(s):
- Russell B. Davis; Downey & Cleveland, LLP
Case Outcome: Verdict – Plaintiff
Award Amount: $10,100,000
What Happened?
Things went terribly wrong for 30-year-old Amy McGouirk when she had surgery to remove her gallbladder in 2011. On October 18, Dr. Tamica White of the Wellstar Medical Group LLC performed the laparoscopic surgery on McGouirk.
In a laparoscopic procedure, surgeons make a small incision in the abdomen to insert cameras or other instruments through the thin tube of a laparoscope to look at or remove abdominal organs. Conversely, in an open surgery, a surgeon cuts a patient’s skin and tissues to get a full view of a patient’s structures or organs. Patients typically recover faster and have better outcomes with the laparoscopic technique. However, this wasn’t the case for Amy McGouirk.
Bile Duct Sliced During Surgery
During the laparoscopy, Dr. White severed McGouirk’s common bile duct. Bile is the fluid liver cells secrete to carry away our waste and break down fats during the digestive process. The common bile duct connects the gallbladder, pancreas, and liver to the small intestine.
The day after the problematic surgery, Amy was in critical condition with acute respiratory failure. She moved to another hospital to receive care from a doctor specializing in surgery of the liver, bile duct, and pancreas. After Dr. White’s surgery, McGouirk suffered years of medical problems and surgeries stemming from White cutting her common bile duct.
Severe Post Operative Problems
In the first year after the surgery, Amy spent anywhere from one day to more than a week in the hospital for eight of the 12 months. In the years after the surgery, McGouirk suffered from recurrent abdominal pain, infections/sepsis, and the dislodging of drainage tubes inserted to help her condition. On top of that, she experienced ongoing fatigue, nausea, and diarrhea.
It took two tries for doctors to repair Amy’s common bile duct, which is central to elimination and digestion functions. In the first instance, doctors attempted to surgically repair her common bile duct in December 2018. Unfortunately, this procedure also had problems that forced the doctors to abort the repair. In 2019, doctors were able to surgically repair McGouirk’s bile duct. Following this procedure, however, McGouirk experienced fevers and tachycardia, requiring extended hospitalization.
She had multiple abdominal drains that led to infections and other complications extending into the fall of 2019. Things got so bad that Amy required the insertion of a feeding tube through her abdomen and into the stomach. McGouirk endured several imaging studies, liver biopsies, and interventional radiology procedures to assess her condition over time.
However, that wasn’t the end of it. The numerous surgical procedures resulted in a ventral hernia, requiring surgical repair in July 2020. A ventral, or abdominal hernia, happens when a weakness or gap in the abdominal wall allows intestinal or other tissue to stick out of the wall.
Allegations and Testimony
McGouirk and her husband filed a malpractice lawsuit against Dr. White and her practice group, Wellstar Medical Group LLC. McGouirk alleged that White didn’t comply with the accepted standard of care in her surgical performance and preoperative treatment of Amy. She also alleged that Wellstar Medical was vicariously liable for Dr. White’s conduct as her employer.
McGouirk Testimony
As she painted the picture of her life after the botched gallbladder surgery, Amy testified that she still has abdominal pain and suffers from depression. Since the disastrous medical problems, she has been unable to return to her work or prior activities. Amy also described the harm the initial year of recovery and hospitalizations had on the relationship with her five-year-old son. McGouirk sought damages for past and future pain and suffering.
During the six-day trial, her husband, Allen McGouirk, testified about the burden of becoming his wife’s caregiver and the negative impact on their relationship. Allen asked for loss of consortium damages.
Throughout the trial, counsel for the defense asserted that Amy made a good recovery from her injuries.
Plaintiff’s Specialized Expert Weighs In
Lawyers for the McGouirks provided the jury with testimony from an expert in hepatobiliary surgery. Surgeons in this area specialize in procedures to treat disorders of the liver, pancreas, gallbladder, and bile duct system. This plaintiff expert testified that White failed to review McGouirk’s ultrasound and CT scan before starting the procedure to remove her gallbladder. If Dr. White had reviewed the tests, the expert stated that she would have been aware that McGouirk had an enlarged liver. The specialist went on to say that rather than her gallbladder, the enlarged liver could have been the cause of some or all of McGouirk’s abdominal pain. The expert contended that White could have tried less invasive treatments such as weight loss instead of jumping to a surgical solution if she had seen the liver size in the test images.
The expert, who had a deep knowledge of gallbladder surgery standards, also explained that Dr. White’s conduct before and during the surgery prevented her from securing “adequate and reasonable visualization of the hepatobiliary tree during surgery.” Without a proper visual during the procedure, in the expert’s opinion, White mistook McGouirk’s cystic duct for her common bile duct. When she mistakenly triple-clipped and made a transverse cut in the common bile duct, catastrophic injury to the duct occurred.
White’s failure to take an alternative approach when she was having difficulty getting exposure and identifying the critical anatomy in the laparoscopic method also fell short of accepted standards. The plaintiff’s expert maintained that when she encountered problems, Dr. White should have done a “top-down” dissection of the gallbladder, converted the procedure to an open procedure, or aborted the procedure to ensure she did not cut the wrong structure and cause a serious and preventable injury to McGouirk.
Defense’s General Surgery Expert Disagrees
The jury heard testimony from the defense’s sole expert—a general surgery expert. This expert asserted that Dr. White did the cholecystectomy (gallbladder removal) in accordance with the standard of care. Dr. White was correct to perform the surgery based on McGouirk’s initial symptoms of biliary dyskinesia and findings that the gallbladder was not functioning properly, stated the defense expert. In the view of this expert, Dr. White was not required to do any more workups or exclude any other causes of McGouirk’s pain before proceeding to the gallbladder removal surgery.
The defense’s expert also stated that an enlarged liver did not mean McGouirk could not have the surgery. Injury to the common bile duct is a “known and accepted risk” during this procedure, said the expert, even when a surgeon adheres to the standard of care. In his view, White complied with standards when she performed McGouirk’s surgery.
Lastly, the defense expert said White did properly employ an alternative once the duct was cut. Namely, she converted the operation to an open procedure, in line with the standard of care.
Who Won the Case?
The jury ruled in favor of Amy, awarding her $10 million in damages. Her husband won $100,000 for his claim of loss of consortium.
Expert Specialities
The plaintiffs retained an expert witness in:
- Hepatobiliary Surgery
The defendants retained an expert witness in:
Key Takeaways
The importance of using credible, specialized experts was never more apparent than in this case. Even though the jury heard counterpoints to most of the plaintiff’s expert opinions from the defense expert, they appeared to simply disregard them. The reason for this is no secret. The jury likely saw the expert in hepatobiliary surgery as more credible than a general surgery expert.
This case centered around gallbladder surgery. The hepatobiliary system is a complex system where multiple organs interact to keep our elimination and digestive systems healthy. Most people would trust a person with intricate knowledge of anatomy and surgical standards for gallbladder treatments and surgeries over someone who knows only about general surgeries.
In your next malpractice case, be sure to get the most specialized medical expert you can. Generalists’ testimony won’t ring true in front of common-sense jurors.
