A Texas hospital will have to defend itself in court against a wrongful death suit brought by the family of a patient who bled out after a surgeon transected her artery during a bilateral lumbar laminectomy and discectomy procedure, despite the hospital's objections to the plaintiff's expert opinions on the case.

The plaintiffs' experts argue that Renaissance Hospital failed to properly assess the competency and credentials of Merrimon Baker, MD, the orthopedic surgeon who accidentally transected Jennifer Renee Abshire's right internal iliac artery during the spinal procedure at the Houston hospital in August 2006. Not recognizing his error, Dr. Baker closed without repairing the artery, and Ms. Abshire subsequently suffered massive internal hemorrhaging, cardiac arrest and death, according to court documents.

Ms. Abshire had been referred to Dr. Baker's care by John Webb, MD, of Beaumont Spine Pain & Sports Medicine Clinic, which according to court documents is owned and operated by the hospital. Expert reports from 3 physicians and one healthcare administrator, submitted by the plaintiffs, indicated that Dr. Baker had a "well-documented history of malpractice, drug addiction, mental problems and loss of privileges at other hospitals," and that this information was readily available in the public domain. The experts opined that both Dr. Webb and the hospital appeared negligent in failing to note these alleged shortcomings and in granting him privileges and referring patients, including Ms. Abshire, to his care.

The experts also found that the hospital's PACU nurses breached the standard of care by failing to recognize and respond to signs that Ms. Abshire was in trouble after her surgery. The patient was allegedly exhibiting signs of hypovolemia and her abdomen was visibly expanded due to her severe internal hemorrhaging. According to court documents, one of the expert reports asserted that the nurses "breached the standard of care by failing to (1) recognize hypovolemia, (2) demand more aggressive fluid resuscitation, (3) demand the continuous presence of a physician at [Ms.] Abshire's beside and (4) institute the chain of command." The plaintiffs argue that the hospital is liable for the selection, training and supervision of these nurses to ensure they adhere to proper standards of care.

The hospital filed a motion to dismiss the case on the grounds that the expert reports were inadequate, failed to identify malice or intent to harm Ms. Abshire, and reached "speculative and conclusory" opinions without sufficient details to back them up. The hospital also argued that Dr. Webb is not an employee of the hospital and therefore the facility should not be held responsible for his referral to Dr. Baker.

The trial court disagreed and denied the defendant's motion, and on June 30, the Court of Appeals of Texas upheld that ruling. "We conclude that the [expert] reports discuss the standards of care, breach, and causation with sufficient specificity as to each of the appellants to inform appellants of the conduct appellees have called into question and to provide a basis for the trial court to conclude that the claims have merit," wrote a 3-judge panel in their opinion last month. The hospital is one of several defendants, including Dr. Webb and Beaumont Spine & Sports Medicine, named in the suit.

Irene Tsikitas