New York State Jury Awards $ 50 Million In Damages To Obstetrical Patient Who Received Improper Medical Care For Fistula
On Nov. 30, 2009, plaintiff Llaulin Cruz, 31, a physical therapist aide, came to St. Barnabas Hospital in the Bronx for delivery of her first child. During the delivery, the OB-GYN, Michael Ihemaguba, M.D., who was on-call at the hospital, performed a mid-line episiotomy after the infant's head had already been delivered. He further told Ms. Cruz to continue to push and she suffered a fourth degree laceration. Ihemaguba repaired the laceration in a negligent manner, ultimately resulting in a recto-vaginal fistula. Cruz complained to Ihemaguba of gas coming from her vagina following the delivery. Ihemaguba told Ms. Cruz that it would get better.
In April of 2010, Cruz was pregnant again and she began to see midwife Gloria Murray for her prenatal care and ultimate delivery of her second child. Cruz complained to Murray of a fecal smelling discharge coming from her vagina. Murray then called Dr. Ihemaguba by telephone for consultation; she had consulted with Ihemaguba numerous times in the past when there was a question about a patient. Ihemaguba told Murray to simply send Cruz to him after the delivery of her second child. On Oct. 31, 2010, Cruz presented to St. Barnabas Hospital for the delivery of her second child. Upon admission, Cruz was examined by Ihemaguba; he performed a physical examination, a vaginal examination and had the patient sign a consent form for a vaginal delivery. Murray delivered the child vaginally on the morning of Nov. 1, 2010. Cruz claimed that her recto-vaginal fistula was exacerbated by the performance of a vaginal delivery over a pre-existing recto-vaginal fistula.
Cruz was ultimately diagnosed with a recto-vaginal fistula and treatment was undertaken after undergoing her second delivery vaginally. She required 13 separate surgeries over a 3 year period with three different physicians at four different hospitals in an attempt to repair the condition. Cruz underwent an ileostomy to divert stool from the colon and rectum while attempts were made to repair the fistula. When this was unsuccessful, Cruz's rectum was surgically removed and her colon was attached to her anus in a procedure known as a "pull down" surgery. During this procedure, a colostomy was also performed. This colostomy was later reversed.
Cruz's fistula was ultimately repaired but she has lost normal control of her sphincter and bowel function. Since her rectum was surgically removed, Cruz no longer can hold stool within her body normally--the rectum acts as a reservoir to hold stool. Cruz requires daily use of panty liners and cannot have sex with her husband due to the extreme pain it causes her. Expert testimony established that her condition would worsen as she grows older and that she will eventually require a permanent colostomy.
On Sept. 21, 2011, Cruz filed an action against Ihemaguba, St. Barnabas Hospital and Murray, in the Supreme Court of New York, Bronx County. Cruz alleged that the defendants had been negligent in Cruz's obstetrical and gynecological treatment. Plaintiff specifically alleged that Ihemaguba, and by extension St. Barnabas Hospital, was negligent in performing an improper episiotomy, failed to properly repair a fourth degree laceration, ignored her complaints of gas, failed to diagnose and treat the resulting fistula. During the second pregnancy, it was alleged that Ihemaguba should have either arranged for a cesarean section for Ms. Cruz, or advised Midwife Murray that a cesarean section had to be arranged. Counsel further alleged that Murray was also negligent in failing to arrange for Cruz to undergo a Caesarian birth.
The matter proceeded to a jury trial over which Judge Wilma Guzman presided. Cruz's expert OB-GYN testified that Ihemaguba departed from the standard of care in a number of areas. He argued that Ihemaguba should not have performed a midline episiotomy or told Cruz to continue pushing after the baby's head had emerged. He also argued that Ihemaguba was negligent in failing to investigate Cruz's gas complaints, that he was further negligent in advising Murray to proceed with a vaginal delivery and did not arrange for a cesarean section for Cruz's second delivery. He maintained that Murray should have also arranged for Cruz's second child to be delivered via cesarean section.
Cruz's expert on colo-rectal surgery opined that had Cruz's fistula been diagnosed prior to her second delivery, it could have been successfully repaired with surgery that had a 90% success rate.
Defense counsel denied liability. Counsel maintained that Ihemaguba did not depart from the standard of care and argued that there was no documentation to support Cruz's complaints of fecal vaginal discharge prior to her second delivery. In testimony, Ihemaguba denied receiving a phone call requesting a consult from Murray.
The defense's expert OB-GYN testified that Cruz's fistula was the result of a cloacal malformation unrelated to the care provided by the defendants.
The jury found that Ihemaguba, Murray and St. Barnabas hospital had departed from the standard of care and that their departures were a substantial factor in causing Cruz's injuries. Murray settled early in the trial for $ 925,000.00. The jury found Ihemaguba and St. Barnabas Hospital was negligent and that they bore 90% of the responsibility. It found that Murray was 10% liable. Cruz was awarded $ 40 million in future pain and suffering along with $ 10 million in past pain and suffering.
Cruz was represented by Edward J. Sanocki and Maria Morano of Sanocki Newman & Turret, LLP. Defense counsel included Carl Weinberg of Schiavetti, Corgan, DiEdwards, Weinberg & Nicholson, Yuvall Bar-Kokhba of Garbarini & Scher, P.C., and Charles Kutner of the Law Office of Charles Kutner.
For expert information, please view our summary of the case: Llaulin Cruz v. Michael Ihemaguba, M.D.; St. Barnabas Hospital; 2015 Jury Verdicts LEXIS 5361
For all your medical malpractice litigation needs, please visit our homepage for MedMal Navigator: http://www.lexisnexis.com/en-us/products/lexisnexis-medmal-navigator.page