Settlement Reached in Suit Involving Man who Suffered Irreversible Brain Damage
Citizens' Voice - Wilkes-Barre, PA
Nov. 2, 1999
By Tim Gulla
Attorneys for a 50-year-old Exeter man who suffered irreversible brain damage following a 1998 kidney stone operation entered into a confidential settlement agreement on Monday with Wyoming Valley Health Care System and a Wilkes-Barre anesthesiologist.
A civil jury trial of Carmen Insalaco's lawsuit against the health care organization and the doctor was scheduled to begin Monday.
According to Joseph Quinn, who filed the lawsuit on behalf of Insalaco's wife, Gerri, the trial was expected to last eight to 10 weeks.
However, attorneys for the four parties who were involved in the suit informed the special trial master appointed to hear the case, Attorney Conrad Falvello, that a settlement has been reached.
Although he could not to go into detail about the confidential agreement, Quinn said on Monday that the settlement would allow Gerri Insalaco to bring her husband home from a Pittsburgh-area medical facility and would ensure that Carmen Insalaco would be provided with medical care and therapy.
A hospital system spokesperson stated: "Wyoming Valley Heath Care System is pleased to be able to reach settlement in this case. We would like to thank the judge (Michael Conahan) and the special trial master (Falvello) for their efforts in helping reach that settlement. That represents the extent of our comment at this time."
Judge Michael Conahan handled pre-trial matters in the case.
Quinn alleged that Carmen Insalaco's brain injury, which has left him unable to talk, walk or do anything independently, stemmed from the negligent management of anesthesia during a simple surgery.
According to the Insalaco family's lawsuit, Carmen Insalaco went into Wilkes-Barre General Hospital on April 1, 1998, with complaints of intense abdominal pain. He was diagnosed with an obstructed kidney and surgery was performed.
The Insalaco's family alleged that Carmen was evidencing signs of respiratory distress, wheezing, while he was being weaned off the anesthesia. Additionally, the family's lawsuit alleged that Carmen's oxygen saturation levels following the surgery were another sign that something was wrong.
However, it was alleged, the on-call anesthesiologist, Dr. Erwin Moritz, did not stay with Carmen Insalaco following the surgery. The lawsuit alleges he only stuck his head in the doorway to the operating room for five seconds.
The lawsuit alleges that Moritz, during his deposition, acknowledged that he should not have left the operating room if he knew Insalaco was wheezing. The lawsuit alleges that Moritz's employment contract mandated that he perform a post-anesthesia follow up by remaining with the patient as long as necessary; informing hospital personnel caring for the patient of any specific problems; determining when the patient can be discharged from the recovery room; and managing all anesthesia-related complications.
Despite testifying at his deposition that intubation and extubation are the two most important times in anesthesia, the lawsuit alleges, Moritz was not present during Carmen Insalaco's extubation.
And despite hospital policy and employment obligations, the lawsuit alleges, Moritz signed Insalaco's recovery assessment form in blank prior to leaving and noted that Insalaco had no complications in a post operative summary form.
Between 7:15 and 7:30 p.m. on April 1, 1998, it is alleged Insalaco suffered respiratory problems that deprived oxygen to his brain.
Despite those problems, Insalaco was transferred by a nurse from the operating room to the post anesthesia recovery unit at 7:32 p.m. At 7:47 p.m., he suffered cardiac arrest, according to the lawsuit.
From 7:32 p.m. until the cardiac arrest, the lawsuit claims, hospital records show that the only treatment Insalaco received was Proventil therapy.
The Insalaco family filed its 90-page lawsuit on June 15.
Gerri Insalaco commented on Monday, "I'm just happy it's finally settled and it's behind us." She added that she was very happy she could bring her husband home.
According to Quinn, Insalaco should never have been extubated, or weaned off the anesthesia while problems were evident. "The sad part is his condition was totally capable of being reversed," Quinn said.
According to Quinn, "The case was outrageously indefensible. This should have never happened."
Several months ago, Wyoming Valley Health Care System and a Kingston obstetrician were the subjects of a $6.7 million jury verdict in a medical negligence case. A confidential settlement on punitive damages was reached in that case. Quinn was the plaintiff's attorney in that lawsuit.
Pennsylvania Law Weekly
Volume XXIII, Number 5
Copyright 2000 by American Lawyer Media, ALM LLC
January 31, 2000
Verdicts and Settlements
$21 MILLION SETTLEMENT FOR OXYGEN-DEPRIVED PATIENT
INSALACO V. MORITZ. $21 MILLION SETTLEMENT
Date of Verdict or Settlement: N/A
Court and Case Number: C.P. Luzerne No. 4188-C of 1998.
Judge: Conrad Falvello.
Type of Action: Medical malpractice.
Injuries: Generalized hypoxic encephalopathy.
Plaintiff(s)' Attorney(s): Joeph A. Quinn Jr., Michell M. Quinn and Melissa A. Scartelli, Wilkes-Barre.
Defense Attorney(s): Patrick Carey, Scranton; Jeffrey Tindall, Pittsburgh.
Plaintiff(s)' Expert(s): John Eichhorn, M.D.; Altole Jacobi, M.D.;- Sheldon Deluty, M.D.; Michael Booth, C.R.N.A., Lewis Mustard, Ph.D.; Faye Maria Kopplin, R.N.; Robert Voogt, Ph.D.; Richard Bonfiglio, M.D.; Gregory O'Shanick, M.D.; Richard Fischbein, M.D.; Andrew Verzilli, Ph.D.; William Black, M.D.; Robert O'Leary, M.D.
Defense Expert(s): Aaron Ehrenwerth, M.D.; Ronald Cranford, M.D.; Marcia Sipski, M.D.
Plaintiff Carmen Insalaco went to the emergency room at Wilkes-Barre General Hospital complaining of left lower quadrant pain. After he was examined, Insalaco was scheduled for a cystoscopy procedure, which is a visual examination of the bladder.
Insalaco was allegedly underventilated during the surgery, evidenced by the fact that his oxygen saturation level dropped from 99 percent to 97 percent. Ten minutes after the surgery was completed, Insalaco was placed on 100 percent oxygen and woke up wheezing.
The attending C.R.N~A. extubated Insalaco, although hospital policy required the attending anesthesiologist to be present for extubation. The anesthesiologist observed Insalaco's extubation for only a few seconds before indicating in a recovery assesment that the patient had no complications and was stable and then leaving the hospital.
Insalaco was having problems breathing, but the C.R.N.A. decided to discontinue his 100 percent oxygen mask and instead placed him on a 50 percent venti mask, apparently increasing his oxygen deprivation.
The nurse transferred Insalaco from the operating room to the PACU so a breathing treatment could be administered. When the nurse noticed that his condition continued to worsen without any sign of stopping, she questioned whether she had placed the tube into his esophagus in the original extubation and proceeded to extubate him again.
Insalaco suffered a cardiac arrest but after he was re-intubated, his vital signs returned strongly.
The anesthesiologist, Dr. Erwin Moritz, returned to the hospital and allegedly changed Insalaco's chart to indicate that he did have complications and that his condition was "unstable." Later that night, he also allegedly placed an addendum in Insalaco's file saying that he left the hospital just before the patient entered the PACU and that Insalaco was breathing well.
Insalaco suffered generalized hypoxic encephalopathy, a disease of the brain caused by oxygen deprivation that leads to brain damage, coma or a vegetative state.
Insalaco's wife sued for lost earning capacity, past and future medical costs, loss of consortium and negligent infliction of emotional distress.
The case settled before trial for $21 million.