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Scuzzaro v. Loma Linda University Medical Center11/14/2003
After a 13-day trial, a jury awarded plaintiff Jeanette Scuzzaro damages in her medical malpractice action. The damages included $750,000 for past pain and suffering, $750,000 for future pain and suffering, $100,000 for past loss of earnings, and $302,178 for future loss of earnings. The latter figure was reduced to a present value of $43,168.
During trial, the trial court granted defendant Yonemoto's non-suit motion. In posttrial proceedings, the trial court granted the motions of defendants Petti and Umeda for judgment notwithstanding the verdict and for a new trial. Ms. Scuzzaro appeals.
FACTS
Ms. Scuzzaro went to Dr. Beckner, a dentist, in September 1996. At the time, she was age 52 and in good health. After some dental work, she was referred to Dr. Roberts, an oral surgeon. Dr. Roberts removed a lower left wisdom tooth and one other tooth in February 1997.
In March 1997, Ms. Scuzzaro felt some pain and noted a small red growth on her lower left inner jaw, near the place where the teeth had been extracted. She went back to the dentist and was given antibiotics, which were ineffective. By June, the extraction wound was healed, but the growth was the size of a BB, and her gum was swollen. Dr. Moss or his associate, Dr. Roberts, took a biopsy and forwarded the tissue to Dr. Melrose, a dentist specializing in oral pathology.
Dr. Melrose testified that he received the tissue and studied it. He also looked at an x-ray of the lower left jaw. He found malignant cells and diagnosed a primary squamous carcinoma. The diagnosis was "squamous carcinoma moderately differentiated." In lay terms, he found a malignant cancer tumor originating in the skin cells of the lower left jaw.
A primary issue in the case is whether the cancer had spread to the lower left jawbone or not. The technical issue is whether the cancer was properly staged as a T-2 or T-4 cancer. Staging is the " rocess of classifying tumors, esp. malignant tumors, with respect to their degree of differentiation, to their potential for responding to therapy, and to the patient's prognosis." (Davis, Taber's Cyclopedic Medical Dictionary (16th ed. 1989) p. 1738.) Although Dr. Melrose made the diagnosis, he did not stage the tumor. Instead, he notified Ms. Scuzzaro's dentist.
Ms. Scuzzaro's dentist referred her to defendant Petti, an oral surgeon at Loma Linda University Hospital, in June 1997. By that time, the tumor had grown bigger. Dr. Petti agreed with the diagnosis. Dr. Petti staged the cancer as a T-4 cancer which had invaded the jawbone. He told Ms. Scuzzaro that he would remove her left jawbone and replace it with bone taken from her leg, technically a fibula free flap. Plaintiff contends that the cancer should have been staged as a less virulent T-2 cancer and that her jawbone did not have to be removed.
Before surgery, Ms. Scuzzaro's case was reviewed by a tumor board headed by Dr. Petti. The tumor board staged her cancer as a stage 4 cancer.
Surgery was scheduled in August 1997, but was subsequently advanced to July 18, 1997. Dr. Petti removed the jawbone and doctor Umeda reconstructed it with bone from Ms. Scuzzaro's leg. The jawbone that was removed was lost during surgery and, as a result, it was not tested to determine if the cancer had invaded it or not.
The fibula flap failed four days after the initial surgery. A second flap failed in August 1997. Ms. Scuzzaro also developed a severe leg infection in August 1997. Defendant Yonemoto commenced radiation treatments in September 1997.
Other problems ensued. Ms. Scuzzaro eventually had a total of 18 surgeries on her face and eight on her leg. He
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