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McGarry v. Horlacher

6/21/2002



Rendered on the 21st day of June, 2002.


. Lynn McGarry, her husband, Edward, and their two children (hereinafter collectively referred to as "McGarry") appeal from a judgment of the Montgomery County Court of Common Pleas in favor of Dr. James B. Horlacher. The trial court directed a verdict or granted summary judgment on some of McGarry's claims, and a jury found in favor of Horlacher on the remaining claims.


. The facts and procedural history of the case are as follows. McGarry gave birth to her second child on August 15, 1997 by Cesarean section. Horlacher was her obstetrician/gynecologist and performed the Cesarean section. McGarry had a routine follow-up appointment with Horlacher several weeks later.


. In November 1998, when McGarry went to Horlacher's office for an annual exam, Horlacher's nurse midwife was unable to perform a routine Pap smear because of a large mass in McGarry's abdomen. Horlacher suspected that the mass was a fibroid. Fibroids are growths in or around the uterus that are generally harmless but that may be surgically removed if they cause discomfort or unusual bleeding. Horlacher performed an ultrasound in his office and sent McGarry for a more specialized ultrasound at another location to attempt to exclude the possibility that the mass was on McGarry's ovaries. The ultrasounds were consistent with a large fibroid of the uterus.


. Horlacher informed McGarry of various treatment options. One option was to do nothing because McGarry was not suffering any ill effects from the mass. Another was to attempt a myomectomy, which is the removal of the fibroid. With a myomectomy, however, the patient runs the risk of a hysterectomy, especially with a large fibroid. A hysterectomy was another option. Because McGarry was only thirty-one years old and was interested in having more children, she elected to have a myomectomy. Before the myomectomy was performed, McGarry was given monthly injections of Lupron for three months in an effort to shrink the size of the fibroid and ease its surgical removal. The mass did not shrink during the course of the Lupron injections; in fact, it continued to grow.


. Because Horlacher believed that a myomectomy would probably lead to a hysterectomy, he recommended that McGarry try a relatively new procedure called embolization before opting for surgery on the uterus. A radiologist performed the embolization procedure on McGarry on April 16, 1999. The embolization was unsuccessful, and it also revealed that the abdominal mass was pressing on McGarry's ureters and could ultimately cause kidney damage. After learning about the possible kidney damage, McGarry decided to have a hysterectomy.


. Horlacher performed the hysterectomy on April 18, 1999. When Horlacher opened McGarry's abdomen, he noticed that the suspected fibroid had undergone a lot of degeneration, and he thought that it might have been some type of tumor. A pathology test confirmed that the mass was leiomyosarcoma, not a fibroid. Leiomyosarcoma is a very aggressive cancer that is extremely rare in premenopausal women. It is unusual for a woman to survive leiomyosarcoma, even if it is discovered in its early stages. Horlacher determined that McGarry's leiomyosarcoma was in Stage III at the time of surgery, which meant that it had advanced beyond the uterus and cervix.


. On October 1, 1999, McGarry filed a medical malpractice claim and other claims against Horlacher. She claimed that Horlacher had deviated from the standard of care by failing to diagnose and properly treat her leiomyosarcoma and had failed to inform her of the risk that the mass could be cancer in presenting the various treatment options.

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