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Greynolds v. Kurman11/3/1993
EDWARD J. MAHONEY, Judge.
Defendant-appellant, Andrew Kurman, M.D., appeals from a jury verdict rendered against him in favor of plaintiff-appellee, K. Jack Greynolds, in a medical malpractice action. The malpractice action arose after Dr. Kurman performed a cerebral angiogram on Greynolds which caused Greynolds to suffer a stroke. We affirm.
In late July 1987, Greynolds and his wife, Mary Greynolds, visited relatives in Charleston, West Virginia. During the visit, Greynolds suffered from a transient ischemic attack ("TIA") on July 29. A TIA is "a sudden loss of neurological function" caused by "vascular impairment to the brain." Stedman's Medical Dictionary (25th Ed. 1990) 152. TIAs are usually brief attacks that pass with "no persistent neurological deficit." Sloan-Dorland Annotated Medical-Legal Dictionary (1992 Supp.) 41. In layman's terms, "TIAs are warning signs of an impending stroke." Id., citing Campbell v. United States (C.A.7, 1990), 904 F.2d 1188, 1189. On at least two previous occasions since 1979, Greynolds had suffered from TIAs.
As a result of the TIA in West Virginia, Greynolds had garbled speech and expressive and perceptive aphasia. "Aphasia" is a medical term used to describe the "loss of the power of expression by speech, writing, or signs, or of comprehending spoken or written language." Sloan-Dorland Annotated Medical-Legal Dictionary (1987) 44.
On July 29, 1987, Greynolds was transferred to the Akron General Medical Center. Upon arriving in the Akron General emergency room, the Greynoldses were met by Greynolds's cardiologist, Dr. Litman. At Dr. Litman's request, Dr. Jose Rafecas, a medical neurologist, examined Greynolds. Dr. Rafecas determined that because of Greynolds's past medical history, which included previous TIAs, he was at a high risk for a stroke, and sought to pinpoint the exact source of vascular insufficiency to the brain.
Dr. Rafecas placed Greynolds on the drug Heparin, and ordered that a technician perform Doppler and ultrasound studies on the carotid arteries in Greynolds's neck. The Doppler and ultrasound studies were noninvasive tests performed to determine whether there existed any lesions in the arteries which could be surgically treated. The test results showed a mild amount of atherosclerosis in Greynolds's carotid artery, but did not pinpoint the source of his TIAs.
After receiving the results of the noninvasive tests, Dr. Rafecas ordered that Greynolds undergo a cerebral angiogram. A cerebral angiogram is an invasive procedure by which a catheter is inserted into the femoral artery in a patient's groin. The catheter runs through the arterial system into the carotid artery in the neck. Then, contrast dye is injected into a patient's carotid arteries so that doctors can study the vessels supplying blood to the brain. The procedure is not without risks. It can cause spasms in the vascular walls, thus restricting the blood supply to the brain, or plaque can be dislodged within the arterial system, causing an occlusion. Also, the contrast dye used in the procedure can produce a reaction which causes an occlusion. If one of the aforementioned incidents occurs during the procedure, it may restrict a patient's blood supply to the brain, and a patient can suffer a stroke. During the trial, expert witnesses for both sides explained that during cerebral angiograms performed upon healthy patients, two to three percent of the patients suffer from a stroke as a result of the procedure.
Before Dr. Kurman performed the cerebral angiogram on Greynolds, members of the "operating team" had Greynolds sign two consent forms. On July 31, 1987, Greynolds
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