Virginia Mason Medical Center was found negligent after a man was left disfigured after complications in an abdominal-tumor surgery. The hospital may appeal.
A jury awarded $8.5 million to a Seattle couple after the man underwent a surgery at Virginia Mason Medical Center and developed complications that led to months of reconstructing his penis.
The couple said they had insisted that a specific doctor handle a portion of the procedure, but they learned later that a less-experienced doctor did so.
The verdict Wednesday in King County Superior Court found Virginia Mason was negligent in causing injury to Matthew and Dr. Sarah Hipps. The jury awarded $6 million to Matthew Hipps and $2.5 million to Sarah Hipps.
The Hippses said they felt vindicated by the jury and betrayed by Virginia Mason, where Sarah Hipps worked as an anesthesiologist at the time of her husband’s surgery. “I felt totally betrayed,” she said. “These were people I worked with for years.”
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Virginia Mason issued a statement saying it is committed to providing the safest care for every patient and is assessing its options, such as an appeal.
“We strongly disagree with both the jury’s decision against our organization and with the plaintiff attorney’s misleading, post-verdict portrayal of the facts in this case,” the statement says. A spokesman said he would not answer questions about the case.
It began in 2013, when Matthew Hipps, now 47, was diagnosed with an abdominal tumor. To remove the tumor, he consented to surgery, part of which involved inserting a stent in the tube that carries urine from the kidney to the bladder.
The Hippses said they wanted the head of Virginia Mason’s urology department, Dr. Kathleen Kobashi, to handle that portion of the surgery. They said they made that clear verbally and in a consent form that Matthew Hipps signed.
“I had no qualms at all about Dr. Kobashi. She’s great,” said Sarah Hipps, who worked with Kobashi on past cases.
The Hippses said they were told the surgery went well and the tumor was removed. But after going home, Matthew Hipps experienced complications. His attorney Michael Wampold said his bladder backed up with urine because the procedure had “obliterated” his urethra. He suffered “overflow incontinence,” Sarah Hipps said.
He then had to have his penis splayed open so that tissue taken out of his facial cheek could be grafted onto the organ to rebuild the urethra.
For seven months he couldn’t work, run, have sex or coach his children’s sports teams. He woke up screaming in pain some nights. “It affected everything in my life. It affected my relationship with my spouse,” he said.
As the Hippses eventually learned, Kobashi never appeared for the procedure. It was done by Dr. Chong Choe, a urologist who had come to Virginia Mason as a fellow for further training in female pelvic-floor surgery.
The Hippses said that, when they met Choe that morning, he said he was there to get them to sign a consent form authorizing Kobashi to do the stent procedure, not to perform the procedure himself.
The consent form presented to the jury, though, showed “Kobashi/Choe” were authorized, in Choe’s writing.
The Hippses contend Choe’s name was later added to the form. They said they asked for a copy of the original form but were told by hospital officials it had been discarded and were offered a scanned version of the document.
The jury denied the Hippses’ charge of “medical battery” stemming from the alleged change in the consent form. Medical battery requires evidence of intent to harm, according to Virginia Mason’s response to the Hippses’ lawsuit.
“The jury rejected the Hipps’ claim of medical battery and returned a verdict in favor of Virginia Mason on that claim,” noted the hospital’s statement.
Still, Judge Beth Andrus took issue with Virginia Mason’s consent form. The hospital has interpreted the form to say it authorizes a doctor, such as Kobashi, to perform a procedure, or have an assistant perform it, according to the Hippses and Wampold, their attorney.
But the form uses the word “and” not “or,” Wampold said. So a fellow, such as Choe, could participate along with the primary doctor, but that doctor couldn’t send a fellow in as a substitute, Wampold said.
Andrus instructed the jury, in writing, that the form allows primary doctors to ask an unnamed doctor to assist them in a procedure. “It does not allow the named physician(s) to assign an unnamed physician to perform the procedure in the absence of the named physician(s).”
Wampold said Andrus’ instructions may open the door for other patients to file lawsuits for procedures performed by physicians they didn’t consent to.
The issue of what role fellows play in surgery was a component of a recent Seattle Times investigation of a neuroscience institute based at Swedish’s Cherry Hill facility.
Swedish’s high-volume surgeons managed their caseloads by running multiple operating rooms at the same time, The Times investigation found. Those star surgeons draw patients from around the region, but staffers expressed concern that they would only be in the operating room for a short period of time during some surgeries, leaving a fellow to do much of the work.
Swedish’s interim CEO, Guy Hudson, has said the surgeries may overlap, but that the surgeon is there for the “critical” portions of each case.
Swedish’s consent form from a 2014 case had some similar wording to the one Virginia Mason used in the Hipps case, with the patient giving consent to a surgeon “and such associates as my doctor may choose …”
Matthew Hipps said his wife, a fourth-generation physician, was devastated and shaken by his case. Virginia Mason “is where she trained, where her mentors and friends are. One of the hardest parts was watching her go through this,” he said.
Sarah Hipps now works at Kaiser Permanente.
The scariest part of his ordeal, Matthew Hipps said, is knowing he had a great advocate at his side. “Anyone who doesn’t have anyone, Lord knows what happens,” he said.