Surgeon Must Face Second Trial in Stroke Suit
A cardiovascular surgeon must face a second trial over claims that he performed an unnecessary surgery that caused a patient's stroke, the Iowa Supreme Court has ruled.
William McGrew visited a Waterloo, Iowa, cardiovascular surgeon in 2014 after experiencing transient foggy vision in one eye. An ophthalmologist initially diagnosed McGrew with cataract, but he was referred to the surgeon to rule out other possibilities.
Because of McGrew's age (69) and history of hypertension, the cardiovascular surgeon suspected carotid disease and recommended a CT angiogram to further investigate, according to a summary in the Iowa Supreme Court's opinion.
The CT angiogram was performed at a local imaging center and read by a radiologist who interpreted it as showing 65% stenosis, or narrowing, of the right carotid artery. The surgeon did his own review and interpreted the results as showing 70% stenosis, according to court documents. The surgeon believed that McGrew was at significant risk for stroke and he recommended surgery, specifically a right carotid endarterectomy to remove the plaque from the right carotid artery. He advised McGrew of the surgery's possible risks, the most common being a stroke.
The endarterectomy initially appeared successful, but the next morning, McGrew experienced facial droop and weakness on his left side. An MRI and CT scan showed that McGrew experienced a stroke on the right side of his brain. A CT angiogram showed that his right carotid artery was blocked. The surgeon performed another surgery to remove the carotid artery blockage, but the second surgery did not alleviate McGrew's symptoms, according to court documents. McGrew remains wheelchair-bound, unable to move his left side, and requires nursing home care.
McGrew and his family later went to a neurologist who analyzed McGrew's prior CT angiogram. He interpreted the angiogram as showing only 40% stenosis. The neurologist also asked a neuroradiologist to analyze the CT angiogram, and he assessed the stenosis at 32%. In his opinion, 40% stenosis was not significant to justify an endarterectomy, the neurologist told McGrew.
McGrew sued the surgeon and the radiologist in 2016, and later settled with the radiologist. The McGrews claimed that the surgeon negligently misinterpreted the CT angiogram and performed an ill-advised surgery that resulted in a stroke. The McGrews sought damages for pain and suffering, permanent loss of function, loss of income, past and future medical expenses, and loss of consortium.
At trial, attorneys for the surgeon asked the court to limit his and the radiologist's testimonies, arguing that their opinions were not properly disclosed in expert reports. The trial court granted the motion, and jurors heard only a limited version of the testimony. In addition, some medical records were redacted. A jury found in the surgeon's favor, deeming him not negligent.
The McGrews appealed. In a January 21, 2022, opinion, the Iowa Supreme Court ruled that the trial court abused its discretion by not allowing the earlier testimonies. Justices said both the neurologist and the neuroradiologist should have been allowed to testify on the applicable standard of care. The district court also abused its discretion in preventing McGrew from introducing complete versions of the contemporaneous medical records, the court ruled.
Justices reversed the district court's decision and remanded the case for a new trial.
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