Opinion ID: 1872831
Heading Depth: 1
Heading Rank: 2

Heading: lana fox's version of events

Text: Lana Fox has worked as a lab technician for most of her adult life at various places in Florida and later in Mississippi. One significant experience in her work background was a ten (10) year stint with the University of Florida and the federal government where Mrs. Fox was engaged in cancer research which involved working with carcinogens. From the record, it appears that this employment was from 1970 until May of 1980. In 1971, Lana met and married her husband, Donald Fox, who was also a lab technician working for the federal government in Gainesville, Florida. In May of 1980, Mrs. Fox and her husband moved from Florida to the State of Iowa. In 1984, Donald Fox secured a job in Columbus, Mississippi, as a lab technician in the hospital located on the Columbus Air Force Base. Thus, the Foxes moved to Mississippi and settled in Caledonia. Once the Foxes were settled in Mississippi, Mrs. Fox worked various odd jobs for temporary periods of time which included work in a couple of medical groups in Columbus. However, in the fall of 1985, a new medical clinic, Emergi-Care, opened in Columbus. Mrs. Fox was employed at Emergi-Care as a lab technician when the facility opened, and she was still employed there at the time of trial in August of 1988. On December 31, 1985, Mrs. Fox experienced a severe attack of abdominal pain, and she contacted one of the physicians at Emergi-Care where she worked. The physician provided some medication which eased the pain, and she returned to work at the clinic with no complications. However, the physician at Emergi-Care recommended that she see a gynecologist because he suspected that a cyst could be one possible cause for her pain. Therefore, on January 8, 1986, Mrs. Fox went to see Dr. Perrin Smith, an obstetrician-gynecologist of the Columbus Women's Clinic. Mrs. Fox's complaint was severe lower abdominal pain. Dr. Smith did a pelvic exam and suspected that Mrs. Fox had endometriosis or possibly a cyst. Dr. Smith recommended an out-patient laparoscopy so that he could determine a diagnosis. Mrs. Fox informed Dr. Smith that she would think about it and would be back in touch. Although Dr. Smith conducted a pelvic exam, Mrs. Fox alleged that Dr. Smith never mentioned the IUD to her at this first visit, and she never mentioned it to him. Mrs. Fox sought a second opinion. She made an appointment with Dr. Miles of the same medical group, Columbus Women's Clinic, and on February 14, 1986, Mrs. Fox saw Dr. Miles. According to Mrs. Fox, she told office personnel at the second visit that she was there for a second opinion; however, she also told office personnel that she had never been there before, and a new chart was started for her. Apparently, Mrs. Fox believed that if Dr. Miles knew that her first opinion was from his medical partner, Dr. Smith, then she might not get a truly unbiased opinion. Dr. Miles provided the same information as Dr. Smith. That is, she might have endometriosis or a cyst, and a laparoscopy was needed in order to confirm a diagnosis. When Dr. Miles provided the same diagnosis as Dr. Smith, Mrs. Fox then informed him that Dr. Smith was her first opinion and that she had a laparoscopy tentatively scheduled with him. According to Mrs. Fox, she and Dr. Miles discussed the IUD at the February 14th appointment. When he did the pelvic exam he says, `I see you have a IUD.' I said, `Yes, it's a CU-7; it's been in a long time.' And we discussed how long it had been in. He said, `Well they recommend that they be changed much more frequently.' And I told him I realized that and I had been intending to do so at some time, and I had kind of put if off because I was having no problems, no pain, no discomfort, and like most manufacturer rec  any recommendations and all it's done to protect the company as much as anything, and since I was having no discomfort, no problems, I didn't see any reason to change horses when I was doing fine. Dr. Miles offered to remove her IUD at this visit, but Mrs. Fox declined the offer. Mrs. Fox acknowledged that her IUD was long overdue for a change, but she testified that if Dr. Smith found cancer, he had mentioned that a total hysterectomy might be required. Therefore, if she had cancer, she saw no reason for paying Dr. Miles for the removal of an IUD if she eventually ended up with a total hysterectomy. At trial, Mrs. Fox guessed that she had been wearing this particular IUD, CU-7, manufactured by the Searle Company, for six or seven (6-7) years. However, on cross-examination, she gave the question additional thought and testified that she had been wearing the same IUD for ten to twelve (10-12) years. Evidence in the record indicates that this particular IUD should be replaced every three (3) years. In the meanwhile, Mrs. Fox scheduled the laparoscopy for February 27, 1986, with Dr. Smith. Two days prior to the procedure, February 25, 1988, Mrs. Fox went to see Dr. Smith in what was described as a pre-op visit. According to Mrs. Fox, Dr. Smith did not examine her during this visit, and her IUD was not discussed. During this visit, Mrs. Fox informed Dr. Smith that she once worked with carcinogens as a lab technician, and for that reason, she feared that he might find a cancerous tumor. Consequently, Mrs. Fox gave special instructions to Dr. Smith for the preservation of any tissue specimens that he removed from her body in the event she had cancer, so she might be able to trace the causation to her research work of prior years. Apparently, Mrs. Fox wanted the specimens for any potential evidentiary value that it might have in a possible lawsuit. According to Mrs. Fox, [h]e (Dr. Smith) said there would be no problem preserving the specimens as I requested. There was no discussion of the IUD, it was never brought up. Mrs. Fox testified that Dr. Smith requested that she and her husband be checked into the hospital an hour before the surgery was scheduled so that he could discuss the procedure in more detail when her husband was present: He said since we were talking about possible hysterectomy or partial removal of internal organs and all like that, that he preferred that my husband be there; in fact, he asked me wasn't my husband with me when I arrived that morning and I said, no, he wasn't, he was working, and he said that since, you know, this would possibly be a necessary procedure that he preferred that my husband be in on those conversations since it would affect our lives, both of us, depending on what type of surgery would be done, therefore he said he didn't really think we should go into it then because he would  He would feel obligated to go through it again Thursday morning with my husband present so that he would know what to expect after the surgery and what might possibly be done, and so we arrived before six o'clock even though I was scheduled for seven o'clock surgery. Mrs. Fox testified that she and her husband arrived an hour early as requested in order to meet with Dr. Smith prior to surgery. Significantly, both Mrs. Fox and her husband steadfastly maintain that Dr. Smith never came to the room to see them prior to the surgery. According to Mrs. Fox, she did not see Dr. Smith until she was on the operating table and was being prepped for surgery. Q. Okay, in the OR here was there any discussion about an IUD? A. Only when Dr. Smith came in. Q. Okay, tell us about that if you would. A. Do you want me to start at the beginning of the OR or at  when Dr. Smith came in because there are several things that happened in the operating room before he arrived? Q. Okay, well tell us about what Dr. Smith  what Dr. Smith told you about the IUD. A. He walked in the room and says, `Good morning,' you know, or  No, he said, `Hi, there, are you ready to get that IUD out and have that D and C?' And I thought the man was crazy or badly confused; he didn't know what patient I was, and I said  I looked straight at him and I re  you know, `No, I'm not here to have a D and C. I do not want my IUD out. I am here for a laparoscopy only.'       A. He [Dr. Smith] just looked, you know, he had his mask on; he was kind of, you know, you can just see him grinning and at that point he had come closer to the stretcher and he put his  You know, kind of patted me on the left shoulder like there, there, little girl, and I felt a  a very burning sensation in my shoulder and I said, `Ow, my shoulder is burning,' and Mr. Richardson said he was injecting, and I started yelling, `No, stop.' I said it three times that I can recall before I became unconscious. Following surgery and a brief stay in the recovery room, Mrs. Fox was brought back to her room. When Mrs. Fox awakened from surgery, she discovered that her IUD had been removed and that she had had a D & C. Dr. Smith came by the room following surgery and talked with Mr. Fox. Mrs. Fox was awake at this point, but she was still groggy. Dr. Smith informed Mr. Fox that the laparoscopy revealed mild endometriosis which could be treated with medication, and he found some adhesions which he transected. No cyst or cancer was indicated. Dr. Smith testified that he informed Mr. Fox that he removed the IUD and the reasons for doing so. Allegedly, Mr. Fox thanked Dr. Smith for removing the IUD and commented that he and his wife had discussed the need to replace it. According to Mr. Fox, his wife was livid with anger when she left the hospital. When Mrs. Fox regained her senses, Mr. Fox quickly learned that Mrs. Fox did not want her IUD removed. The Consent Form: Once Mrs. Fox was checked into the hospital on the morning of February 27, 1986, Nurse Perian Grimes brought in a consent form for her to sign. At trial, Mrs. Fox testified that she pointed out to Nurse Grimes that she had made special arrangements with Dr. Smith for the preservation of her specimens. Therefore, Nurse Grimes made a notation on the form that she (Fox) had discussed this with Dr. Smith. The following is Mrs. Fox's testimony on this point: She came in when they brought us up from admitting; uh, she brought the surgical permit and had asked me to sign it. I said, `Well I  I read everything before I sign it.' And as I read the paper she took my vital signs and I finished the paper before she finished the vital signs, and I said, `I have only one correction here at the bottom where it says about medical specimens,' I said, `I had told Dr. Smith in the office that there were three methods by which I wanted the pathology lab to preserve the specimens and therefore I didn't want them to just merely go to pathology without those instructions because the specimens could be destroyed for what might, you know, be necessary later as far as recouping costs for cancer which is extremely expensive and I had been exposed to carcinogens in my work with the federal government in cancer research; it was documented in my personnel file, but if the specimens were destroyed or improperly handled, then there would be a lot of hassle in getting the payments for the surgery and for follow up care for cancer if the specimens were not handled properly by the pathology lab.' According to Mrs. Fox, once Nurse Grimes made a notation on the consent form about her discussion with Dr. Smith concerning the preservation of specimens, she then agreed to sign the form. On cross-examination, Mrs. Fox provided additional details of her initial reluctance to sign the surgery consent form: Q. And the only thing you objected to was the section down there authorizing and directing the hospital pathologist to use his discretion in the disposal of any severed tissue or member, right? A. I objected to two  two points on the paper in talking with the nurse. I said, `About this part that says they can do any other procedure,' I said, `I'm only here for a laparoscopy. Should I strike this out?' And she said, `No, that's there mostly in case you would like to go [sic] into arrest or if there would be bleeding and they would have to do something to stop the bleeding and so they put that in there to cover anything that might accidently happen that would require them to do life saving measures.' And I said, `Okay, I can  I can handle that.' And then I went down to the next part where I had her write in  Q. Right. A.  That I had discussed this with Dr. Smith and he knew from our discussion in his office the prev  two days before how the specimens were to be handled; they weren't just to be handed to pathology; there were to be specific instructions. Q. So that part of the consent you wanted some writing put in on it, right? A. Definitely. The two paragraphs in the consent form which Mrs. Fox describes in the above testimony are as follows: I recognize that, during the course of the operation, unforeseen conditions may necessitate additional or different procedures than those set forth above. I, therefore, further authorize and request that the above named surgeon, his assistants or his designees perform such procedures as are, in his professional judgment, necessary and desirable, including but not limited to procedures involving pathology and radiology.       3. I hereby authorize and direct the hospital pathologist to use his discretion in the disposal of any severed tissue or member, except ____ In the blank space at the end of item three following the word except, there is a handwritten note which states, consult with Dr. Smith  discussed this with patient. On April 7, 1988, when Lana Fox went to see Dr. Smith for a post-op follow-up, she confronted him about the IUD removal and the D & C. Mrs. Fox testified that even before she went to see Dr. Smith, she had decided that she would sue him and that she was on a mission. Regarding damages, Mrs. Fox testified that following the surgery by Dr. Smith, she felt, dirty, demoralized, and used. Mrs. Fox testified that she suffered from depression and had withdrawn from society in general. She testified that she could not trust people, especially medical doctors. She also testified that it was difficult to have sex and that this had caused marital problems. Mr. Fox testified that his wife underwent an abrupt personality change. Mr. Fox stated that his wife lost interest in gardening and in activities that they both enjoyed in the past such as hunting and fishing. She doesn't seem to get as much enjoyment out of life as she did before.