Opinion ID: 163699
Heading Depth: 3
Heading Rank: 1

Heading: Dawn Hartnett’s Surgery

Text: In December 1996, Dawn Hartnett, a 31-year-old mother of two, was diagnosed with a pancreatic mass. On January 3, 1997, the defendant Dr. Terrence O’Rourke performed surgery on Mrs. Harntett, removing her spleen, 60% of her pancreas, and a benign cyst. In order to prevent further bleeding, Dr. O’Rourke ligated the splenic artery. The parties agree that, in performing this procedure, the appropriate method is to apply a double ligature. Both Dr. O’Rourke and the vascular surgeon who assisted him in the operation, Dr. William C. Chambers, Jr., testified in their depositions that Dr. O’Rourke applied a double ligature. However, Dr. O’Rourke’s post-operative notes do not expressly refer to a double ligature. The notes state: -3- Splenic artery was ligated as it came off the celiac and splenic vein ligated as it terminated into the portal vein. Aplts’ App. at 119 (emphasis added). Initially, the surgery appeared to be successful, and Mrs. Hartnett was transferred to the recovery room in stable condition. However, two hours later, Mrs. Hartnett suffered massive internal bleeding and lost consciousness. In an emergency surgical procedure, Dr. O’Rourke reopened the abdominal incision, observed bleeding from the splenic artery and the tumor bed, and removed a large volume of blood. His post-operative notes describe this second operation as follows: There was approximately 1500 cc of clotted blood within the abdomen which was rapidly removed. Pressure was applied to the area of the previous dissection. Once the patient was stabilized, it could be seen that there was bleeding from the splenic artery. This was controlled with a clamp and suture ligatures. In addition, there were multiple sites of bleeding in the tumor bed from small veins. These were controlled with suture ligation, clipping, and pressure. There were numerous sutures of 5-0 Prolene and suture ligatures of 3-0 silk. The patient became progressively stable throughout the procedure . . . . . Sterile dressings were applied, and the patient was brought back to the intensive care unit in critical, but stable condition. Id. at 120 (emphasis added). -4- Despite these efforts, Mrs. Hartnett suffered ischemic encephalopathy (brain injury from decreased blood flow) and never regained consciousness. A neurologist later concluded that she had suffered irreversible brain damage. The family elected to discontinue life support, and, tragically, Mrs. Hartnett died on January 9, 1997.