The family of a woman who bled to death hours after a common surgery is suing Clovis Community Medical Center and a doctor who works there.
On April 13, 2011, 40-year-old Nicole Caruso had a 40-minute surgery and was discharged hours after the operation. Within 14 hours, though, Caruso died at her Clovis home.
Caruso's death is the subject of a wrongful death civil trial that is underway in Fresno County Superior Court. CCMC and Dr. Hoa Pham, the anesthesiologist responsible for Caruso's medication for her surgery, are accused of medical malpractice.
The two defense lawyers, one representing CCMC and the other representing Pham, contend that their clients' actions were within the standard of care.
The operating surgeon, Dr. Michael Synn, has already settled out of court for an undisclosed amount.
In his opening statement Thursday, Joseph Davis, the lawyer representing the victim's husband, Tom Caruso, spelled out his case:
Caruso, who was a health care marketing researcher, wanted to have her IUD birth control device removed and get a tubal ligation. She received a total of three procedures at CCMC on April 13 -- a hysteroscopy to locate her IUD, the removal of the IUD, and the tubal ligation, also known as the process of getting one's tubes tied.
At some point during one of the procedures, a needle penetrated Caruso's left internal iliac artery and left a 3-millimeter by 4-millimeter perforation -- the size of a pencil point.
Apparently unaware that Caruso had slow internal bleeding, caregivers moved Caruso to the Post Anesthesia Care Unit. She stayed at the hospital for three hours before she was discharged at 6 p.m.
Her husband took her home and helped her into bed. Later that night, he gave her a Vicodin prescribed by Pham to alleviate her pain and help her sleep. Because his wife was still in pain after the Vicodin, Tom Caruso tried to reach Synn. He then called hospital staff and told them that if his wife remained in pain and Synn did not call him back, he would return his wife to the hospital.
After he got off the phone, Tom Caruso found his wife asleep and took it as a good sign. He woke her up to give her another Vicodin at about 1 a.m. and when he tried to wake her up at 5 a.m., she was unresponsive. Nicole Caruso had gone into cardiac arrest and died.
The autopsy showed that a little over 2 quarts of blood had drained out of the punctured artery.
Pham's lawyer, Michael Ball, said in his opening statement that the anesthesiologist's discharge orders were met and that when Pham last saw Caruso after her surgery, there was no cause for concern over her state.
William White, the lawyer representing CCMC, asserted in his opening statement that the care and treatment provided by the nurses and staff of the medical center were within the standard of care.
Both sides have a number of witnesses and experts slated to weigh in on the case beginning Monday morning.
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