The medical malpractice civil trial of heart surgeon Pervaiz Chaudhry in Fresno County Superior Court began Thursday with the opening statement by the attorney for a patient left in a vegetative state after open-heart surgery.
When heart patient Silvino Perez, 76, kept bleeding after the surgery, he lost so much blood that his brain was starved of oxygen and now he’s permanently comatose, attorney Ricardo Echeverria of Claremont said.
Chaudhry is to blame because he left the operating room after the surgery April 2, 2012, before Perez had been sewn up by a physician’s assistant and before he was stable, in violation of Community Regional Medical Center policy, Echeverria told the jury.
“He’s the captain of the ship going into the surgery,” Echeverria said.
The doctor also violated policy by not having a backup cardiac surgeon when Chaudhry left the hospital grounds, the attorney said.
When Perez turned blue from lack of oxygen due to the bleeding, Chaudhry was a half-hour away at a restaurant in north Fresno for a business meeting, Echeverria said. He came back to the hospital, but by the time he got there it was too late, Echeverria said.
But Chaudhry’s defense attorney, Jim Goodman of San Francisco, said a review of the evidence by medical experts shows Chaudhry was indeed in the operating room until Perez was stable. Testimony by medical staff in the operating room that day proves it, he said.
“This is a very unfortunate case in which we had an extremely rare complication,” Goodman said. “In every step of the process, he was not in any way negligent. What he did met the standard of care in every instance.”
The surgery to replace a heart valve and repair a damaged aorta went smoothly, and Chaudhry left to go talk to the family while an experienced physician’s assistant who had worked with Chaudhry many times sewed up the patient, which is normal procedure, Goodman said. The doctor then left for the meeting in north Fresno with a visiting heart physician.
When it became evident that excessive bleeding was occurring, Chaudhry was called and he immediately returned to the hospital, Goodman said.
But the family’s attorney said Perez was never stable after the surgery. Medical records, cell phone records and interviews with the surgery team shows excessive bleeding was a problem from the start, he said.
“Mr. Perez continued to bleed and bleed,” Echeverria said, and lost up to a third of his blood supply. The problem caused “pure chaos” in the operating room, he said.
Before Chaudhry returned, the physician’s assistant reopened the chest, massaged his heart and tried to hook him up to a heart-lung machine while on the phone with Chaudhry for instructions, but was unsuccessful, Echeverria said.
But Goodman said whether Chaudhry was in the hospital or not is not a factor in what happened. Even if Chaudhry had stayed at the hospital, “the same massive bleeding would have occurred.”
Chaudhry, one of the busiest cardiac surgeons in the state, was the medical director for cardiothoracic surgery at both Community Regional Medical Center and Fresno Heart & Surgical Hospital at the time of the surgery. The suit was filed by Perez’s wife and stepson in December 2013.
Echeverria said Chaudhry was “spread too thin” by both a heavy caseload – 749 surgeries over 730 days – and his professional responsibilities to properly care for Perez.
But Goodman said the area has a lot of severe heart cases. “His policy is never say never – that accounts for the number of surgeries,” he said.
The trial is scheduled to go through March. Testimony begins Monday in the courtroom of Judge Jeffrey Hamilton.
Meanwhile, a manager at Fresno Heart & Surgical Hospital filed suit, claiming that she was punished with a layoff after she filed a complaint that Chaudhry had left the operating room there. Valerie Villalobos was later rehired but then resigned, citing a hostile work environment.