The civil malpractice trial of Dr. Pervaiz Chaudhry resumed Monday with a former hospital worker describing the heart surgeon as "cocky" and a "kingpin" at Community Regional Medical Center in Fresno.
Chaudhry wielded power, James Robillard testified, because he was friends with top administrator and brought a lot of heart patients to CRMC, which translated to major revenue for the hospital.
But Robillard, 66, also told the Fresno County Superior Court jury that Chaudhry's disregard for patient safety caused him to report him to the California Department of Public Health and the Medical Board in April 2012 after one of the heart surgeon's patients went into a coma.
His reporting of Chaudhry, he said, got him fired from CRMC.
Chaudhry, 57, is on trial in Fresno County Superior Court because a jury ruled on March 1 that he was negligent for leaving a CRMC operating room and letting his physician assistant close the chest of a 70-year-old patient, Silvino Perez.
Perez ended up losing blood during the April 2, 2012, surgery and going into a coma. He remains in a vegetative state today.
Now the same jury is hearing testimony to determine whether Chaudhry should pay damages to Perez's stepson, Cristobal Arteaga.
Arteaga is being represented by attorneys Jeffrey S. Mitchell of San Francisco, Steven A. Heimberg of Los Angeles and Ricardo Echeverria of Claremont. If the attorneys prove Chaudhry's conduct with Perez and other patients has been malicious or oppressive, Chaudhry would have to pay punitive damages.
Chaudhry is being represented by San Francisco attorneys James M. Goodman and Rebecca Cachia-Riedl, who have been doing most of the trial without Chaudhry being in the courtroom.
Chaudhry testified in his trial in late January and early February. He then told the court that he was traveling to Pakistan, where his family lives. He returned to Fresno in late February and was last seen in Judge Jeffrey Hamilton's courtroom during closing arguments, but hasn't attended court since the jury found him negligent.
On Monday, Robillard testified that he was a perfusionist, a person who operates a heart and lung machine. He assisted Chaudhry in hundreds of heart operations. Robillard testified that he wasn't the perfusionist for Perez's surgery, but had seen Chaudhry leave the operating room many times before the patient's chest is closed.
Robillard said he didn't tell CRMC administration about Chaudhry's pattern and practice of leaving the operating room because "everyone knew he ran the cardiac-surgery show." People who "didn't fall in line with him would not be included in the show," he said.
He said he had reason to fear Chaudhry's influence at CRMC; Robillard's company, Perfusion Associates of California, had a contract with CRMC. If he criticized Chaudhry, he said, he could lose his contract, which would have put his employees out of work.
His conscience, however, started to bother him when his employee, Aaron Schreur, the perfusionist in Perez's surgery, told him that Chaudhry had left the operating room, leaving his physician assistant in charge of closing the patient's chest. He said Schreur also told him that Perez lost a lot of blood, went into cardiac arrest, and into a coma.
A few weeks after the Perez's surgery, Robillard said he complained to the California Department of Public Health and the Medical Board. The two agencies agreed to keep his name anonymous, but his name was later revealed to Chaudhry and hospital officials.
In October 2013, the Department of Public Health fined CRMC $75,000, but never named Chaudhry or Perez.
Robillard testified that the fine "was a slap on the wrist." In addition, he said, Chaudhry served only a two-week suspension. Once he returned to the hospital, "he was cocky as ever," Robillard told the jury.
In late October 2013, Robillard said he called Perez's family to tell them what Chaudhry had done since the Department of Public Health never did. He said he made the phone call because the family was nearly ready "to pull the plug on Perez" and never knew of Chaudhry's role in putting the man in a coma.
The phone call led Arteaga to sue Chaudhry and CRMC in December 2013. (Prior to Chaudhry's trial, CRMC reached a confidential settlement with Arteaga.)
Robillard testified his company didn't get its contract renewed with CRMC in the summer of 2012. Instead, the hospital hired him and his employees as full-time hospital staff.
But in 2014, Robillard was fired after the hospital accused him of violating patient confidentiality. Goodman told the jury on Monday that Robillard accessed patient medical records electronically without authorization.
Robillard, however, told the jury that he sued Chaudhry and CRMC in 2015 for wrongful termination and retaliation for being the whistle-blower who told state health investigators about Chaudhry. He also told the jury that Chaudhry had sued him in October 2014 for defamation and asked for $40 million in damages, but the surgeon quickly dismissed the lawsuit.
Robillard contended that Chaudhry pressured CRMC to fire him. "Everyone knew Chaudhry was the kingpin there," Robillard told jury.