UPDATE: Jurors on Tuesday ordered Fresno surgeon Pervaiz Chaudhry to pay $12.39 million in punitive damages. That brings the total judgment against the doctor to $68 million.
ORIGINAL STORY: Fresno surgeon Pervaiz Chaudhry must pay $55.6 million to the family of a man who was left in a coma following a heart operation six years ago that ended badly at Community Regional Medical Center, a jury ruled Monday in Fresno Superior Court.
Now, the same jury will determine how much money in punitive damages Chaudhry, 57, must pay to deter his conduct for leaving the operating room while his patient's chest remained opened. The jury found Chaudhry's leaving to be malicious, oppressive or fraudulent. Punitive damages are often many times greater than the actual damages.
Chaudhry, who was absent during most of his weeks-long civil trial, was not i present when Monday's verdict was announced in Judge Jeffrey Hamilton's courtroom. He is in Pakistan, where he has family, lawyers said.
The jury's award is one of the highest, if not the biggest, ever reached in Fresno Superior Court.
In 2011, a jury ordered two senior officers of a defunct northwest Fresno business and its subsidiaries to pay $46.5 million to more than 1,200 victims of an alleged Ponzi scheme. The victims — many of them from Fresno's Armenian-American community — won't ever get full restitution from HL Leasing Inc. and its subsidiaries Heritage Pacific Leasing and Air Fred LLC, lawyers said. The defendants don't have that much cash and the mastermind of the Ponzi scheme, John W. Otto, committed suicide in 2009.
In Chaudhry's trial, the jury award follows its ruling on March 1 that he was negligent for leaving the operating room and ordering his physician assistant, Bella Albakova — who happened to be his girlfriend at the time — to close the chest of 70-year-old Silvino Perez, a retired farm and packinghouse worker from Sanger.
While Chaudhry was headed to a business luncheon in northeast Fresno after the surgery in April 2012, Perez lost so much blood that his brain was starved of oxygen, causing him to go into a coma.
The jury awarded Perez $25 million for past and future pain and suffering. Now 76, Perez remains in a vegetative state, but he can feel pain, said Ricardo Echeverria of Claremont, one of three lawyers representing the Perez family. Their other lawyers are Jeffrey S. Mitchell of San Francisco and Steven A. Heimberg of Los Angeles.
Because Perez was the primary caretaker for his wife Maria, who suffers from symptoms of dementia, the jury awarded her $25 million for her pain and suffering and loss of love and support.
Additionally, Chaudhry must pay $5.6 million in medical bills to the Perez family.
During the trial, Chaudhry's lawyers, James M. Goodman and Rebecca Cachi-Riedl, described him as a brilliant, hard-working surgeon who did high-risk surgeries to save lives. Testimony revealed that Perez was not Chaudhry's initial patient; he testified that he volunteered to do the surgery to help out another heart surgeon.
Goodman and Cachia-Riedl contend that Chaudhry was not at fault because Perez suffered an "extremely rare complication during surgery."
During his trial, Chaudhry testified that he didn't leave the operating room until Perez was in stable condition. But Albakova and other medical staff in the operating room said he left Albakova in charge of closing the chest.
Perez's lawyers told the jury that Chaudhry put profits over patient care. Over a two-year period, from April 2010 to March 2012, Chaudhry did 749 surgeries, testimony revealed. During many of his surgeries, Chaudhry would leave the operating room and order Albakova to close the patient's chest, said Echeverria, who described Chaudhry's conduct as "despicable."
"This is not a simple mistake, not an oops," Echeverria told the jury, referring to Perez's botched surgery. "It's utter disregard for patient safety."
Chaudhry not only left the operating room, he left the hospital, Echeverria said, "to attend a business meeting so he could shake someone's hand." According to testimony, Chaudhry received two phone calls about Perez's excessive bleeding, but continued to drive to the meeting at Campagnia Bistro in northeast Fresno.
According to Echeverria, CRMC rules say surgeons must remain at the hospital until the patient is stable in the recovery room. If Chaudhry had to leave, Echeverria said CRMC rules requires him to find a heart surgeon with compatible skills.
To support his case, Echeverria called heart surgeon Subashini Daniel, a former associate of Chaudhry's, as a witness. Daniel testified that she told Chaudhry that she disagreed with Albakova closing the patient's chest because that's "a critical part of the surgery." Daniel said Chaudhry ignored her concerns.
Echeverria also called Valerie Villalobos, director of surgical services at Fresno Heart and Surgical Hospital, as a witness. Villalobos testified that she confronted Chaudhry about leaving the operating room at Fresno Heart and Surgical Hospital several weeks before when another patient's chest was closed. The confrontation came before the Perez surgery, Echeverria told the jury.
"You need to go back to the operating room," Villalobos told Chaudhry, according to Echeverria.
Chaudhry cursed her and told Villalobos to get out of his way, Echeverria told the jury. "You guys are idiots," Chaudhry said, according to Villalobos' testimony.
Chaudhry was cocky and thought of himself as a "kingpin" at CRMC, Echeverria said, because he brought a lot of buisness to the hospital, which paid Chaudhry handsomely. Chaudhry's plan was to "control the market" and put his competition out of business, Echeverria said.
Because Perez is disabled, his stepson, Cristobal Arteaga, sued Chaudhry and his Valley Cardiac Surgery Medical Group for negligence. Arteaga also sued CRMC for negligence, but the hospital reached a confidential settlement before the trial began.
In closing arguments last week, Echeverria showed jurors photographs of Perez at a nursing home. His body is fragile, his skin is deteriorating, and he has bloody knuckles and sores, said Echeverria, who described Perez as a "simple, hard-working man," who was loyal to his wife of 46 years.
"He lost his life, and his wife lost her best friend," he said.