A 12-member jury had awarded $1.415 million in damages to 83-year-old Harvey Bergeron and $400,000 to his wife after finding that two DHC cardiac surgeons neglected to give Bergeron a blood thinner after a post-surgery complication that led to a stroke.
The stroke occurred one week after Bergeron underwent triple bypass surgery performed by a DHC surgeon working in a program at Concord Hospital. Three days after his bypass surgery, Bergeron experienced atrial fibrillation, a condition in which the heart beats irregularly and blood clotting can occur. The next day, a second DHC cardiothoracic surgeon discharged him without having administered an anticoagulant, or blood thinner, according to Bergeron's lawyer, Rick Fradette of Beliveau, Fradette, Doyle & Gallant in Manchester, N.H.
The clinic's lead attorney, Ron Snow of Concord, N.H.-based Orr & Reno, said DHC has asked the trial judge in the Merrimack County Superior Court to erase the verdict or order a new trial because the doctors did follow guidelines set by the American College of Cardiology and the American Heart Association, which only recommended blood thinners for chronic or persistent atrial fibrillation.
"We were found guilty of negligence for following a national guideline on how to treat this patient," Snow said. "It's really that presumption, so it's clear that we've got to pursue this because a lot more is at stake than just one case."
Snow is concerned that if the verdict stands, a precedent will be set for doctors who previously felt secure when following guidelines.
"If our cardiology people who perform surgery every day have to live with the fact that they can be negligent for following a national guideline, then we've got to start making hard decisions," he said.
Fradette said that the DHC doctors had followed the guidelines "blindly," observing what he called an "arbitrary" recommendation that blood thinners only be used for episodes lasting longer than 24 hours.
"They were using the guidelines as a shield to defend their negligence," Fradette said.
Both of the two cardiothoracic surgeons, Drs. Constance Haan and Paul Uhlig, have since left DHC, which is affiliated with the Dartmouth-Hitchcock Medical Center.
Dick Burke, director of insurance claims for DHMC, said the nearly $2 million award is "very generous under the circumstances."
Burke said that none of the heart experts who testified in the trial saw any evidence that the clinic doctors had violated a standard of care.
"We're disappointed and we will vigorously appeal," Burke said.
The case will likely go to the New Hampshire Supreme Court, Snow said.
Dr. William Nugent, section chief of cardiothoracic surgery at DHMC, said patients who experience relatively short, non-chronic episodes of atrial fibrillation are not typically given anticoagulants because the risks associated with administering them are nearly equal to the risks associated with abstaining.
"The whole phenomenon of anticoagulating everyone is fairly new," Nugent said.
Nugent said the award in the malpractice case seems "unprecedented."
"A large award like that gets peoples' attention and it implies something seriously wrong was done, and I don't think anything seriously wrong was done so that doesn't make sense to me," Nugent said of the $1.8 million award.
