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Ala. SC affirms $2 million award against surgeon

By Jessica M. Karmasek | May 24, 2012


MONTGOMERY, Ala. (Legal Newsline) - The Alabama Supreme Court, in a ruling earlier this month, upheld an award of more than $2 million to a couple who sued a surgeon for medical malpractice.

Defendant Dr. Zenko J. Hrynkiw, a neurosurgeon, performed fusion surgery on plaintiff Thomas Trammell's spine in July 2005 to relieve pain in his lower back, and pain and numbness in his right leg and foot, both of which were caused by a herniated disk that was putting pressure on a nerve.

Soon after the surgery, Trammell experienced weakness, numbness and pain in his lower extremities, along with numbness in his perineal area and urinary and fecal incontinence. The conditions are symptoms of cauda equina syndrome, or CES, a compressive neuropathy involving multiple nerve roots affecting motor, sensory, bowel, bladder and sexual function.

Days later, Hrynkiw performed a second surgery on Trammell's spine. The second surgery provided him no relief. He is now permanently partially disabled.

Nearly two years after the surgeries, Trammell and his wife, Barbara, sued Hrynkiw and his practice, alleging a violation of the Alabama Medical Liability Act.

More specifically, the couple alleged that Hrynkiw negligently diagnosed, cared for and treated Trammell by negligently performing the original July 15, 2005 surgery and by providing negligent postoperative care.

The case was eventually tried before a jury in Jefferson County Circuit Court in February 2011.

The jury found in favor of the Trammells, awarding compensatory damages of $1,650,000 to Thomas and $500,000 to Barbara. The court entered a judgment on the jury's verdict.

Hrynkiw filed a postjudgment motion seeking, alternatively, a judgment as a matter of law or a new trial.

After a hearing on the motion, the circuit court denied the motion. Hrynkiw appealed to the state's high court.

On appeal, the surgeon argues that the circuit court erred by not granting him judgment as a matter of law on the Trammells' claim relating to his postoperative care because the couple failed to present substantial evidence that any of Trammell's injuries were probably caused by his postoperative care; and that the court erred in allowing hearsay testimony under the learned-treatise exception.

The Court, in its May 11 ruling, found that the Trammells presented "sufficient evidence" of the surgeon's failure to adhere to the standard of care applicable to postoperative treatment of CES.

"As a result of this failure, Thomas' condition became irreversible in whole or in part," Justice Michael F. Bolin wrote for the Court, adding that "some or all" of the man's injuries were the proximate result of Hrynkiw's delay in performing a second surgery.

"Prompt intervention would have placed Thomas in a better position than he was in as a result of the inferior medical care."

The Court also held that the circuit court did not exceed its discretion in allowing another doctor, Robert Hash III, to reference medical treatises during his direct testimony.

"In the present case, Dr. Hash's testimony did not amount to mere generalized statements that the earlier an injury or disease is treated, the better the outcome for the patient," Bolin wrote in the Court's 39-page ruling.

"Instead, Dr. Hash testified that early diagnosis and earlier decompression surgery would have relieved the pressure on the cauda equina and the nerve endings that had been compressed."

From Legal Newsline: Reach Jessica Karmasek by email at jessica@legalnewsline.com.

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