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Suit faults training in fatal surgery


St. Petersburg Times

Last year, high school teacher Al Greenway died at St. Joseph’s Hospital after a doctor using a $1-million surgical robot accidentally cut two of his main blood vessels.A lawsuit filed Tuesday by Greenway’s widow accuses the hospital of allowing doctors inexperienced with the robot to perform his surgery. The suit charges that the hospital was more interested in using its new device than in ensuring Greenway’s safety.

“It was a totally unnecessary and avoidable death,” said Tampa attorney Steven Yerrid, who represents Brenda Greenway. “The conventional surgery was basically jettisoned and this robotic surgery was not only suggested but really pushed.”

St. Joseph’s spokeswoman Lisa Patterson said hospital officials had not had time to review the lawsuit Tuesday. She added that the hospital stands by its official statement released last year.

At that time, hospital officials called what happened to Greenway a “tragic, isolated accident.”

Greenway, 53, a Desert Storm veteran and science teacher at Plant High School, had a cancerous kidney that needed to be removed.

In the operating room, surgeon Tod Fusia sat at a console about 10 feet from the operating table using sophisticated control sticks to manipulate the da Vinci Surgical Systems robot, a machine with three arms that look like they belong to a 6-foot-tall insect.

A tiny camera attached to the robot’s middle arm allowed the surgeon to see into Greenway’s body. Fusia controlled the other two arms to make cuts to blood vessels necessary to remove the kidney. At some point, however, the aorta and the vena cava were cut.

The surgeons discovered the problem about 90 minutes later, after they could not remove Greenway’s kidney with the robot’s assistance and proceeded with traditional hands-on methods. A vascular surgeon repaired the vessels, after which Fusia closed the surgical site.

A postoperative X-ray revealed that an absorbent pad had been left inside Greenway’s body that forced the surgeons to reopen the site to retrieve it, according to the lawsuit. A needle was also missing and never accounted for, the suit stated.

After the surgery, Greenway began showing signs of distress, according to the suit. A nurse tried to find a surgeon to assist in his treatment, but her requests went unfulfilled for more than two hours, the suit stated.

Mrs. Greenway’s wife was informed that one of her husband’s blood vessels was “nicked,” but that he was “fine,” according to the lawsuit. She was not told of the severity of the injuries, even as blood seeped from her husband’s nose, ears and mouth, the suit stated.

Greenway died the next day.

The lawsuit contends that Fusia and the assistant surgeon were ill-trained in the use of the robot.

Fusia had attended a three-day certification course during which he did not perform a robotic organ removal, the lawsuit stated. After he gained certification, Fusia had performed only three robotic organ removals, according to the lawsuit.

And during a surgery performed about a week before Greenway’s, problems arose that forced Fusia and the other surgeon to abandon the robot for more traditional methods.

Hospital officials held a news conference two weeks after Greenway’s death to explain what happened. They said the robot had not malfunctioned and the surgeon was experienced and highly skilled.

They said he had used the robot in “about 10” similar kidney removal operations and many more prostate removals without any trouble. The doctor was not suspended and continued operating at the hospital, officials there said.

“If you listened to that press conference, you’d think that nothing was wrong and everything was great with the robot,” Yerrid said. “One problem. The patient was dead.”

The lawsuit names only the hospital as a defendant. Yerrid said the doctors’ conduct “has been addressed.” He would not comment further on that issue.

According to Florida Department of Health records, Fusia and the other surgeon paid $1-million in September to settle a claim for an incident that occurred Oct. 11, 2002, the day of Greenway’s surgery.

Robots including the da Vinci are considered a major surgical breakthrough and a harbinger of technology to come. The arms mimic the movements of a surgeon, and in many cases the robot can perform very fine movements in tight spaces without damaging surrounding tissue as much as in traditional surgery. The robots are also tremor free.

Yerrid said he believes this lawsuit, filed in Hillsborough Circuit Court, could help define the responsibilities of hospitals that purchase the equipment.

“The hospital assumed a duty to make sure that the usage was proper and safeguards were in place to protect the hospital’s patients,” said Yerrid, who in October won a $16-million medical malpractice lawsuit in Pinellas County. “The mantle of responsibility needs placing as these technologies are used more and more.”

– Graham Brink can be reached at 226-3365 or