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Some of these negligence allegations are supported by Dr. Arnold S. Seid, a California surgeon and expert witness hired by the plaintiff, who evaluated Godat's actions. In his supplemental report dated September 11, 2008, he faulted Godat and Abraham for not communicating about the Springs case prior to commencing anesthesia despite their ability to do so. "The two physicians failed to discuss the small size of the forearm lesion, the adequacy of local anesthesia with conscious sedation and the significant severe medical problems that put Mr. Springs at an extreme degree of risk if general anesthesia were employed." In his opinion, "[t]his failure to communicate and prevent the catastrophic complications of the anesthetic constitutes gross negligence on the part of Dr. Godat."
Attorneys for the defendants maintain that they too have experts who will show that the doctors in this case were not at fault. "Dr. Godat provided care in a logical and caring manner," Bell adds. "We don't think he has any liability in the case."
Whether a judge will allow Godat's so-called "underlying issues" into evidence depends upon whether they are relevant to the issue of negligence or whether they are just Weisbrod's attempt to paint Godat as a bad person so a jury will conclude he is a bad doctor. But these kinds of allegations can also sweeten the settlement offer in a case. "The lawyer's skill is somehow finding a way to connect some salacious fact to a relevant issue [such as failing to communicate] before the court," Johnston says. "Since you don't know until trial if the judge is going to let that evidence in, a party may pay big money in settlement to keep that fact out."
On the other hand, Abraham's alleged inexperience is relevant to the question of whether she was negligent. At the time of Springs' surgery, she had only been out of her anesthesiology residency for three months and on the job with Texas Anesthesia Group for just more than three weeks. During her third week of residency at the University of Texas Medical School at Houston, Abraham was involved in a difficult intubation of patient Terri Rogers, who suffered a perforated esophagus and in December 2006 filed a lawsuit against Abraham and other medical entities and staff—a malpractice claim that Abraham denied but settled on January 21, 2009.
Although Abraham worked with Godat in her first month on the job, Godat maintains that it was a pure scheduling happenstance that she was assigned to the Springs surgery. Godat's staff called TAG's office scheduler (he used TAG on the advice of his brother), and Abraham's name merely came up next in the rotation.
In his videotaped deposition taken July 25, 2008, Godat—dressed in a suit and sipping a Dr Pepper between seemingly nervous swivels of his chair—outlined his routine preop procedure to Weisbrod thusly:
"I didn't choose Dr. Abraham," Godat said. When asked who did, he responded, "I don't know."
Did you obtain the previous records of Mr. Springs' hernia or kidney surgery? "No."
Did you make an effort to speak with the surgeons who were involved in Mr. Springs' previous surgeries? "No."
Were you aware that Mr. Springs had a history of difficult intubations? "No."
Did you talk beforehand to the anesthesiologist? "No."
Do you routinely offer your patients a choice of anesthesiologist? "No."
"He was a charismatic person, and we just got along very well," Godat said of Springs. "I do remember him saying that he just wanted to be put to sleep."
"Mr. Springs' unfortunate and unforeseen complication is not related in any regard toDr. Abraham providing care in a negligent fashion."
—Dr. Joyce Abraham's attorney, Bill Chamblee
Though Chamblee maintains that every anesthesiologist—through no fault of their own—will eventually be faced with a patient producing unpredictable, devastating, natural results similar to Springs, the incident has given pause to Springs' friends and family.
Staubach, for example, is putting off back surgery to correct spinal stenosis because—as was Springs'— it's an elective surgery.
"It just reminds you that the most important person in surgery isn't the doctor," Staubach says, "it's the anesthesiologist. I know every day there are millions of people put under and brought back successfully. But you look at Ron and just makes you think, 'You know what, maybe I'll just take another Advil and deal with it.'"
And when a supposedly simple surgery leaves a high-profile patient a vegetable and the lead physician testifies to stuff like, "I wasn't there at the time and I...I don't know exactly what happened," you can bet the procedure will be thoroughly examined and cross-examined.
Godat said he was talking on his cell phone and walking toward the operating room when he received another call alerting him that Springs was ready for surgery. He said in his deposition that he was initially talking to his brother, though, curiously, Mark testified that he doesn't recall the moment.
"I don't...I don't remember," Mark said in his deposition on January 4, 2010. "I don't remember if I was on the phone to him. I don't even know when the Ron Springs thing happened."