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."
Though there is no concrete evidence to the contrary, Weisbrod and Adriane aren't buying Godat's excused absence.
"I don't think he was on the phone with his brother," the attorney claims. "I think he ducked out of the operating suite for some personal issue...But I do know that he should've been there."
Answers Bell, "It was not inappropriate for Dr. Godat not to be present when anesthesia started. He was, in fact, on campus, but unaware that it had even started. By the time he walked in, a code for Mr. Springs was in progress."
What Godat missed was Springs suffering from unpredictable throat spasms that closed his airway while under anesthesia. By the time Abraham and emergency personnel helped re-establish the passage, Springs had gone almost a half-hour with an unsecured airway and anywhere from 2 to 4 minutes without oxygen to his brain. His catastrophic damage is the result of hypoxic brain injury due to oxygen deprivation.
While the Springs camp is critical of Abraham's inexperience and lack of investigation into the medical history before surgery, her attorney backs her actions as "wholly appropriate." Both sides agree, however, that Abraham did not discuss the type of anesthesia to be used on Springs with Godat or the patient, did not check his past surgical history (two operations were performed at Medical City), did not know the source, severity or size of the wound to be removed, and didn't even know that her patient was a transplant recipient or former football player (ironically, her Facebook page states that she is a fan of the Dallas Cowboys).
"Everything I did that day was appropriate," Abraham said in her deposition. "I wouldn't have changed approach or medicines."
Chamblee says his client was well-trained, responsible and accurate in her care. "To call Dr. Abraham inexperienced is just ridiculous."
Walls, however, can't hide his contempt for the doctor. "There was a level of incompetence that turned into a perfect storm that day," he says. "Dr. Abraham just ran roughshod over the process. From the first step, everything she did was unnecessary, and the way she did it was just disrespectful to all Ron and I went through."
Despite the tragedy resulting in subsequent litigation, less than a month after Springs nosedived into his coma, his family consented to Godat finally removing the cyst, but only with her husband's current critical care provider administering conscious sedation during the procedure. The operation went smoothly.
"Things happen," Abraham testified in her deposition. "It happened under my care, yes. What happened that day...it happened. A good outcome doesn't always come out of everything...even when you act appropriately."
At 4:37 p.m, Abraham places an IV in Springs' neck; prepares a knockout cocktail of propofol, lidocaine and fentanyl; and commences anesthesia. With Springs comfortably "under," Abraham attempts to attach the LMA over his nose and mouth and down his throat at 4:46. Unsuccessful at sliding the LMA's short endotracheal tube into her patient's airway, she manually forces oxygen into his lungs via positive pressure airway ventilation (commonly referred to as "bagging"). At 4:50—after an increase of the drug relaxant sevoflurane and a second failed attempt with the LMA—Abraham tries again to bag air into Springs.
But this time she can't depress the bag. Something is blocking Springs' airway. The worst nightmare: laryngospasm.
Undetectable if not invisible, Springs' airway is involuntarily contracting and constricting, to the point of slamming shut his breathing passage. While alerting the scrub nurse on duty to call for assistance, Abraham delivers through the IV the paralysis-inducing drug rocuronium, and atropine to combat Springs' rapidly declining heart rate.