In January 1992, Sandra DeMarco Guida fell and injured her left knee at the Lackawanna County Courthouse, which prompted her to seek medical treatment from defendants, Robert Gavin, Jr., M.D. and Adel R. Barakat, M.D., according to court papers.
In her lawsuit, Guida alleged that the doctors, along with co-defendant Moses Taylor Hospital, were negligent for failing to investigate a bony abnormality in her left leg, which was apparent on an x-ray and a bone scan, according to her attorney Michael F. Barrett. Because of this alleged oversight, Barrett said, cancer ravaged Guida’s pelvis and leg bones, requiring her to undergo surgery to remove her left leg, hip, pelvis, and buttock.
When Guida was taken to Moses Taylor Hospital in Scranton following the 1992 fall, an x-ray indicated that there was no fracture, but the plaintiff claimed in her suit there was a bony abnormality in the visualized portion of the distal femur. A radiologist recommended x-rays of Guida’s entire femur and a bone scan.
Guida was then seen by Gavin, an orthopedic surgeon, who ordered a bone scan. The plaintiff claimed in court papers that Gavin never obtained full x-rays of Guida’s entire left femur and hip. Nor did he discuss the results of a bone scan performed in February 1992, the plaintiff claimed, which showed an abnormality “on the left femur of uncertain origin.”
According to court papers, Gavin claimed that Guida contacted him about the bone scan results, but when he was unable to come to the phone, she became angry and decided to seek treatment from another doctor. According to Gavin’s pretrial memorandum, Guida made no further attempt to set an appointment with the doctor.
In March 1992, Guida came under Barakat’s treatment for the trauma to her left knee, according, to court documents. During an initial visit, Barakat, also an orthopedic surgeon, examined Guida’s knee and found no problem. According to an office note quoted in the plaintiff’s pretrial memorandum, the doctor diagnosed Guida as having a “subsiding and possibly recovered sprain of the left knee and fibrous dysplasia of the left distal femur.” Barakat did not order any further treatment for the fibrous dysplasia, nor did he obtain full x-rays of Guida’s left femur and hip, the plaintiff said.
In April 1997, Guida, then 39 years old, fell at home and experienced increased leg pain, Barrett said. She was admitted to the Milton S. Hershey Medical Center where it was determined that Guida had broken her left hip. She was subssequent1y diagnosed with osteosarcoma of the left hip.
In May 1997, Barrett said, Guida had to undergo surgery to remove her left leg, hip, pelvis, and buttock.
Guida, a former resident of Scranton and a current resident of Harrisburg, underwent chemotherapy in the wake of the surgery. Her cancer has been in remission since then, Barrett said.
At trial, Barrett argued that the x-ray and bone scan should have led Guida’s doctors to further investigate the irregularity in the bone. They also should have cautioned her, he argued, that it had the potential to become cancerous.
Counsel for Gavin, James J. Wilson, argued that the doctors did nothing wrong, as there is no standard of care for orthopedic surgeons requiring that fibrous dysplasia be monitored for the development of cancer. Even if the doctors had ordered an x-ray of Guida’s hip in 1992, he said, it would not have shown the presence of cancer because this was a fast-growing cancer that did not arise until some time in 1996.
Wilson also argued in court papers that Guida decided not to follow up with Gavin, choosing to seek the care of another doctor after Gavin declined to speak with her while he was with another patient. He also raised an issue of spoliation, arguing that the defendants were prejudiced by the disappearance of the January 1992 x-ray reviewed by Gavin in the Moses Taylor Emergency Room.
After a six-day trial and about three hours of deliberation, the 12-person jury returned an 11 -1 verdict for the plaintiff. The jury found Gavin 60 percent liable and Barakat 40 percent liable. Moses Taylor Hospital was found not liable.
Barrett said he filed a petition seeking about $298,000 in delay damages. That petition, along with post-trial motions filed by the defense, ate still pending before the court.
Defense counsel for Barratt and Moses Taylor Hospital could not be reached for comment.