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Mergenthaler v. Ganchi

March 31, 2008


On appeal from the Superior Court of New Jersey, Law Division, Passaic County, Docket No. L-1505-04.

Per curiam.


Argued February 27, 2008

Before Judges Cuff, Lisa and Lihotz.

Plaintiff, Bonnie L. Mergenthaler, appeals from a no-cause verdict following trial on her medical negligence claims against defendant Amir Ganchi, M.D.*fn1 Plaintiff asserts the jury verdict is against the weight of the evidence and the trial court erred in denying her motion for a new trial. We affirm.

Plaintiff testified she believed she was having cosmetic surgery to remove a cluster of spider veins. On June 14, 2002, defendant performed a stripping ligation to treat the varicose veins on plaintiff's right leg appearing along the course of the greater saphenous vein, which is a superficial vein that runs from the dorsum of the foot up the medial part of the leg, all the way up to the thigh where it joins the deep femoral vein. During surgery, defendant made an incision below the groin and located the greater saphenous vein and disconnected the saphenous vein from the femoral vein. Defendant then made a small incision in the ankle area and passed a stripper device all the way up the faulty saphenous vein. Thereafter, defendant made several small incisions in the calf area, clipped and removed the varicose veins that were connected to the faulty saphenous vein, and then removed the entire saphenous vein from plaintiff's leg using the stripper device.

During the vein stripping, defendant encountered bleeding in the groin area; he discovered two open and bleeding vessels.

Defendant controlled the bleeding by using clips. When defendant began closing the incisions, he again noticed bleeding in the groin area. He made another incision, dissected down, and determined the bleeding emanated from behind the femoral artery. Defendant stated he repaired the bleeding with clips and 2.0 sutures without causing damage to the femoral vein.

Following surgery, plaintiff was in pain. Linda Petsch, plaintiff's sister, described plaintiff's right leg as "triple its size and grayish in color." Plaintiff was re-hospitalized on June 30, 2002, after being diagnosed with a deep vein thrombosis of the common femoral, superficial femoral, and popiteal veins. In October 2002, Herbert Dardick, M.D., chief of surgery and vascular surgery at Englewood Hospital, performed a bypass graft procedure on plaintiff's right leg. Dardick testified that the bypass helped relieve the pressure in plaintiff's leg, however its long-term effectiveness was uncertain.

At trial, plaintiff argued that defendant failed to properly address the bleeding that occurred during the varicose vein surgery and thus, deviated from accepted standards of medical care. Plaintiff maintained that when defendant attempted to stop the bleeding, he occluded the femoral vein, which caused the deep vein thrombosis in her lower right leg.

Also, plaintiff's expert suggested defendant should have requested a vascular surgeon to assist when he encountered the bleeding in the course of the varicose vein surgery. Defendant responded that he did not damage the femoral vein and his expert witnesses opined that plaintiff's deep vein thrombosis was more likely a spontaneous post-operative complication or the result of plaintiff's pre-existing hypercoagulable condition.

The bulk of the trial testimony was presented by the parties' respective experts. We provide that portion of the experts' opinions discussing whether defendant deviated from accepted standards of medical care when he addressed the bleeding that was encountered during plaintiff's surgery.

Plaintiff presented the videotaped de bene esse deposition of her expert, Richard Steven Nitzberg, M.D., a general and vascular surgeon who reviewed photographs of plaintiff, and plaintiff's medical records, which included films, reports and defendant's post-operation reports. Nitzberg commented:

Well, what struck me about [defendant's operative report] was that when you do this procedure, you really don't see the femoral artery. Now, you may feel it to help you guide yourself to where you're going to start to look for the saphenous vein, but you really should not see or be anywhere near the femoral artery. That's really the wrong place to be. That's much deeper than you need to be ...

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