Wednesday, July 18, 2007

The Return of Weis' Hired Hand

Team Crewcut Charlie Weis brought in San Diego surgeon Alan Wittgrove, above, to testify Tuesday in Weis' medical malpractice lawsuit against Massachusetts General Hospital doctors Charles Ferguson and Richard Hodin.

Wittgrove, who has performed 3,500 operations like the gastric bypass procedure that Weis underwent, also testified in the first trial. And like that first trial, Wittgrove acknowledged that he was paid $7,500 for his testimony.

Wittgrove said Hodin, whom Ferguson entrusted with Weis' post-operative care, made the wrong decision when Weis took a turn for the worst after the July 2002 surgery. Wittgrove said Hodin should not have administered the blood-thinning drug Heparin while Weis was hemorrhaging before a second surgery was performed to stop the bleeding.

"He should have operated on him to stop the bleeding," Wittgrove said. "And in doing so, he would have repaired the leak that was also there."

And as he did in the first trial, Wittgrove blamed the partial paralysis in Weis' feet on Massachusetts General's apparent failure to monitor his thiamine (B-12) levels.

Defense attorney William Dailey then had his turn at Wittgrove, attacking the Californian for being a vitamin salesman.

Weis is expected to take the stand Wednesday.

In a sidenote, a videographer for WHDH-TV in Boston appears to have made a mistake during Monday's testimony that cost them their job. The videographer, who was also the pool cameraman, mixed the identities of Weis and WBZ-TV reporter David Robichaud. The Boston Herald reported that the videographer was fired for the mistake.

Now to put the day's testimony in perspective, we turn to our medical expert, Gary Gaffney, M.D., University of Iowa Hospitals and Clinics and founder of the site Steroid Nation.

"Wittgrove essentially repeated his performance of the first trial, maintaining that the surgeons waited too long to re-operate on Weis for internal hemorrhaging. Rather than operate to stop the bleeding, the surgeons choose to administer Heparin, a powerful anti-coagulant that exacerbated the internal hemorrhaging. Wittgrove also contends that Weis' leg pain can be attributed to a deficiency of Vitamin B-12, well known in gastric bypass patients.

"Wittgrove's second-guessing can be easily answered by the defendant's lawyers. The surgeons became concerned about Weis' labored breathing as a sign of a pulmonary embolism. Pulmonary embolism (blood clots in the lungs) can cause sudden death; Heparin administration will dissolve any clots moving into the lungs. Apparently acting on the available data, the surgeons decided to treat an immediate threat of an embolism while watching the threat of internal bleeding, which in this view is a defensible action. When further lab tests pointed toward hemorrhage, the doctors revised the bypass surgery.

"In the first trial, the defense answered the B-12 charge by saying they indeed administered B-12 to Weis. In cross-examination on Tuesday, the defense pointed out Wittgrove receives $7,500 a day for expert testimony, as well as trying to paint him as a vitamin pusher. Those points are likely superfluous to the issues in the trial.

"In other news about gastric bypass surgery, recent research has indicated that bypass patients require less alcohol to reach the legal blood level and metabolize the alcohol more slowly. Here's a toast to Coach Weis who can now save on liquor costs."

Previous coverage:
Preview: A legal perspective
Day 1: Battle lines drawn
The mistrial: A look back at our coverage of the first trial.

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