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A Union County jury awarded $4.5 million on April 6 in a medical malpractice suit, Ayala v. Friedlander, M.D., over errors in a man's spinal surgery.

But the plaintiff, Carlos Ayala, will recover $2.25 million because of a high-low agreement that the lawyers entered after closing arguments. The high was $2.25 million, and the low was $525,000.

Ayala's suit claimed a March 2011 lumbar fusion surgery performed by neurosurgeon Marvin Friedlander and orthopedic spine surgeon Douglas Bradley deviated from the accepted standards of care because a pedicle screw was placed in the wrong location. The suit also claimed Friedlander deviated from the standard of care after surgery by failing to make timely diagnosis and treatment of the mispositioned screw.

According to the plaintiff's lawyer, Paul da Costa of Snyder Sarno D'Aniello Maceri & da Costa in Roseland, the errant screw caused the plaintiff to develop pain in his right leg, numbness in his right calf and weakness in his right toes because it was impinging on the L5 nerve root. Friedlander did not order a CT or MRI until January 2013, when the pedicle screw was found to be in the wrong position and a failed fusion was diagnosed, the suit claimed. Ayala underwent a revision surgery in May 2013.

During a four-week trial before Superior Court Judge Robert Mega, the defense emphasized the fact that Ayala had a serious work injury in June 2008 while working as a forklift mechanic, which resulted in a significant L5-S1 disc herniation and lower back pain, da Costa said. The defense also emphasized that Ayala was not able to return to full duties as a forklift mechanic before the fusion surgery; argued that all proper procedures were used during the fusion surgery; and contended that the plaintiff never had the typical symptoms that would result when a pedicle screw was impinging on a nerve root, he said. Rather, the defense claimed that the right lower extremity symptoms were likely caused by a traction injury from the fusion surgery.

The jury found both defendants liable, allocating 75 percent of the fault to Friedlander and 25 percent to Bradley. The jury awarded $2.4 million for pain and suffering and loss of enjoyment of life; $2 million for lost income, and approximately $123,000 for medical expenses.

Under the high-low agreement, each doctor is to pay half of the $2.25 million, da Costa said.

Louis Ruprecht of Ruprecht, Hart, Weeks & Ricciardulli in Westfield, for Bradley, confirmed the verdict and the high-low settlement.

Friedlander's lawyer, Michael Heron of William Brennan's office in Shrewsbury, did not respond a call about the case.

— Charles Toutant

$3.35M For C-Section Injury

Jiminez v. Jersey City Medical Center: a Hudson County judge on Feb. 21 approved a $3.35 million settlement reached in a case brought on behalf of a woman who sustained brain damage during a Cesarean section procedure.

In April 2013, Frida Jiminez, then 35, went to Jersey City Medical Center for the procedure, which had been scheduled because of a placental condition known as placenta previa, which can cause bleeding. The procedure proceeded well, with the child being delivered healthy, but as removal of the placenta began, Jiminez started bleeding heavily because of a more serious placental condition, placenta accreta, according to plaintiff counsel William Crutchlow of Eichen Crutchlow Zaslow in Edison.

The obstetrician performing the surgery, Cheryl Carter, M.D., determined that a hysterectomy would be required, to which Jiminez verbally assented, Crutchlow said. Jiminez was administered a general anesthetic, and Carter solicited help from another obstetrician, with roughly 45 minutes passing between that time and when the procedure was completed, the suit claimed.

According to Crutchlow, Jiminez's oxygen levels dropped because of continued blood loss, and she was left without a pulse for several minutes before being revived. As a result, she sustained brain damage that has rendered her nonverbal and in need of assistance for most daily tasks, he said. Relatives are raising the child, he added.

Jiminez stayed at Jersey City Medical Center for a period of years and since was moved to a long-term care facility in Jersey City, though the family intends for her ultimately to live with relatives in Mexico, Crutchlow said, noting that the lifetime cost of life-care plans was estimated at $18 million for at-home care or $8.7 million for facility care.

The suit claimed Carter and the anesthesiologist, Alexander Gak, M.D., were negligent, alleging that Carter should have performed the hysterectomy immediately, and that the doctors should have triggered a “rapid transfusion protocol” sooner, in order to address the blood loss. Also named as defendants were the hospital, on the theory of apparent agency, and the OB/GYN department chair, Michael Bimonte, M.D.,, who the suit claimed failed to have a procedure in place to deal with placental complications of the type Jiminez experienced.

According to Crutchlow, Carter contended that she had no time to prepare for the complication and handled the situation properly. She contended that Gak didn't effectively advise her in real time about the status of the patient's vital signs, while Gak contended that Carter didn't effectively advise him in real time as to the level of blood loss. Biomonte contended that the practice group had proper procedures in place. The defendants disputed liability through expert testimony, Crutchlow said.

The parties had completed expert discovery and were ready for trial when they settled. Gak agreed to pay $2 million, and Carter, $1 million—each sum representing the doctor's policy limit, Crutchlow said. The hospital agreed to pay $250,000, and Bimonte, $100,000, he said.

Hudson County Superior Court Judge Joseph Isabella on Feb. 21 approved the settlement in a friendly hearing.

Calls to defense counsel—Sam Rosenberg of Rosenberg, Jacobs & Heller in Morris Plains, for Jersey City Medical Center, Carter and Biomonte; and Richard Tamn of Krompier & Tamn in Parsippany, for Gak—were not returned.

— David Gialanella

$735K in Bergen Auto Case

Aponte v. Hemhauser: A Lyndhurst woman has received $735,000 as compensation for injuries she sustained in a car accident.

Plaintiff Jeanette Aponte, now 41, received her settlement funds on Dec. 28, 2017, a week after she agreed to settle her lawsuit with Travelers Insurance Co., the carrier for defendant Thomas Hemhauser, also of Lyndhurst, said Aponte's attorney, Alex Capozzi.

Aponte was injured on March 26, 2015, as she was driving on Ridge Road in Lyndhurst, said Capozzi, of Brach Eichler in Roseland.

Hemhauser, according to the lawsuit, was driving in front of Aponte and made an illegal U-turn, and his car collided with Aponte's, Capozzi said.

As a result of the accident, Aponte sustained a concussion, and an aggravation of a pre-existing cervical and lumbar condition, Capozzi said.

Aponte underwent neuropsychological treatment, physical therapy and pain management, Capozzi said. She also underwent an anterior cervical discectomy and fusion.

The lawsuit was filed in Bergen County Superior Court.

The case had not yet been scheduled for trial. The parties settled after a conference with Superior Court Judge Lisa Perez-Friscia, Capozzi said.

Travelers retained Stephen Cahir of the Morristown law office of William Staehle. He did not return a call about the case.

— Michael Booth