Intuitive Trial Witness Says Robotic Surgery Hastened Death

The stress and complications from a lengthy prostate operation assisted by an Intuitive Surgical Inc. robot hastened a patient’s death from heart disease, a doctor testified.

Fred Taylor might have lived five more years, and had a much better quality of life, had he never suffered the consequences of the botched robotic procedure in 2008, John S. MacGregor, a cardiologist and professor of medicine at University of California, San Francisco, told a jury as a state court trial entered its third week in Port Orchard, Washington.

“A number of complications put stress on his heart and his body in general,” MacGregor said. “I think the prostatectomy and the aftermath of his prostatectomy accelerated his cardiovascular disease and hastened his death.”

The case brought by Taylor’s widow against Sunnyvale, California-based Intuitive, whose robots were used in more than 300,000 U.S. operations last year, is the first to go to trial over claims that the company marketed its da Vinci surgical system too aggressively.

Josette Taylor alleged in her complaint that Intuitive’s training was simplified to sell more robots, which led to errors in removing her husband’s prostate gland. He died of heart disease in 2012 at age 71.

Heart Attacks

Taylor’s autopsy indicated he suffered a number of heart attacks in the last several years of his life, MacGregor said. It’s possible that Taylor suffered a heart attack the day after his Sept. 9, 2008, robotic procedure, MacGregor said, answering questions from the plaintiff’s attorney Richard Friedman. Blood enzyme tests measuring heart muscle damage rose dramatically the day after surgery when compared to pre-surgery tests, MacGregor told the jury.

Taylor was heavily sedated and was put on a ventilator following surgery, so he wouldn’t have noticed symptoms of a heart attack, MacGregor said. Taylor’s heart attack may have gone unnoticed by intensive care unit staff because a heart-monitoring machine picks up only on irregular heart rhythms, said MacGregor, who is on staff at San Francisco General Hospital Medical Center.

Before prostate surgery, Taylor suffered high-blood pressure, elevated cholesterol and diabetes, and he had undergone by-pass surgery for clogged arteries in 2002.

Taylor’s Prescriptions

Lawyers for Intuitive have argued that Taylor never should have been a candidate for robotic surgery because of his obesity, and that he didn’t regularly take his prescriptions to control his heart-disease risks.

Under cross examination by defense attorney Jeffrey Johnson, MacGregor agreed that Taylor’s out-of-control diabetes, morbid obesity and his family history of cardiac disease risks put him at greatest risk for eventual death from coronary artery disease. Defense lawyers had previously said that medical records indicate Taylor’s health conditions were better controlled when Taylor was in a hospital or a rehabilitation facility.

Intuitive said it faces 26 lawsuits from people alleging injuries tied to its da Vinci surgical system, according to a regulatory filing this month. The company also has entered into agreements with some plaintiff lawyers temporarily suspending the statutory deadline for filing suits for other patients who say they were hurt by robotic surgery, it said. Intuitive has seen a “substantial increase” in such claims, according to the filing.

Surgical Tools

In robotic surgery, a doctor sits at console several feet from the patient and peers into a high-definition display. Foot pedals and hand controls maneuver mechanical arms equipped with surgical tools, guided by a 3D camera that shows the work as it is done inside a patient.

After seven hours of trouble with robotic surgery on Taylor in September 2008, urologist Scott Bildsten and other doctors turned to traditional surgery and then emergency care to repair a rectal laceration. Bildsten had performed 100 successful prostatectomies using a traditional procedure and hadn’t used the da Vinci system on a patient unassisted.

Bildsten testified last week that while Intuitive deemed him ready after one day of the company’s training and two supervised operations, he now knows he needed more training to perform the robotic surgery unassisted.

The case is Estate of Fred E. Taylor v. Intuitive Surgical Inc., 09-2-03136-5, Superior Court, State of Washington, Kitsap County (Port Orchard).

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