Intuitive Witnesses Blame Patient Death on Bad Heart

Witnesses for Intuitive Surgical Inc. testified that heart disease, not a failed robotic procedure, killed a patient whose widow is suing the company over claims that overly aggressive marketing caused surgical errors.

Forensic pathologist Eric L. Kiesel yesterday told state court jurors in Port Orchard, Washington, that the patient, Fred Taylor, was a “time bomb ready to go off” due to progressive heart disease. Kiesel, testifying in the trial’s fourth week, and at the start of Intuitive’s defense, was one of two physicians present during Taylor’s autopsy.

Kiesel said in response to questions from Intuitive lawyer Jeffrey Johnson that there’s no medical evidence suggesting Taylor’s prostate removal surgery or its complications contributed to his death.

Intuitive, the Sunnyvale, California-based company whose robots were used in more than 300,000 U.S. operations last year, is in the middle of the first trial of at least 26 lawsuits from people alleging injuries tied to its da Vinci system.

Taylor’s wife, Josette Taylor, alleged in her complaint that Intuitive’s training was simplified to sell more robots, which led to errors during his operation at Bremerton, Washington-based Harrison Medical Center. He died of heart disease in 2012, four years after the surgery, at age 71.

Blocked Arteries

Kiesel testified that Taylor’s autopsy showed his arteries were 50 to 90 percent-blocked, including a graft Taylor received during 2002 heart bypass surgery. Additionally, Taylor’s heart was enlarged from pumping harder, weighing 2 1/2 times more than a normal-size heart, Kiesel testified.

Taylor’s cause of death, listed as “natural” on the autopsy report, was the result of atherosclerosis and hypertensive cardiac disease, said Kiesel, who has worked as a medical examiner in several counties and is now in private practice.

“He’s got lots of reasons to have cardiac arrhythmia,” Kiesel said. “He was a time bomb ready to go off. He could have gone off at any time.”

During cross-examination, plaintiff attorney Richard Friedman continued his strategy of pointing to post-surgical complications as the reason Taylor’s heart disease worsened, and ultimately, led to his death.

Saying that Taylor suffered from depression when he couldn’t resume his physical and social activities, Friedman asked Kudenchuk whether depression worsened Taylor’s heart disease. The cardiologist answered that adding one more stressor to Taylor’s bad health wouldn’t have made a difference -- he had already sealed his “death sentence” by not making lifestyle changes to improve his heart function.

Seven Hours

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

A second witness yesterday, University of Washington cardiologist Peter Kudenchuk, said that Taylor’s health risks prior to prostate surgery -- diabetes, high blood pressure and high cholesterol, which weren’t adequately controlled -- ultimately caused his heart to stop.

“I would say, in all honesty, Mr. Taylor was lucky to live until age 71,” Kudenchuk said.

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.

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).