Jury decides hospital not to blame for Smedley’s death

A medical malpractice lawsuit against Winchester Medical Center and Valley Health Systems ended Thursday night with a jury finding the defendants did not contribute to the death of John H. Smedley Sr. after a heart operation three years ago.

Smedley, Warren County’s long time commissioner of the revenue, was declared brain dead Aug. 24, 2012, after undergoing the second of two heart operations within a day. The lawsuit, filed by Smedley’s widow, Doris Smedley, accused a nurse caring for Smedley of failing to call the attending physician after a monitor reading of post-operative data fell below normal limits.

The jury found the nurse, Melanie Spiva, did not violate any standards of care and did not contribute to Smedley’s death.

The verdict came after a four-day trial that immersed the jurors in the intricacies of open-heart surgery. They saw readings obtained from electronic monitors that were hooked up to Smedley in the hours and days before his death. Witnesses from both sides – most of them doctors and nurses – gave different interpretations of the data and conflicting explanations of what was going on inside Smedley’s body that led to his death.

Carla Dallmann, Valley Health’s vice president of quality, patient safety, patient experience and risk management, said she was pleased with the verdict, which came after about 2-½ hours deliberation.

“The Winchester Medical Center cardiovascular critical care team was saddened by the unexpected death of Mr. Smedley,” Dallmann said. “We feel the intensive care that was provided to Mr. Smedley during and after his surgery was excellent, and we were confident in defending our care.”

Dallmann said the verdict was also vindication for Spiva and another registered nurse, Tammy Madagan, who were named in the civil complaint filed by Smedley.

“They’re really good nurses,” Dallmann said of Spiva and Madagan, both of whom testified and were in the courtroom throughout the trial.

David Silek, of Manassas, one of Smedley’s attorneys, said testimony Thursday by Dr. Scott Silvestry, a Florida-based thoracic and cardiac surgeon, may have swung the case toward the hospital.

Silvestry downplayed the significance of a heart-related reading that fell below normal limits in the hours before Smedley’s death. The reading of the central venous pressure – referred to during the trial as CVP – was the focus of Doris Smedley’s case.

Her attorneys contended that Spiva should have called Dr. Kenneth Saum, the attending physician, at home and informed him of the drop in the reading shortly before and after 9 p.m. The reading later returned to an acceptable range.

Silvestry said the drop in the CVP reading would not have been enough to make him return to the hospital if a nurse had called him about it.

“I would say, ‘thank you very much,’ and hang up,” Silvestry said.

Another attorney was filling in for Silek during Thursday’s testimony, but he speculated that Silvestry’s comments made a difference in the outcome.

“I thought the first three days of the trial went exceedingly well for the plaintiff,” Silek said. “But clearly the expert for Valley Health, whom they paid $20,000 to testify, created doubts in the minds of the jurors as to the cause of death,” Silek said.

Doris Smedley said she filed the lawsuit to obtain a specific explanation from the hospital’s medical staff about why her husband died suddenly after he appeared to be recovering from the first heart operation.

Smedley said she was dissatisfied with a meeting she had with Saum about a month after her husband’s death to discuss what went wrong.

“I was disappointed but I wasn’t surprised,” Smedley said of the verdict. “I knew that this was a long shot, and I was going up against a big opponent.”

Smedley said she would file an appeal.

“I owe it to John to try and find the answers,” she said.

Contact staff writer Joe Beck at 540-465-5137 ext. 142, or jbeck@nvdaily.com

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