Jury clears hospital of malpractice in Smedley lawsuit

WINCHESTER -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 12 hours. 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. Doris Smedley sought $3 million from the hospital and Valley Health.

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

Earlier Thursday, lawyers for Doris Smedley and the hospital spent much of their closing arguments deriding expert witnesses who appeared for each side during four days of testimony in circuit court.

Doris Smedley’s lawyers contend her husband’s death resulted from the failure of a nurse to follow a doctor’s order that the nurse call him at home if an abnormal reading appeared in a piece of heart-related data.

John Smedley, 64, who served as Commissioner of the Revenue from 1988 until his death on Aug. 24, 2012, had checked into the hospital a few days earlier complaining of chest pain and shortness of breath. He underwent open-heart surgery on Aug. 23 and was recovering in his room when his condition suddenly deteriorated at or shortly after 11 p.m. The attending surgeon, Dr. Kenneth Saum, returned to the hospital to perform a second operation to stop a bleeding graft on a blood vessel.

The surgery was successful, but the bleeding had deprived Smedley’s brain of oxygen, and he was declared brain dead hours later on Aug. 24.

Catherine Bertram, the lead attorney for Doris Smedley, argued that the fatal bleeding had begun hours before 11 p.m. and could have been halted in time if nurse Melanie Spiva had followed instructions to call Saum.

Bertram said nurses were instructed to call Saum if the reading for John Smedley’s central venous pressure should drop below or rise above certain levels.

The reading twice showed it had dropped below the specified range shortly before and after 9 p.m. before returning to normal levels.

Witnesses called by defense attorneys Ruth Griggs and Colleen Gentile testified that the abnormal central venous reading – CVP in medical shorthand – was not necessarily a reason to be concerned about Smedley’s condition in light of a long list of other electronic readings that showed him to be making good progress and the absence of any outward signs of deterioration until after 11 p.m.

Gentile also argued that Saum’s order should be read in a way that a nurse was not required to call him if the CVP reading turned abnormal.

Bertram mocked one defense witness, Dr. Scott Silvestry, as “the $20,000 man,” a reference to the amount of money she said he received for his testimony on behalf of the hospital.

Silvestry, a cardiothoracic surgeon from Florida, spent much of Thursday contradicting Bertram’s contention that Smedley died from slow internal bleeding that went undetected for hours while Spiva was caring for him.

Silvestry said the bleeding was sudden, catastrophic and began after 11 p.m., well past the time that the CVP readings had gone from abnormal back to normal.

Gentile said the plaintiff’s expert witnesses who testified earlier in the week had never performed open heart surgery and lacked credibility in determining the cause of Smedley’s death and judging the level of care provided by Spiva.

“I would propose to you that the plaintiff is hiding from the medicine because she doesn’t like it,” Gentile said of Bertram.

After the jury began its deliberations, Carla Dallmann, vice president of quality, patient safety, patient experience and risk management at Valley Health, said in an interview that she was pleased with the way the trial had gone.

“We have sympathy with the Smedley family and the loss they felt, but we are completely confident in the care he received,” Dallmann said of John Smedley.

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