Harford County Jury Finds Two Vascular Surgeons Negligent in Bypass Surgery That Left Patient Paraplegic

On July 16, 2007, Victoria Little went to a Harford County hospital for an aortobifemoral bypass, an operation that uses a graft to route blood around a blocked abdominal aorta. She had been sent to Vascular Surgery Associates with pain in her thighs and buttocks, which turned out to come from the blockage. Two surgeons from the practice, Dr. Roger Schneider and Dr. Mark Gonze, performed the procedure.

They chose a 16 x 8 mm graft and tried to sew it to the aorta. The sutures would not hold. Each attempt reopened the connection and the bleeding resumed, and the surgeons eventually abandoned the plan and converted to a different bypass, an axillobifemoral procedure, using a smaller graft. By the time it was finished, Ms. Little had lost about 5,100 cubic centimeters of blood, roughly her entire blood volume. Normal blood loss for an uncomplicated aortobifemoral bypass is 500 to 600.

Afterward she had temporary damage to her kidneys, liver, heart and lungs. The injury to her spinal cord was permanent. She is paralyzed from the waist down and has little bowel and bladder control.

The case went to a jury in the Circuit Court for Harford County in 2010 and turned on one question: did the graft match the aorta? Ms. Little argued that her aorta measured only 7 to 8 millimeters, pointing to Dr. Schneider's own operative note, which described it as extremely diminutive, and to testimony from a vascular surgeon who measured about 8 millimeters on an angiogram. She said a graft that size could not be sewn to such a small vessel, and that the resulting blood loss and low blood pressure injured her spinal cord. The surgeons said her aorta was 14 to 15 millimeters, large enough for that graft, and that it was so diseased and brittle that it could not hold stitches. Dr. Schneider also described the paralysis as a rare complication of clamping the aorta. At trial, the jury was also told that Dr. Schneider was not board certified in vascular surgery, after the judge found that his own testimony about his credentials had opened the door.

The jury sided with Ms. Little and found Dr. Schneider, Dr. Gonze and Vascular Surgery Associates negligent. It found for the anesthesiologist and his group. The verdict was $3,557,398: $224,398 for past medical expenses, $2,000,000 for future medical expenses and $1,333,000 for pain and suffering. Maryland's cap on non-economic damages in medical malpractice cases cut the pain and suffering award to $650,000, and judgment was entered for $2,874,398. Dr. Gonze and the practice settled with Ms. Little after trial.

Dr. Schneider appealed alone. In 2012 the Court of Special Appeals reversed and ordered a new trial, ruling that the jury should not have heard about his board certification and that the judge was wrong to bar testimony about a CAT scan from an unrelated hospital visit. Ms. Little took the case to the Court of Appeals of Maryland. In an opinion by Judge Adkins filed August 22, 2013, the court held that Dr. Schneider had put his own qualifications at issue and that the trial judge acted within his discretion on both rulings. It reversed the intermediate court and sent the case back with directions to affirm the Harford County judgment.

Jonathan Schochor, James D. Cardea and Scott P. Kurlander of Schochor, Federico and Staton, P.A. appeared for Ms. Little in the Court of Appeals, together with Andrew H. Baida of Rosenberg, Martin, Greenberg, LLP.