Opening statements and the first testimony from witnesses for the plantifs took place Tuesday in the civil lawsuit involving Meadowview Regional Medical Center and the estate of the late Herberta "Bertie" Lang.

The lawsuit was filed by members of the Lang family after Bertie Lang died on Dec. 8, 2005 at St. Joseph's Hospital in Lexington from complications of carotid artery surgery performed by a former surgeon at MRMC on Dec. 6.

The suit has accused Meadowview and its parent company Lifepoint Hospitals, LLC of corporate negligence after granting temporary privileges for Dr. John Christian Gunn to perform thoracic and vascular surgery at the facility in September 2005.

Jury selection took place Monday, with 15 jurors selected to hear testimony in the case. Eight women and seven men make up the jury; three alternates were selected should a juror have to be dismissed from the case before testimony concludes.

The case is expected to take three weeks with attorneys for the plantiff presenting their side of the story first. Attorneys for MRMC will then present witnesses to explain their side.

Attorney Robert Houlihan of Savage, Elliott, Houlihan, Moore, Mullins and Skidmore of Lexington, representing the Lang family began opening statements shortly after 9 a.m., telling jurors "Bertie Lang was a very active 71 year old lady with a loving family," and "the most important thing you will learn about Bertie Lang … she was a very committed member of this community."

Houlihan outlined the course of events which brought Lang to consult with Gunn on Nov. 21, 2005, regarding blockage of her right carotid artery and the need to have surgery to prevent her from having a major stroke.

Houlihan also told jurors they would learn the diagnosis of Lang's right carotid artery having 70 to 80 percent blockage was incorrect due to a misdiagnosis of a magnetic resonance angiography by Dr. Daniel Beineke and that Gunn was not qualified to perform vascular surgery, which led to Lang's death.

"What we're claiming in simplest form is the hospital was wrong in issuing privileges to Dr. Gunn … he was not qualified for the surgery he performed," said Houlihan.

Houlihan also claimed former MRMC CEO David Loving "fast-tracked" Gunn's temporary privileges for monetary gain to the hospital, citing a $700,000 recruiting bonus package for the addition of another general practitioner surgeon on staff at the hospital.

At the time of Gunn's brief tenure at MRMC from September 2005 to January 2006, Dr. Larien Kearns was the only general practitioner surgeon on staff.

Houlihan also outlined the credentialing process of the hospital, saying the hospital by-laws as drafted by the 37 physicians practicing there at the time didn't require board certification of doctors in order to be hired.

Houlihan noted Gunn had failed his board certification in 2002, 2003, 2004, 2005, and again in 2006.

"The competency of Dr. Gunn is a fair issue," Houlihan said and in closing noted he would be asking for $38,000 in compensatory damage if the jury found in favor of his client.

Attorney Todd Thompson of Thompson, Miller and Savage of Louisville representing Meadowview Regional Medical Center noted in his opening statement "we (Meadowview) did not settle (lawsuits) like Beineke and Gunn … we have a story to tell."

Thompson countered Houlihan's statement of Gunn's hiring, saying "there was a dire need for a surgeon and there wasn't a reason of financial gain."

He went on to note during a period before Gunn came to Maysville, there were nine days when no surgeries were performed at MRMC because of a lack of surgeons.

"The need for surgery coverage at the hospital was the driving need," said Thompson.

From a period of 2004 to 2005, Kearns and Dr. Jose DeMoya were on staff to perform surgery, but DeMoya retired in 2005, leaving a gap filled by physicians from Lexington who were under contract to perform surgeries at Meadowview. Thompson said the lack of follow-up care locally by the out-of-town physicians was a cause of concern for the hospital and patients.

"Nobody is interested in bringing in anything else but the best to this hospital," he said of the five doctors on the Medical Executive Committee and the three members of the Credentialing Committee involved in approving Gunn's appointment to the medical staff.

Thompson also noted the medical staff at MRMC electing not to require board certification of a doctor in its by-laws isn't an unusual practice for hospitals across the country and candidate reference forms are not required by the Joint Commission on the Accreditation of Healthcare Organizations.

In outlining Gunn's credentials from former employers and Loyola University where Gunn completed his fellowship in 2001, Thompson noted Gunn had completed 797 surgeries when he arrived in Maysville.

Following lunch, Houlihan called Dr. Willis Wagner, a vascular surgeon at Cedars Sinai Medical Center in Los Angeles to testify. Wagner serves as chief of Vascular Surgery at the 1,000 bed facility and has been an expert witness in medical lawsuits for 15 years.

Wagner said under questioning he had reviewed the case of Bertie Lang, which included records from Dr. LeRoy Gallenstein, Lang's primary care physician; Gunn's pre-operation records; hospital records; Lang's MRA films and CT scan results; as well as Lang's records from St. Joseph's Hospital in Lexington.

Testimony revealed an April 2005 scan of Lang's carotid artery showed a 30 to 40 percent blockage, and Wagner was asked if he would perform surgery on a 71-year-old patient with that condition, to which he answered "absolutely not," saying the risk of surgery was greater than the risk of stroke.

Houlihan then reviewed the results of the MRA taken by Beineke on Nov. 8, 2005 and the misdiagnosis of a 70 to 80 percent blockage of the artery, and then asked Wagner if Lang qualified for carotid artery surgery.

"She should not have had the surgery," Wagner said. "It's the worst case of medical malpractice I've ever seen."

After giving a technical medical description of carotid artery surgery procedure to remove plaque build-up, Wagner described the effects of Gunn's errors during surgery, which resulted in a herniation of the brain and put pressure on the brain stem, causing the death of Lang.

Wagner said after viewing Gunn's videotaped testimony about the surgery, he (Gunn) either had a "profound lack of knowledge, or dishonesty."

Thompson's cross-examination of Wagner was short, focusing upon the fact Wagner had been retained in the case to review the deposition of Gunn during his lawsuit against the Lang family and the fact Wagner said he would not provide testimony for either MRMC or its administration.

Thompson also verified with Wagner he has served on hospital credentialing boards during his time as a practicing physician.

The last witness of the day was Shari Lang Stafford, the daughter of Bertie Lang, who at times became emotional as she talked about her mother.

Under questioning by Houlihan, Stafford related the events which led up to her mother's decision to have surgery at Meadowview with a new doctor the family was unfamiliar with and in such a short time frame after being told she needed to have surgery.

Stafford said as a family, her father Jerry Lang, brother Terry Lang, herself and Bertie Lang discussed on Dec. 5, 2005 the decision to go forward with the surgery without getting a second opinion or instead of traveling to Lexington or Cincinnati for the procedure.

Stafford said she expressed concerns that Meadowview wasn't equipped to handle an emergency situation should something go wrong with the procedure, but her mother insisted on going forward with the procedure locally rather than wait for an appointment in Lexington and told her family "my mind's made up."

Stafford said the family expected the surgery to take an hour to an hour and a half, but instead it took "twice as long" and when Sherry Goodwin, director of the operating room, finally came out to talk with the family she told them the surgery wasn't going well.

"I asked if this was life threatening and she turned away and she said it's very serious," said Stafford.

According to Stafford, when Gunn finally came to talk with the family, he said the surgery didn't go well and when he made the incision, it pulled the plaque out and turned the artery inside out and he tried to repair the damage with stitches and with a patch, at which point he fell to his knees and covered his face with his hands.

"He said "This isn't your fault, it's my fault"," Stafford told the court, adding Gunn told the family "she's in the hands of a higher power."

Stafford said after lunch, her brother Terry Lang requested his mother be sent to Lexington by Air-Care and by 7 p.m., they were visiting with Bertie Lang at the hospital in Lexington.

On Dec. 7, Bertie Lang was still able to talk with her family, but the nurses advised family members to have "happy conversations" with their mother and on Dec. 8, before her husband Jerry Lang, her daughter Marita Lang and her grandchildren could reach the hospital to visit with her she passed away.

"I told her to fight but if she needed to go on to heaven that was OK," Stafford said of her last conversation with her mother.

After a 15 minute recess, Thompson said he had no questions for Stafford and court was recessed for the day.

Houlihan said jurors will hear videotaped testimony of Gunn and other witnesses during today's proceedings.

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