Out-patient gynecological surgery results in death of 40-year-old. Defense. Fresno County.


Woman is discharged home after surgeon punctures left internal iliac artery; bleeds to death. Surgeon settles out; defendant anesthesiologist says there were no signs of a problem when he discharged her.

The Case

  • Case Name: Thomas Caruso v. Hoa V. Pham, M.D., Community Regional Medical Center
  • Court and Case Number: Fresno Superior Court / 12CECG01086
  • Date of Verdict or Judgment: Tuesday, October 01, 2013
  • Date Action was Filed: Tuesday, April 03, 2012
  • Type of Case: Medical Malpractice, Wrongful Death
  • Judge or Arbitrator(s): Hon. Jeffrey Y. Hamilton
  • Plaintiffs:
    Thomas Caruso, spouse of decedent patient, Nicole Caruso.
  • Defendants:
    Hoa V. Pham, M.D, anesthesiologist
    Clovis Community Medical Center
  • Type of Result: Jury Verdict

The Result

  • Gross Verdict or Award: None. Defense Verdict.
  • Trial or Arbitration Time: 12 days.
  • Jury Deliberation Time: 3 hours.
  • Jury Polls: 12 - 0 for defendant, Hoa V. Pham, M.D.; 11-1 for defendant Community Regional Medical Center.

The Attorneys

  • Attorney for the Plaintiff:
    Davis & Winston by Joseph A. Davis, Beverly HIlls.
  • Attorney for the Defendant:
    McCormick, Barstow, Sheppard, Wayte & Carruth LLP by Michael F. Ball, Fresno (for Hoa V. Pham, M.D.).
    Baker, Manock & Jensen by William M. White, Fresno (for Community Regional Medical Center).

The Experts

  • Plaintiff’s Medical Experts:
    Marlyn Cheng, M.D., anesthesiology, Los Angeles.
    Felice L. Gersh, M.D., gynecology, Irvine.
    Timothy P. Luckett, BS, RN, Rancho Cucamonga.
  • Defendant's Medical Experts:
    Don F. Mills, M.D., anesthesiology, Newport Beach.
    Donna Shoupe, M.D., gynecology, Los Angeles.
    Rita Kae Restrepo, RN, Alameda.
    Christopher Swalwell, M.D., pathology, San Diego.
  • Plaintiff's Technical Experts:
    Joseph J. Penbera, Ph.D., economist, Fresno.
  • Defendant's Technical Experts:
    Karl Erik Volk, economist, Walnut Creek.

Facts and Background

  • Facts and Background:

    Plaintiff, Thomas Caruso, claimed that Clovis Community Medical Center and Anesthesiologist, Hoa V. Pham, M.D., were negligent in the care and treatment of his wife, Nicole Caruso, age 40, after laparoscopic gynecologic surgery which led to her death.  The operating OB-GYN surgeon, Howard Michael Synn, M.D.,  punctured the patient’s left internal iliac artery.  The defendants were unaware of the injury, and with no signs or symptoms of any post-operative problems, they discharged the plaintiff’s wife to home that same day.  The following morning, she went into hypovolemic shock due to internal bleeding and died.  The surgeon settled with the plaintiff before trial.

    Plaintiff asked the jury for $450,000 in general (non-economic) damages and $2.5 million in special damages for loss of income and household services. 

  • Plaintiff's Contentions:

    Plaintiff alleged that Dr. Pham was negligent in his post-operative care of the decedent with regard to the pain medications prescribed and in his discharge of her from the PACU to the level- two step-down unit (also called the short stay surgery area) before her final discharge to home.

  • Defendant's Contentions:

    Defendants denied liability. That when Dr. Pham discharged decedent to the step-down unit there were no signs or symptoms contrary to her being stable.

Injuries and Other Damages

  • Loss of income and household services.

Demands and Offers

  • Plaintiff §998 Demand: Separate $1 million 998 demands to Dr. Pham and to the hospital, reduced later to $475,000 each.
  • Defendant §998 Offer: None.