The evidence is “overwhelming” that something happened during dental surgery for a teen with cerebral palsy that left him severely disabled, said a lawyer during a civil trial on Friday.
Calgary lawyer Brian Devlin said there is no evidence of a stroke, tumour or disease that could have left Shawn Gallant, 18 at the time, in the condition he found himself after surgery at the Red Deer Regional Hospital Centre to remove his wisdom teeth in September 2004.
“What you have here is a young man who goes in for surgery and comes out the other side totally changed,” said Devlin, who is representing Shawn’s parents Paul and Sharon Gallant in a civil lawsuit against Red Deer anesthesiologist Dr. Alayne Farries.
Before surgery, Gallant, who also coped with scoliosis and spastic quadriplegia, attended school in Red Deer, could communicate and enjoyed taking in Red Deer Rebels games. Now, he can no longer communicate, is prone to outbursts and seizure-like events, and can’t operate his electric wheelchair or feed himself.
The additional brain damage Gallant suffered is consistent with the injuries caused by insufficient oxygen at some point in the surgery or recovery, Devlin said in Red Deer Court of Queen’s Bench.
Devlin also called into question the credibility of Farries’ testimony on Wednesday. Farries told the court she only became aware in 2008, following a discovery for the lawsuit, that she had given Gallant a typical adult dose of 0.6 milligrams per kilogram of body weight of a neuromuscular blocker anesthetic instead of a lower dose of 0.3 or 0.4 milligrams, which she would typically give a patient with Gallant’s level of cerebral palsy.
That amounts to a “breach of standard of care,” argued Devlin.
Farries’ Calgary lawyer Laurie Goldbach countered that evidence was given in court that the amount of the neuromuscular blocker given to patients can vary and is not always reduced. A larger dose of anesthetic can leave patients feeling weak as they wake up and some may try to dislodge their tracheal tube.
But there is no evidence higher doses cause brain or cognitive damage or that the effects of the anesthetic last, she said.
Goldbach also disputed suggestions that at some point Gallant didn’t get enough oxygen. That would have been a significant event noticed by the up to four people in the operating room and would have triggered monitor alarms. Farries testified that she closely monitored Gallant’s oxygen levels at all times and there were no problems, although he took longer to wake than usual.
If something had happened why were no other people who were in the operating room asked to testify, Goldblach asked, suggesting they would not have backed up the lack of oxygen theory.
Hospital records would have shown any evidence there was an oxygen problem, she said. “They don’t, because it didn’t happen.”
Further, there is no medical or scientific evidence pointing to brain damage from a lack of oxygen.
Also, no evidence from medical experts was presented that suggested the standard of care was inadequate.
Goldbach also disputed the claim Gallant’s condition after surgery immediately worsened. Testimony from several doctors who treated him later mentioned his condition getting progressively worse.
Lawyers also made submissions on how much in potential damages could be awarded.
Devlin suggested damages in the range of $2.3 million to $3 million depending on care needs.
The defence suggested a lower amount should be awarded for additional long-term care because Gallant was already receiving 24-hour-a-day care.
Justice Monica Bast reserved her decision until a future undisclosed date.
pcowley@www.reddeeradvocate.com