Doctor defends tool implant
HILO » When Dr. Robert Ricketson implanted part of a stainless-steel screwdriver in the back of a patient in 2001, it was "reasonably prudent" because the correct surgical items were missing, Ricketson told a Hilo jury yesterday.
But Hilo Medical Center attorney George Playdon told the jury that inserting part of a screwdriver in a patient's back "was in the outer reaches of outer space."
Attorneys for the plaintiff and three defendants made closing statements yesterday in the four-week trial of a lawsuit filed by Rosalinda Iturralde against Ricketson, Hilo Medical Center and medical supply company Medtronic Inc. for the Jan. 29, 2001, operation on Iturralde's brother Arturo.
Iturralde and her attorney, Mark Davis, said the operation led to complications that caused the death of Arturo Iturralde 2 1/2 years later at age 75.
Ricketson, representing himself, Playdon and Medtronic attorney Murray Levin said Arturo Iturralde had numerous medical problems before the operation: excess weight, uncontrolled diabetes, numerous falls resulting in broken bones, lack of bladder control, heart surgery and strokes.
His eventual death was caused by heart problems complicated by diabetes and other factors, Playdon said.
Ricketson said he intended to use two thin titanium rods to stabilize Iturralde's backbone, hoping to relieve pressure on nerves.
Before the surgery, a head nurse assured Ricketson everything was ready, he said. When the rods could not be found, a Medtronic representative, contacted in Honolulu, offered to fly new rods to Hilo in 90 minutes.
Ricketson said he could not wait because Iturralde already suffered "significant loss of blood" in the surgery. Seeing that a surgical screwdriver shaft was the same diameter as the rods, he cut it to size and inserted it, despite protests of nurses.
A week later, the screwdriver shaft broke when Iturralde fell, and a second operation placed the proper rods in his back.
Iturralde improved but went continuously downhill after a later surgeries in Honolulu not performed by Ricketson.
Davis said a witness for Iturralde testified that the screwdriver break injured the nerve to Iturralde's bladder, leading to repeated bladder infections.
Playdon said other testimony showed that was impossible since such a nerve injury would have paralyzed Iturralde.
Levin said Medtronic was not responsible for Iturralde's death because it sent the titanium rods. Hospital representatives testified the rods never arrived, but Levin said the hospital misplaced larger items.
Playdon said the hospital is not responsible for Iturralde's death because there is no way it could foresee Ricketson putting a piece of a screwdriver in Iturralde's back. Davis said the hospital should never have hired Ricketson since his license was suspended in Oklahoma and revoked in Texas. Davis said Ricketson's license is still valid in Hawaii, and he is "on leave" from Hilo Hospital.
The jury is deliberating the case, in which Davis has asked for about $45 million in damages.