Medical malpractice suit involves makeshift implant

HILO » An hour into back surgery on patient Arturo Iturralde at Hilo Hospital in 2001, Dr. Robert Ricketson discovered that two titanium rods he planned to attach to Iturralde's spine were missing.

Brushing off an offer from a representative of the rod manufacturer to fly two more rods from Honolulu to Hilo in 90 minutes, Ricketson used a hacksaw to cut off the shaft of a screwdriver and inserted it into Iturralde's back.

The screwdriver piece broke a week later. For the next 2 1/2 years, Iturralde suffered increasingly severe medical problems until he died in 2003.

As the medical malpractice trial opened yesterday, Mark Davis, attorney for Iturralde's sister, Rosalinda, told jurors medical supply company Medtronic Inc. failed to check the shipment of rods from New Orleans.

Medtronic attorney Murray Levin said the company sent them. "The rods were lost in the hospital," he said. The hospital is also a defendant, represented by attorney George Playdon.

Ricketson will make his own opening statement to jurors on Monday, representing himself since he failed to buy insurance that would have provided an attorney.

Ricketson's medical license was suspended in Oklahoma because he prescribed narcotic medication for patients but used it himself, becoming addicted, Davis said.

Texas revoked Ricketson's medical license for drug use.

The state of Hawaii had placed Ricketson on probation because of drug use.

In a file at Hilo Hospital, Ricketson himself had reported five prior malpractice lawsuits against him.

A nurse reported seeing him deliberately cut a nerve in another patient's arm, Davis said.

During the screwdriver operation, a nurse shouted, "Dr. Ricketson, you cannot do this," Davis said.

When the broken screwdriver piece was removed later, nurses saved the pieces and gave them to Hilo attorney Robert Marx, who is co-counsel with Davis.

Patient Iturralde, 73, was 5 feet 6 inches tall and weighed 235 pounds. He had had heart surgery, suffered from diabetes and urinary incontinence and various falls, Davis said.

The botched screwdriver surgery, followed by three corrective surgeries, injured Iturralde's nerves, causing inability to walk and further urinary complications that led to infections and his death, Davis said.

Attorney Levin countered that the one week the screwdriver piece was in Iturralde's back did not lead to his death. Even before the operation, "He was a nice man. He was also a very sick man," Levin said.