Trial Magazine

Robinson v. Azer, No. 2015-CA-008980-M (D.C. Super. Ct. June 15, 2017).

In 2013, 82-year-old Eloyd Robinson—who worked full time as an outdoor security guard—had a total knee replacement for arthritis in his right knee. Robinson believed the operation would improve his quality of life and ability to walk his five-mile route at work. Instead, he had to have his right leg amputated above the knee a month after the botched surgery.

The loss of his leg left Robinson—who was formerly a physically active, gregarious community member—self-conscious, homebound, and in need of his wife’s constant care. In 2015, the couple filed suit against Robinson’s orthopedic surgeon, Rida Azer, and Azer’s practice.

Washington, D.C., attorneys Patrick Malone and Kenneth Trombly represented the Robinsons. “Eloyd’s injury took away his mobility, independence, dignity, and his ability to connect with other people,” said Malone. Robinson, a former professional player in the Negro Baseball Leagues, was still active and athletic in his 80s. “It was a profound, very isolating injury—one that has ruined the last decade of his life.”

“We knew at trial we needed to cull the information about Eloyd’s trauma to the essentials,” Malone continued. “That’s difficult to do, especially for lawyers, because we know so many details about our clients and their cases. To prepare, we worked with excellent consultants pretrial to find that fine line between boiling down the facts and oversimplifying.”

At trial, Malone and Trombly identified key “rules of the road” that Azer failed to follow. The attorneys told jurors how Azer did not account for a mesh stent that had been implanted in Robinson’s right thigh in 2011 to prop open the main artery feeding his lower leg. While Robinson’s pre-op medical clearance report noted the presence of the stent, which was also visible in a pre-op X-ray in Azer’s files, the attorneys stressed that the surgeon was not aware of the stent and did not consult a vascular surgeon to learn how to properly incorporate the stent into his surgical plan. The first “rule” Azer violated, the attorneys argued, was “do your homework.”

As described by Malone and Trombly, Azer then violated his responsibility to “do no harm” by applying a tourniquet to Robinson’s right thigh during the four-hour surgery. The tourniquet’s tight pressure damaged the stent, clogging the main artery in Robinson’s leg and severely limiting blood flow to his knee and foot. The plaintiffs’ experts testified that Azer violated the standard of care by not identifying the stent, not seeking a vascular consultation, and then using a tourniquet on the leg of a patient with a weakened vascular system.

At trial, Malone and Trombly ­outlined the critical events of the month-long postoperative period and argued that Azer further violated patient safety rules by failing to “pay attention,” “fix the harm he caused,” or, more basically, show true “care” for Robinson.

“The evening after the operation, nurses tried twice to contact Dr. Azer because they saw signs of a lack of blood flow in his patient’s foot,” Malone said. “It was an opportunity for him to act and treat his patient or simply ask another doctor to take a look. But instead, he did not respond.” The next day, Azer discharged Robinson without examining him personally or having another hospital doctor evaluate him.

According to medical experts, Robinson’s leg could have been saved after the operation if Azer had referred him to a vascular specialist who could have identified and fixed the damage to the stent. Photos taken on Aug. 2, 2013, showed that two weeks after surgery, Robinson’s incision had become thickened and black—clear signs, experts agreed, that the wound was not healing properly.

Instead of treating these symptoms, however, Azer noted in his Aug. 2 consultation report that Robinson’s wound had healed. He then enclosed Robinson’s leg in a thigh-to-foot cast, which made it impossible to monitor any further changes in the appearance of the incision or Robinson’s lower leg. Left untreated, the tissue in Robinson’s knee and leg slowly continued to die.

It was only after the cast was removed more than two weeks later that Azer finally sent Robinson to the hospital. There, a vascular surgeon told the Robinsons that the leg would have to be amputated above the knee. During the amputation surgery, the vascular surgeon removed the stent from Robinson’s thigh, noting in his report that the stent was “occluded.”

At trial, the defendants argued that an undiagnosed diabetic small-vessel disease, not the doctor’s neglect, had damaged the leg and led to the amputation. Jurors rejected this claim and awarded $8.35 million: $6.75 million to Eloyd Robinson for his lost quality of life and pain and suffering and $1.6 million to Clara Robinson for loss of consortium. The plaintiffs had not offered any evidence of specific dollar damages.

“One of the biggest obstacles we faced in this case was getting jurors to appreciate that when an elderly person suffers an injury—one that irreversibly changes his life—it needs to be taken as seriously as an injury to a younger individual,” said Malone. “This verdict was a nice acknowledgment of the value inherent in the life of an elderly person, and I hope it will encourage the community to be more careful about the quality of care provided to our senior citizens.”

The defendants filed a motion to reduce the verdict or grant a new trial, which the trial court denied.