Alexander Nieves as the Administrator of the Estate of Maria I. Ocasio v. Meriden-Wallingford Anesthesia Group, P.C. et al

On July 3, 2024, the jury reached a verdict in favor of the plaintiff in an anesthesia malpractice lawsuit, awarding damages totaling $15.4 million.

Case Background

The Anesthesia Malpractice lawsuit was filed on September 26, 2017,  by Plaintiff Alexander Nieves as the Administrator of the Estate of Maria I. Ocasio in the Connecticut State, Superior Court of New Haven (Case number: NNH-CV17-6073811-S) and was presided over by Judges James Abram, Jon Blue and Robin Wilson.

Cause

On March 17, 2017, Maria I. Ocasio underwent an elective endoscopic retrograde cholangiopancreatography (ERCP) procedure at Midstate Medical Center in Connecticut. The Meriden-Wallingford Anesthesia Group, P.C., including anesthesiologist Dr. Guy J. Aliotta and certified registered nurse anesthetist (CRNA) Richard Ruey, managed Ocasio’s anesthesia. During the procedure, Ocasio experienced severe complications. These included sedation-induced respiratory depression, which progressed to hypoxia. This culminated in cardiopulmonary arrest, resulting in catastrophic anoxic brain encephalopathy. She entered a vegetative state and passed away on April 17, 2017, one month later. Alexander Nieves was appointed Administrator of Ocasio’s estate on July 11, 2017, initiating legal proceedings.

Injuries

Ocasio sustained extensive, severe injuries, ultimately fatal. She suffered a severe anoxic brain injury, evident from widespread abnormal diffusion restriction in multiple brain areas, including bilateral basal ganglia and cortical regions. These injuries resulted directly from a pulseless electrical activity (PEA) arrest during the ERCP. Ocasio also experienced acute and chronic respiratory failure. This necessitated prolonged mechanical ventilation. Additionally, they had multiple seizures indicative of severe neurological damage. Furthermore, they developed dysphagia, likely due to neurological impairment. Other complications included anemia, acute kidney injury, lactic acidosis, and leukocytosis. Significant respiratory issues such as atelectasis, pneumothorax, and bronchospasticity occurred. Additionally, Ocasio suffered skin impairment from immobility. They also experienced tongue laceration and swelling. There were issues of bladder and bowel incontinence. Furthermore, they faced severe cognitive deficits and MRSA bronchopneumonia. Generalized muscle weakness contributed to her overall deterioration.

Damages

The plaintiffs sought relief in the form of money damages under Connecticut General Statutes Section 52-555, reimbursement of costs incurred, and any additional relief deemed just and proper by the Court.

Key Arguments and Proceedings

Legal representation

 

  • Defendant(s): Meriden-Wallingford Anesthesia Group, P.C. | Hartford Healthcare Corporation d/b/a Midstate Medical Center |  Midstate Medical Center |  Guy J. Aliotta, M.D.
    • Counsel for Defendants: Charmagne Ann Padua| Newfield Biondo & Carlino | Danaherlagnese
    • Experts for Defendant(s): Miles Dinner, MD. | Maribeth Massey, CRNA | Andy McCullough, MD

Claims

The plaintiff’s claims focused on alleged negligence by the Meriden-Wallingford Anesthesia Group, P.C., particularly through the actions of Dr. Aliotta and CRNA Ruey. The complaint asserted multiple failures in the standard of care, alleging that the defendants improperly administered excessive anesthesia dosages, failed to adequately monitor Ocasio’s condition during the procedure, and did not recognize the onset of sedation-induced respiratory depression promptly. The plaintiff claimed that the medical team failed to promptly diagnose and treat Ocasio’s hypoxia, allowing it to progress critically. Additionally, the complaint pointed to inadequate monitoring of vital signs and improper supervision of the CRNA by the anesthesiologist.

Further allegations included failures in resuscitation efforts, citing delayed and improper intubation, inadequate management of Ocasio’s dropping blood pressure, and overall poor coordination of the Code team. The plaintiff asserted that the defendants disregarded clear signs and symptoms of respiratory failure. They also alleged that the defendants failed to adhere to established protocols for managing post-anesthesia respiratory distress. The complaint also cited inadequate record-keeping of Ocasio’s condition, vital signs, and resuscitation efforts. Systemic issues were alleged, including insufficient training of the Code team in resuscitation techniques. Additionally, it was claimed that key personnel did not remain present throughout the entire Code event.

Defense

Hartford Healthcare Corporation and Midstate Medical Center admitted Ocasio’s admission and the involvement of Dr. Aliotta and CRNA Ruey but denied they were their agents or employees. They denied all negligence and responsibility for Ocasio’s injuries and death. Meriden-Wallingford Anesthesia Group, P.C., and Dr. Aliotta admitted providing services within their training but denied negligence and responsibility for Ocasio’s outcome, specifically denying each malpractice claim. 

Expert Testimony

For the plaintiff, experts testified on departures from the standard of care in anesthesia, critical care, neurological care, and gastroenterology, attributing Ocasio’s injuries and death to the defendants’ actions. Defense witnesses, including Dr. Miles Dinner and Maribeth Massey, defended Dr. Aliotta and CRNA Ruey’s actions, asserting adherence to the standard of care.

Jury Verdict

The jury awarded $15.4 million in damages, including $1 million for loss of enjoyment of life, $5 million for pre-death pain and suffering, and $9.4 million for death itself. Liability was assigned to both the anesthesia group and Dr. Aliotta’s estate for Maria I. Ocasio’s injuries and death.

Court Documents:

Complaint

Answer

Jury Verdict