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The Gary Rushford Arbitration
This is a small portion of an actual arbitration between a Kaiser Victim and Kaiser Foundation Hospital and the Permanente. It is copied verbatim though the formatting has been changed for the web viewer.
Shih, CA License
#A51754, current status Delinquent,
was the primary care
physician in this case. She was the one who asked if Gary Rushford
pain killers instead of seeing her.
Rushford, the victim who the doctor didn't feel needed to know what
was wrong with him had to have his leg hacked off.
this time because he has no other choice he is forced to remain
The Hands of Kaiser."
November 9, 2003
San Mateo, CA 95113
begin on page 141
A. Of Course, at that point, yes.
Q. But you know it had caused recurrent clotting multiple times during July, right?
A. Correct. In the one leg, correct.
Q. Are you saying you didn't know he had an obstruction in his left leg?
Q. Nobody told you about the June 29th angiogram having an obstruction in that leg?
A. Well, there was no -- He still had a very good pulse in that leg.
A. In terms of saying he had an embolic or embolus in that leg, no, that was really not discussed with me.
Q. So you think he might have systemic asculitis that causes clotting, right?
Q. And we know that you knew that he had something that was an obstruction in his left leg as well, correct?
A. Let me go back and refer to that report.
Q. June 29th embolism, Dr. Airing's radiology report.
MR. SIMONSON: It's at the beginning there, yes.
MS. CANNISTRACI: Q. I'll specifically refer you to the first page --
MR. SIMONSON: Here it is.
MS. CANNISTRACI: Q.
-- of the angiogram, June 29th, last full paragraph. Last
second to the
Okay. So, well, so in reference again to that,
I mean, we didn't really, as I recall, --
Q. So you wait until it's to the clinically unstable to treat it; Is that what you're saying?
Q. So what does that mean? Do you wait until the pulse is lost before you start treating it, or what do you do?
A. Right. In general, even in other cases
peripheral vascular disease, people can have moderate
Q. So this gentleman just gets his leg cut off off on July
21. You all believe that he's got some kind of systemic
MR. SIMONSON; Your Honor, it's an argumentative question. In addition, it misstates the evidence.
It's a hypothetical; it's not argumentative. And it's not
asking for an
A. Well, again, given that: the leg had no symptoms with
pain and the pulse
But he did not
have a symptom of that clot in that. leg. So that's
why a lot
of the questioning or the investigation at that
MS. CANNISTRACI: Q. But he has an occlusion of an entire artery, that's the one near his foot, the tibial artery?
Q. And he's just lost his
You know it's totally obstructed. You're saying that it's
that you don't --
Isn't it true that occlusions, whatever is blocking that artery from
blood flow to that
symptoms would be produced at that point. But people can have
Q. But this isn't your normal situation, right? I mean, ---
But you're asking
me hypothetically in a patient that has an occlusion of an anterior
artery in a peripheral vascular disease situation,
No, I'm not asking.
I'm talking about this patient here, who's just lost his only
his right leg.
A. Again, the issue with that part, is that a clot.? I'm not sure. Again, it could just be vascular inflammation and narrowing of the blood vessel.
Q. And that can cause clotting, right?
that's how -- that's what happened in the other
leg. The issue
with that though is again there were no symptoms in that leg.
And the other question we were trying to answer was, okay, if it is a
in fact of his legs, then you would want to treat the
And how to
Q. It's fair to say you never discussed with Gary the obstruction in his left leg, correct?
A. Right, we just talked about -- I mean, we did the clinical exams of that leg at every visit to ensure --
Q. You never told him he had an obstruction in that leg?
A. Well, we never talked about that particular issue; that's correct.
Q. Don't you think that's something that somebody who just lost their right leg might want to know?
A. That would be speculation on my part.
Q. Well, as a clinician, isn't that something that you feel that you're bound to disclose to your patient?
MR. SIMONSON: That's an expert witness question.
JUDGE BOLLHOFFER: Sustained.
MS. CANNISTRACI: Q. It's also true that you never put anything in your notes that Gary had Buerger's disease, correct?
A. That's correct.
Q. And that you never treated Gary for Buerger's disease, right?
A. Well, there's no real treatment for Buerger's disease, except stopping smoking and aspirin.
Q. And it's fair to say you never - told him to stop smoking during that period?
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