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A man who endured a radiation dose equivalent to 50,000 chest X-rays won $1 million from an Allegheny County, Pa., Common Pleas jury that found his doctor and a Pittsburgh hospital responsible for his injuries. Robert Nicklow of Leisenring, Fayette County, learned that he had a problem when he developed an oozing hole in his back after two angioplasty surgeries to repair damage to his heart in 1996 and 1997. The ulcer, according to Nicklow’s lawyer, Alan Perer, was caused by four hours of radiation used to guide surgeons during the long operations. “He’s living with this problem that could become cancerous, and he just went through a terrible ordeal,” Perer said of his client. Surgeons use X-rays to guide a tube from the groin through the arteries into the heart. The longer the procedure, the more radiation the patient endures. According to Perer, the U.S. Food and Drug Administration issued recommendations in 1994 to doctors and hospitals warning of burns from prolonged radiation in such procedures and suggesting that they create thresholds for surgery that would limit the possibility of radiation burns. “It’s been slow to be followed by doctors and hospitals,” Perer said, usually because angioplasty does not last long. The jury found Nicklow’s doctor, Bassam Kharma, 90 percent liable for the verdict, with the Western Pennsylvania Hospital bearing the burden for the remaining 10 percent. The case was tried for two weeks before Pennsylvania Common Pleas Judge Paul Lutty. Lynn Bell, Kharma’s attorney, said her client had been caught in a catch-22 situation and would appeal the verdict. “It was a long procedure, it was very technically difficult. They got the artery open, and it has withstood the test of time. … He got a superb cardiac result,” Bell said. Bell said the original angioplasty was complicated by the fact that once Kharma started the procedure, he found a calcium deposit in Nicklow’s arteries that had to be removed with the help of a second doctor. The surgery wound up taking 5 1/2 hours, during three of which he received radiation. The 1997 angioplasty lasted 3 1/2 hours, including another hour of radiation. Without the angioplasty, Nicklow would have needed bypass surgery, which was a riskier procedure, Bell said. “Our position is if the angioplasty was terminated, then he was at a very high risk of having a heart attack, and he would’ve had to have gone to bypass surgery,” Bell said. Had that happened, and Nicklow died or was injured as a result, Kharma still would have been blamed, she said — forcing the doctor into a difficult position. Because the FDA reported such a small percentage of radiation burns in angioplasty patients, a risk-benefit analysis revealed that the angioplasty was the better way to go, she said. As for Perer’s contention that the radiation exposure put Nicklow at a higher risk for cancer, Bell said he is at a high risk anyway because of heavy smoking. “Mr. Nicklow was a one-and-a-half to two-pack-a-day smoker, and that was really the substantial factor in any risk he had for developing cancer,” she said. David Johnson, the lawyer representing the hospital, said the hospital has filed post-trial motions seeking judgment notwithstanding the verdict or, in the alternative, a new trial. Perer said he thought his client had a good chance for winning any appeals, though he added that it was possible the case would settle. “These doctors let him go for a year, from doctor to doctor, with this terrible thing on his back,” Perer said of his client. “They did him wrong, basically, and that’s what the jury found, too.”

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