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A jury in Chicago has awarded $22.5 million to a man who lost both legs from overlooked complications of heart surgery. The case is headed for an appeal that may clarify what testimony future juries hear under Illinois’ “lost chance” doctrine. That doctrine allows plaintiffs in medical malpractice cases to seek compensation for missed opportunities for treatment that could have improved the patient’s chances for recovery, even if it is not certain that earlier treatment would have altered the outcome. The case was brought by Taher Anjarwala, a Chicago cab driver with a history of heart illness. According to court documents, Anjarwala, suffering from severe chest pains, went to the emergency room at Rush North Shore Medical Center in Skokie, Ill., on Jan. 2, 1997. Four days later he underwent coronary bypass surgery, which required the use of a heart pump to maintain circulation for eight hours. The next day, he was transferred to Rush Presbyterian St. Luke’s Medical Center in downtown Chicago because of concerns that he might need a heart transplant. When Anjarwala was removed from the heart pump, he suffered serious swelling that was worst in his calves, said Jim Leahy, who represented Anjarwala with his partner Peter Hoste of Leahy & Hoste of Chicago. “What happens is the pressure just builds up inside the calf muscle and cuts off circulation. He lost circulation during transport to Rush downtown around eight p.m. on January 7,” Leahy said. The loss of circulation, known as compartment syndrome, went undiagnosed, despite what both sides conceded was an unambiguous blood test, until around 11 a.m. on Jan. 9. At trial, a nurse testified that Dr. Timothy James, a staff cardiologist, checked Anjarwala for swelling but James testified he did not recall that. The chart, which noted the swelling, did not identify the doctor. Another staff physician, Dr. Elaine Winkel, diagnosed compartment syndrome at 2 p.m. She testified she told James of the diagnosis but James testified he did not learn of the compartment syndrome until 7 p.m. He immediately performed surgery, known as a fasciotomy, to relieve the pressure. But it was too late to save Anjarwala’s legs, both of which were amputated above the knee. David Slawkowski of Anderson, Bennett & Partners of Chicago represented James and Rush Presbyterian St. Luke’s Medical Center. He said an appeal is being prepared based on Judge Donald M. Devlin’s ruling that under Illinois’ “lost chance” doctrine, the jury could not hear expert defense testimony that earlier surgery had only a 10 or 20 percent chance of saving Anjarwala’s legs. “Even if the fasciotomy had been performed at the time of the bypass surgery on the sixth, there is a substantial chance he would have had an amputation, although perhaps a less severe one,” Slawkowski said. “In many states that recognize the lost chance doctrine, the jury is allowed to determine from testimony of the witnesses the percentage of chance that was lost,” he added. “The judge took it out of the jury’s hands and we contend that question has not been decided in Illinois.” Because Anjarwala is a native of Pakistan, Leahy asked potential jurors if they were free of post-Sept. 11 bias. “It became significant at the end of the case because the defense attorney recommended that he [Anjarwala] be given $1.65 million, which is what the victims of the World Trade Center attack are going to be given,” he said. “I objected and the judge struck the testimony and instructed the jury to disregard it.” Slawkowski said he was not playing to prejudice. “The plaintiff suggested a figure of $88 million to the jury as substantial compensation,” he said. “I said attorneys are not the only ones who suggest figures and in the context of society’s measure, $1.65 million, the amount under consideration for the victims of the World Trade Center for the compensation for the loss of a life, can be considered substantial compensation.” Anjarwala v. Rush Presbyterian St. Luke’s Medical Center, No. 98L14068, (Cook County, Ill., Cir. Ct.).

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