March 31, 1999

Bus firm hit with another lawsuit by disabled rider

By Bill Gang


Less than a month after a District Court jury slapped the company that runs the CAT buses with a $25 million judgment for a wheelchair user, a similar lawsuit has been filed against the company.Norma Weinstein, 85, alleges in her lawsuit that a bus driver failed to secure her electric wheelchair in a CAT Paratransit van, and she broke her hip when she fell out of it as the van rounded a corner.The lawsuit, filed Tuesday by attorney Steven Karen against ATC Vancom of Nevada, says the elderly woman was hospitalized for five days.He added that this is the second time Weinstein has been injured in a Citizens Area Transit incident. The first was on Oct. 24, 1996, when she and her wheelchair fell off a paratransit van's electronic ramp as it was being lowered.She sued over that incident as well, but that suit has yet to reach trial.Karen said that despite the incidents and the injuries, Weinstein has no way other than the CAT buses to travel around Clark County.The $25 million judgment, believed to be the largest jury award in Nevada history, involved an incident that further disabled a man who already had lost the use of his legs.Lee O'Brien, already relegated to a wheelchair because of a motorcycle accident in 1982, had been using an automatic ramp to board a CAT bus in 1993 when the driver prematurely raised the device, according to attorney Randy Mainor.O'Brien, 40, said the movement knocked his wheelchair out from under him and sent his head and neck slamming against the metal ramp.Mainor said O'Brien had sensation in his legs -- although not their use -- before the incident, but that ended along with control over bodily functions, his ability to have sex and his ability to participate in wheelchair sports and skiing.Sensation was replaced with chronic pain that requires him to take methadone, the attorney said.The owner of the bus franchise, ATC Vancom Inc. and ATC Vancom of Nevada Inc., accepted responsibility for O'Brien's injuries but offered only $175,000 in compensation.At his trial, Mainor asked the jury to award $14 million, but the jury increased that figure.Problems or questions?Read our policy on privacy and cookies.All contents © 1996 - 2007 Las Vegas Sun, Inc.

Monday, March 04, 2002

Copyright © Las Vegas Review-Journal

Las Vegas surgeon subject of multiple lawsuits

D'Ambrosio accused of turning two older patients into paraplegics


Orthopedic surgeon Francis G. D'Ambrosio set a 2001 record for Clark County. He was sued five times for medical malpractice, including two cases in which he is accused of turning older patients into paraplegics, according to court records.Las Vegas attorney Steven J. Karen said his 71-year-old client, Jacqueline Remy, led a relatively happy life before she visited D'Ambrosio."She was walking OK, but she was hunched a little bit and had some pain," said Karen.On Jan. 4, 1999, D'Ambrosio performed a lumbar laminectomy, an operation intended to relieve pressure on Remy's spine by exposing certain nerves."Following the surgery, the doctor left the hospital," said Karen. "Dr. D'Ambrosio failed to return pages for two hours and during that time, a rent opened in her spine, which meant her spine was bleeding." Remy has been unable to walk ever since."She's got permanent paralysis and loss of bladder control," Karen said.In Karen's view, D'Ambrosio's decision to complete the surgery in under an hour with only a physician's assistant by his side contributed to Remy's woes.Gerald Gillock, a veteran Las Vegas litigator who also is suing D'Ambrosio, said several factors led to multiple lawsuits against the surgeon and his former practice, Advanced Orthopedic Care Associates."Dr. D'Ambrosio and Advanced Orthopedics were the only physicians listed in the Health Plan of Nevada handbook, and Dr. D'Ambrosio was the only spine surgeon approved for coverage by HPN, which also includes Senior Dimensions," said Gillock. "So there was a large number of people who were captive to them because of their insurance."Gillock said HPN and other health maintenance organizations have cut the amount of money paid to each doctor for seeing a patient. "So what happens?" he asked. Some doctors "start using physician's assistants, who start assigning prescriptions, seeing patients and writing reports, which the doctor signs off on without seeing the patient."Gillock also blames D'Ambrosio's malpractice carrier, St. Paul Companies."They started getting a lot of claims against him, and instead of canceling out his insurance, they just kept writing him new policies," he said. "They wrote him a $2 million policy for himself, a $2 million policy for his professional corporation, and a $2 million policy for Advanced Orthopedics, so Saint Paul is up to $6 million in exposure."Such a high policy limit makes settling these cases difficult, Gillock said."Most insurance policies that we run across are 1-3 policies, which means they cover $1 million per incident and $3 million per year," he said. "We always are willing to accept that $1 million for cases which are worth much more than that, and I have never chased a doctor's personal assets."But these are big cases, and you don't take $1 million when the insurance company has $6 million in coverage."D'Ambrosio's attorney John Cotton said Gillock and Karen are seeing patterns where none exist."There's a number of cases that have little or no merit, a number of cases where (D'Ambrosio) got joined in that we don't think he had anything to do with, and some where he was the assistant surgeon," Cotton said. "I don't see any common tie to them."Cotton said D'Ambrosio's popularity as a defendant has more to do with the high-stakes nature of spinal surgery than the doctor's conduct."If somebody has a minor injury, there can be egregious conduct and no one will sue," he said. "It seems that more of the lawsuits have to do with bad results than bad conduct, which is nothing new."Meanwhile, D'Ambrosio has traded in his license to practice medicine here and moved to Malibu, Calif.A spokeswoman for the Nevada Board of Medical Examiners said D'Ambrosio had asked the board to let his Nevada license expire, which it did on June 30."We do not track malpractice lawsuits," said the spokeswoman, who refused to give her name. "Lawsuits are between a doctor and a lawyer and an insurance company."Notwithstanding her statement, the spokeswoman said the board had 19 pages of malpractice data on D'Ambrosio.

Jan. 28, 2009  Copyright © Las Vegas Review-Journal 

Jury gives family $2.5 million award 

Malpractice verdict on doctor thought to be largest since '04 By DAVID KIHARA LAS VEGAS REVIEW-JOURNAL

Elisa Sanchez knew something was wrong. In 2004, the 24-year-old mother found blood in her stool and kept having pain when she went to the bathroom. When she went to local doctor Steven Lampinen, she was repeatedly told that she was merely suffering from hemorrhoids.Seven months after she visited the doctor, Sanchez was rushed to University Medical Center's emergency room because of major pain. Shortly after that, she was diagnosed with colon and rectal cancer. She died in 2007 at the age of 27.Last week, a Clark County District Court jury awarded her family $2.5 million in a medical malpractice lawsuit. The suit contended that Lampinen and Brian Bishop, a nurse at the family practice, were negligent and didn't examine her properly. It's thought to be the largest medical malpractice verdict in District Court since 2004.The jury determined that Lampinen was mostly responsible for the negligence that contributed to Sanchez's death and that he "fell below the standard of care," according to the verdict.If she'd been properly diagnosed when she first visited Lampinen, her chances of surviving the cancer would have been 97 percent, said Steven Karen, one of the family's attorneys. Her chances dropped to 50 percent by the time she was diagnosed in December 2004.Karen said Sanchez likely would be alive today if doctors had diagnosed her cancer earlier. Before she died, Sanchez went through chemotherapy and major surgery, including the removal of her uterus and part of her lower intestines, said Clark Seegmiller, another attorney for the family.Sanchez's husband and 5-year-old daughter live in New Mexico. Although they declined to comment, Karen said they didn't sue solely for money."It was never about money for them," he said. "It was about honoring the loss."Lampinen did not return calls seeking comment and his attorneys weren't available. Lampinen continues to practice in Nevada.Nevada caps malpractice lawsuit awards at $350,000 for pain and suffering. In this case, the jury awarded at least $2 million in "economic losses," or future lost wages. Sanchez worked in retail.Sanchez went to Lampinen in April 2004, after she was diagnosed with colitis at a UMC Quick Care and told to follow up with her primary care physician. He diagnosed her as suffering from diarrhea and other bowel problems and prescribed a laxative, the lawsuit states. He didn't conduct a rectal exam or schedule a follow-up visit, the lawsuit alleges.She next visited Lampinen's practice four months later complaining of constipation, pain and difficulty sitting. At that time, Bishop examined her and believed she was suffering from internal hemorrhoids, according to an expert hired by Lampinen's attorneys. Bishop treated her with an enema.Sanchez returned twice to Lampinen's office but was told that she was suffering from hemorrhoids, the lawsuit states. Lampinen's medical expert said the doctor referred her to a specialist. Karen disputes that.In mid-November, Sanchez was in pain and went to UMC's emergency room. A colonoscopy performed a month later found a cancerous tumor. Although the tumor was removed, the cancer returned and spread throughout her body.Contact reporter David Kihara at or 702-380-1039.

Cancer misdiagnosis results in $2.5 million verdict

By Correy E. Stephenson Staff writer Published: February 12, 2009 The family of a Nevada woman was awarded $2.5 million after her doctor failed to correctly diagnose her with rectal and colon cancer, leading to her death at age 27.Elisa Sanchez was 24 years old and had just given birth to her first child when she visited Dr. Steven Lampinen, complaining of rectal bleeding.The doctor diagnosed hemorrhoids without performing an exam, and despite repeated visits by Sanchez over the next seven months, never ordered a colonoscopy or further tests. After a visit to the emergency room, Sanchez was diagnosed with colon and rectal cancer and died in 2007.Steven J. Karen, a sole practitioner in Henderson, Nev. who represented Sanchez's family, argued that if Elisa had been correctly diagnosed at her initial visit, she would have had a 97 percent chance of survival. Instead, the delay reduced her chances to about 50 percent, he told Lawyers USA.Scott Cook, a partner at Gordon & Rees in Las Vegas who represented the defendant, did not respond to a request for comment.Multiple appointments, missed chancesElisa Sanchez gave birth in November 2003. She had a routine vaginal delivery with no complications, Karen said, and was released the next day after a normal vaginal exam.But about a month later, she started noticing blood in her stool and experiencing tenesmus, a feeling of incomplete defecation.In April 2004, she first visited Lampinen. At that visit, he noted in the chart that Sanchez was suffering from constipation and other pain and finding bright red blood in her stool.But Lampinen did not perform an exam, suggest a follow-up appointment or make a referral to a specialist, Karen said. Instead, he told Sanchez she had hemorrhoids and suggested she use an over-the-counter laxative.Sanchez's symptoms continued to worsen and she returned to the office in August, when she saw a nurse, Brian Bishop. He performed a digital rectal exam and found a palpable mass within the range of his index finger, Karen said, telling Sanchez it was an internal hemorrhoid.Failing to perform a visual exam to confirm his diagnosis was a "big mistake," Karen noted. "All the medical texts state you cannot diagnose an internal hemorrhoid simply by feeling it without visualization."At trial, "I asked [the nurse] how he could feel the difference between a hemorrhoid and cancer, and his answer was that he didn't know – he had never felt cancer before," Karen said. "But there he was, feeling the cancer and calling it a hemorrhoid."Sanchez made two more trips to the office, seeing both Nurse Bishop and Dr. Lampinen and receiving the same diagnosis: hemorrhoids. She was treated with an enema and told to use Preparation H and take a sitz bath.During the bath, Sanchez herself felt the tumor vaginally and went to the emergency room. She then had a colonoscopy and was diagnosed in early December with rectal and colon cancer.Sanchez underwent chemotherapy and radiation as well as major surgeries, including having her entire colon, vagina and uterus removed, and having her anus sewn completely shut, but she died in 2007.Odds of survivalIn order to establish that Sanchez would have had a high rate of survival had her cancer been detected sooner, Karen relied upon a clear timeline.Because there was no detectable tumor in the vagina when Sanchez gave birth in November, Karen was able to establish that the tumor grew from the rectum – where Nurse Bishop palpated it the following August – into the vagina, where Sanchez felt it.Karen also relied upon a study that was published in September 2008 that established survival rates for various stages of these types of tumor.Based on the lack of tumor in November and the symptoms Sanchez displayed at her first appointment in April, Karen's expert told the jury she was a stage 1 or possibly early stage 2 when she had her first appointment with Dr. Lampinen.The study reported that stage 1 patients had a 97 percent chance of survival while stage 2 had an 84 percent chance.When Sanchez was finally diagnosed in December of that year, her odds had dropped to 50 percent.No settlement offersAt trial, Karen presented a four-hour video of Sanchez that she made prior to her death. In addition, her mother testified about how much she missed her daughter and what it was like to watch her die.Karen said the eight-person jury was unanimous in their decision and deliberated for only a few hours before reaching its verdict of $2.5 million – $2 million in economic damages, $250,000 for pain and suffering and $250,000 to her husband and daughter for future pain and suffering.Despite the jury's quick return, Karen said the doctor's insurance company never made a single settlement offer, even after two court-mandated settlement conferences."We offered to settle for the doctor's insurance policy limits on multiple occasions, which was only $1 million," he said. "But they insisted on taking it to trial."Questions or comments can be directed to the writer at: correy.stephenson@lawyersusaonline.comPlaintiff's attorneys: Steven J. Karen of the Law Office of Steven J. Karen in Henderson, Nev. and Clark Seegmiller and Kurt D. Anderson of Seegmiller & Associates in Las Vegas, Nev.Defense attorneys: Scott Cook and Joan Foy of Gordon & Rees in Las Vegas.The case: Family and Estate of Elisa Sanchez v. Lampinen; Jan. 29, 2009; District Court, Clark County, Las Vegas, Judge Jennifer P. Togliatti.Detailed InformationAmount Before Interest    $0.00Subscribe Now or Get 8 Weeks Free

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Attorney Steven Karen

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