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From The Desk of Bucky Hurt

February 7, 2013



Below you will find a story which appeared in the December 19, 2012 DRI publication, "The Voice", regarding Lovett v. Dr. Ravi Shankar and Cancer Care Centers of Brevard, Inc. This was a medical malpractice jury trial handled by attorneys Jennings L. "Bucky" Hurt III, Vance R. Dawson and Steven Burres of our firm. A defense verdict was obtained on November 2, 2012.

A printable edition can be viewed by clicking here.

The detailed summary of the trial which was published in the Florida Jury Verdict Reporter is also included below. For a printable edition of the Florida Jury Verdict Reporter for the Lovett case, click here.


Jennings L. Hurt III
Managing Partner
Rissman, Barrett, Hurt
Donahue & McLain, P.A.
201 E. Pine St.
15th Floor
P.O. Box 4940
Orlando, Florida 32802 - 4940
Off: 407 - 839 - 0120
Fax: 407 - 841 - 9726
Cell: 407 - 760 - 9000
email: bucky.hurt@rissman.com
www.rissman.com




The Voice - December 19, 2012   
HOME

And The Defense Wins


DRI member Jennings L. Hurt III of Rissman, Barrett, Hurt, Donahue & McLain, P.A. in Orlando, Florida, teamed with a partner to obtain a defense verdict for Dr. Ravi Shankar and Cancer Care Centers of Brevard, Inc. on November 2, 2012, in a medical malpractice jury trial in Viera, Brevard County, Florida.

Plaintiff, Marilyn Lovett, received radiation therapy for significant skin cancer on her right forearm between September 6, 2007, and October 3, 2007. Therapy was administered under the care of Dr. Shankar, a radiation oncologist. Ms. Lovett received 3 gray (the amount of radiation) for 19 fractions (the number of dosages or days of treatment). Almost one year later, she developed "late" onset ulceration of her right arm, a known complication. On October 9, 2008, the last date Ms. Lovett was seen by Dr. Shankar, he recommended conservative therapy for the 1.0 x 1.5 centimeter ulcer. Therapy would have consisted of wound care, physiotherapy, and hyperbaric oxygen therapy.

Instead, Ms. Lovett chose to undergo debridement and curettage on at least six occasions by a general surgeon.
During that three-month period of time, the ulcer continued to grow in size. On January 22, 2009, the ulcer was 6 x 14 centimeters. Ms. Lovett then came under the care of a plastic surgeon who instituted the same conservative therapy recommended by Dr. Shankar. Seven months later in July 2009, the plastic surgeon performed a debridement and skin graft procedure that proved to be successful.

Ms. Lovett's tendons and cartilage were significantly damaged and she had to undergo six orthopedic procedures at Shands Hospital in Gainesville, Florida, to regain motion in her arm. She incurred over $500,000 in medical expenses and presently has limited use of her right arm and hand. The plaintiff asked for $825,000 in intangible damages.

The plaintiff maintained that Dr. Shankar's treatment was "too much radiation over a too short period of time." Ms. Lovett argued that she should have been given 2.04 gray for 35 fractions. The defense pointed out that both treatment regimens were within the standard of care and that the plaintiff's recommended treatment would have resulted in an even higher risk of "acute" complications. Both treatment options had the same risk of "late" complications.

The jury deliberated for just under two hours before returning a defense verdict.





Jennings L. ?Bucky? Hurt III
Jennings L. "Bucky" Hurt III



Florida Jury Verdict Reporter Summary


CASE INFORMATION SHEET
FLORIDA LEGAL PERIODICALS, INC.
P.O. Box 3370, Tallahassee, FL 32315-3730
(904) 224-6649/(800) 446-2998 * FAX (850) 222-6266


COUNTY AND COURT:

Brevard County Circuit Court

NAME OF CASE:

MARILYN J. LOVETT

Plaintiff,

v.

RAVI SHANKAR, M.D. and CANCER
CARE CENTERS OF BREVARD, INC.,

Defendants

CASE DOCKET NO. : 05-2010-CA-007098

JUDGE: Charles. M. Holcomb

PLAINTIFF(S) ATTORNEY(S)/TRIAL COUNSEL:

Kenneth J. McKenna, Esq.
Doug Martin, Esq.
Dellecker, Wilson, King, McKenna & Ruffier, L.L.P.
719 Vassar Street
Orlando, FL 32804

DEFENDANT(S) ATTORNEY(S)/TRIAL COUNSEL:

Jennings L. Hurt III, Esq.
Vance R. Dawson, Esq.
Steven B. Burres, Esq.
Rissman, Barrett, Hurt, Donahue & McLain, P.A.
201 E. Pine Street
Suite 1500
Orlando, FL 32801

AGE/SEX/OCCUPATION OF PLAINTIFF OR DECEDENT:

Plaintiff, Marilyn Lovett, is a 74 year-old white female who is retired.

DATE, TIME AND PLACE OF OCCURRENCE:

Mrs. Lovett received radiation therapy for significant skin cancer on her right forearm between September 6, 2007 and October 3, 2007 at Cancer Care Centers of Brevard, Inc.

CAUSE OF INJURY:

This was a medical malpractice case arising out of radiation therapy for significant skin cancer on Mrs. Lovett's right forearm between September 6 and October 3, 2007 at Cancer Care Centers of Brevard, Inc. Radiation therapy was administered to Mrs. Lovett under the care of Dr. Shankar, a radiation oncologist.

Mrs. Lovett received 3 gray (the amount of radiation) for 19 fractions (the number of dosages or days of treatment). Almost one year later she developed "late" onset ulceration of her right arm, a known risk and complication. On October 9, 2008, the last date Mrs. Lovett was seen by Dr. Shankar, he recommended conservative therapy for her 1.0 x 1.5 centimeter ulcer. Therapy would have consisted of wound care, physiotherapy and hyperbaric oxygen therapy.

Instead, and unbeknownst to Dr. Shankar, Mrs. Lovett chose to undergo debridement and curettage on at least six occasions by a general surgeon. During that three month period of time, Mrs. Lovett's ulcer continued to grow in size. On January 22, 2009 the ulcer was 14 x 6 centimeters. Mrs. Lovett then came under the care of a plastic surgeon, Mauricio Castellon, M.D., who instituted the same conservative therapy as was originally recommended by Dr. Shankar. Seven months later in July 2009, Dr. Castellon performed a debridement and skin graft procedure which proved to be successful.

Plaintiff alleged that Dr. Shankar failed to appropriately evaluate Mrs. Lovett's skin condition prior to the administration of radiation treatment and failed to prescribe/administer an appropriate dosage of radiation. As a result, Mrs. Lovett developed extensive edema, ulcers and a need for additional medical care, treatment and procedures.

Plaintiff's theory at trial was that Dr. Shankar's treatment was "too much radiation over a too short period of time." Plaintiff argued that Mrs. Lovett should have been given 2.04 gray for 35 fractions.

The defense pointed out that both treatment regimens; e.g., 3 gray for 19 fractions and 2.04 gray for 35 fractions, were within the standard of care. Further, the defense argued that Plaintiff's recommended treatment, 2.04 gray for 35 fractions, would have resulted in an even higher risk of "acute" complications. Further, both treatment options had the same risk of "late" complications.

NATURE OF INJURY:

Plaintiff argued that Mrs. Lovett experienced damages as a result of receiving "too much radiation over a too short period of time" by Dr. Shankar.

Mrs. Lovett alleged that her tendons and cartilage were significantly damaged as a result of Dr. Shankar's radiation therapy treatment and she had to undergo six orthopedic procedures at Shands Healthcare, located in Gainesville, Florida, to regain motion in her arm. Mrs. Lovett incurred over $500,000 in "gross" medical expenses and presently still has limited use of her right arm and hand.

PLAINTIFF'S EXPERT WITNESSES:

Phillip J. Beron, M.D.
Radiation Oncologist
UCLA
Los Angles, CA

Dr. Beron was Plaintiff's board-certified radiation oncologist expert who testified that Dr. Shankar should not have administered Mrs. Lovett 3 gray for 19 fractions. Rather, Dr. Beron testified that Dr. Shankar should have authorized a radiation a dosage of 2.04 gray for 35 fractions.

Dr. Beron further testified that Dr. Shankar's treatment of Mrs. Lovett fell below the standard of care and that all of Mrs. Lovett's radiation necrosis was attributable to Dr. Shankar. On cross examination, Dr. Beron admitted he relied upon the tables as set forth in "Principles and Practice: Radiation Oncology" by Brady and Perez (Fifth Edition) in arriving at his conclusions. Dr. Beron also admitted that the Perez and Brady textbook, which was co-authored by defendants' expert, Dr. Manon, was authoritative.

DEFENDANT'S EXPERT WITNESSES:

Rafael R. Manon, M.D.
Radiation Oncologist
M.D. Anderson Cancer Center
Orlando, Florida

Dr. Manon was the Defendants' board-certified radiation oncologist expert. Dr. Manon testified that Dr. Shankar was compliant with the standard of care and that Dr. Shankar's relying upon the schedules set forth in "Principles and Practice: Radiation Oncology" by Brady and Perez was appropriate.

Dr. Manon saw no evidence to suggest that Dr. Shankar was negligent in his care and treatment of Mrs. Lovett. Dr. Manon's impression was that Mrs. Lovett's right forearm skin cancer was aggressive which meant the cancer needed to be treated aggressively in order to get it under control. Dr. Manon testified if the cancer had been left untreated, it would have spread and may have caused further damage to Mrs. Lovett.

Ravi Shankar, M.D.
Radiation Oncologist
Melbourne, Florida

Dr. Shankar testified that Mrs. Lovett presented to him with significant right forearm skin cancer. Upon examination, Dr. Shankar noted that Mrs. Lovett's right forearm, both the front and back sides, was covered with multiple areas of skin cancer.

Dr. Shankar testified there were several factors involved in formulating Mrs. Lovett's treatment plan. Dr. Shankar took into consideration Mrs. Lovett's age, the type of cancer, stage, size of the field, her history of smoking, chronic exposure to sunlight, many areas of cancer in multiple parts of her body and the published treatment guidelines.

Dr. Shankar testified that there are multiple guidelines, but he considered the Massachusetts General Guidelines promulgated by Harvard in arriving at a treatment recommendation for Mrs. Lovett.

In formulating this treatment plan, Dr. Shankar sought the input of his three fellow radiation oncologists and radiation physicist. The radiation physicist provides advice regarding the right beam energy, exactly how to deliver the treatment, what to shield, how to shield, the dose amount to the skin at the recommended level, and how certain characteristics can affect the delivery of radiation.

Dr. Shankar recommended a four week period of treatment. He wanted to treat Mrs. Lovett for nineteen days (referred to as 19 fractions) with electron beam radiation, given superficially to the front and back of Mrs. Lovett's right forearm.

CHECK APPROPRIATE SPACE: __X___ Verdict

DATE OF VERDICT:

November 2, 2012

VERDICT:

Defense Verdict

COMPARATIVE NEGLIGENCE:

Not applicable.

JUDGMENT:

For Defendants, Ravi Shankar, M.D. and Cancer Care Centers of Brevard, Inc.

DATE OF FINAL JUDGMENT:

December 21, 2012

DEFENDANT'S OFFER:

$75,000

PLAINTIFF'S DEMAND:

Plaintiff's counsel requested $902,633.35 during closing argument, which included $825,000 in past and future non-economic damages and $77,633.35, which represented Plaintiff's total "paid" medical expenses.

ATTORNEY'S COMMENTS:

The jury deliberated 1 hr, 55 minutes before returning a defense verdict.




Submitted By:

Jennings L. Hurt III

Vance R. Dawson

Steven B. Burres

Date: December 28, 2012

Firm:

Rissman, Barrett, Hurt, Donahue & McLain, P.A.

Address:

201 E. Pine Street, Suite 1500
P.O. Box 4940
Orlando, FL 32802-4940

Telephone:

(407) 839-0120

Fax:

(407) 841-9726