Copyright © Las Vegas Review-Journal
By CHRIS DI EDOARDO REVIEW-JOURNAL
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.