A Florida hospital and orthopedic surgeon have been ordered to pay $2.15 million in damages to a former ballerina who now walks with a cane after an appeals court allowed a surgical tech's surprise testimony about what went wrong during the patient's hip arthroscopy.

In 1997, Marc J. Philippon, MD, performed hip arthroscopy on Katie Shreffler, then 17, to repair a labral tear. After surgery, Ms. Shreffler continued to be in pain and had limited mobility. A debridement a year later did not solve the problem. The second surgeon told her that he found gouges in her cartilage caused by a sharp instrument, according to court documents. Finally, Ms. Shreffler filed suit in 1999, claiming that Dr. Philippon and Holy Cross Hospital of Fort Lauderdale had been negligent.

A key moment in the trial occurred when the plaintiffs produced testimony from Julie Snogles, a surgical tech who was present during the procedure. Until then, the defense didn't know that she was going to testify. Ms. Snogles' testimony became an issue in the appeal, which was decided in March by the District Court of Appeal of Florida, Fourth District. On June 4, the same court denied the hospital and surgeon a rehearing on their appeal.

Ms. Snogles testified in the 2007 trial that Ms. Shreffler was only Dr. Philippon's second or third hip arthroscopy patient. She said Dr. Philippon told her that it was a new procedure and that he was new at performing it, according to court documents. Halfway through the procedure, the surgeon created a third portal. Ms. Snogles said she asked him why he was making a third hole, and he answered that it was to remove a foreign object. The implication was that a shaver broke during the procedure, although Ms. Snogles testified that she never saw a foreign object being removed, nor did she see him break either of the shavers.

By the time of the trial in 2007, Ms. Snogles no longer worked at Holy Cross Hospital, and the hospital offered the plaintiff's attorneys no help in locating her. However, Ms. Shreffler's attorneys found her through an Internet search. The appeals court said the hospital and surgeon knew that the tech was in the room and could be brought in to testify. She was, after all, a former employee of the hospital. "They could not be 'surprised' by her 'existence' as a possible witness," wrote the appeals judges.

Attorneys for the hospital and Ms. Shreffler did not respond to requests for comment.

After hip surgery and the debridement, Ms. Shreffler, who studied ballet for 15 years, continued to be in pain and had trouble walking, according to a 2007 press report, after the jury trial.

Bruce Montoya, Dr. Philippon's attorney in Denver, said the surgery wasn't the cause of Ms. Shreffler's pain and problems walking. "Ms. Shreffler had a congenital abnormality in her hip, which continued to cause her problems — even after Dr. Philippon's corrective surgery in 1997. The last MRI taken before trial was in 2003 and noted that her labrum, which was repaired by Dr. Philippon, was perfectly normal," said Mr. Montoya in a statement.

Dr. Philippon went on to become chief of orthopedic surgery at the hospital, according to his practice website. He now practices in Vail, Colo., specializing in sports medicine and research.

Mr. Montoya said that the jury ignored the medical evidence presented during the trial. "While the jury got it wrong in this case, we believe in the checks and balances of our judicial system and the case remains on appeal in Florida."

Outpatient Surgery Magazine staff

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