A patient who was injured during a robotic hysterectomy is suing Wentworth-Douglass Hospital in Dover, N.H., and 2 surgeons who the patient's lawyers argue had not been trained well enough on the da Vinci robot before performing the procedure.

Last March, 47-year-old Sherry Long underwent a robotic hysterectomy at the hospital, with surgeon Rebecca Banaski, MD, manning the da Vinci robot under the supervision of Elizabeth Chase, MD, according to the suit, obtained by the Fosters Daily Democrat. During the surgery, both of Ms. Long's ureters were severed, although the mistake was not recognized at the time. After the surgery, Ms. Long began to experience renal failure and other kidney problems.

"As a result of the gross negligence of the Defendants, the Plaintiff was required to undergo extensive surgical repairs of her ureters and is left with permanent damage that will require medical attention for the remainder of her life," claims the suit. The complaint also alleges that Ms. Long was "never informed" that Dr. Banaski "had insufficient training, education and experience to perform the operation herself and was going to be assisted and supervised by" Dr. Chase.

When reached for comment, a Wentworth-Douglass spokeswoman said the hospital had not been served with the suit and declined to discuss the case or the hospital's policies for training surgeons who operate the da Vinci robot. According to published reports, Wentworth-Douglass requires surgeons who use the robot to take a 2-day course operating on human and pig cadavers, followed by 4 live cases under supervision.

Nora Distefano, market development specialist for Intuitive Surgical, says the company's responsibility is to provide training on the use of the robot, but that the information provided during such training "is not intended to substitute for formal medical training or certification," nor are the training programs "a replacement for hospital credentialing requirements." She notes that Aleks Cukic, Intuitive Surgical's vice president of strategy, has gone on record to say that the learning curve for surgeries performed with the da Vinci Surgical System "varies from procedure to procedure and from surgeon to surgeon," and "there's no number" of surgeries required to master the device.

A Wall Street Journal report in early May called attention to 3 cases, including Ms. Long's, in which complications arose from robotic surgeries performed at Wentworth-Douglass, a 178-bed community hospital. The article noted that the hospital had "used the da Vinci about 300 times in four years" — "a fraction of the usage rate of some big medical centers and, some surgeons say, too little for the doctors at the hospital to master it."

The hospital responded to the article by arguing that "Wentworth-Douglass Hospital's robotic surgery complication rates are lower than published rates and in some comparisons lower by half" and that the Joint Commission had confirmed its appropriate use of the machine.

But attorney Peter Mathieu of the Coolidge Law Firm, who's representing Ms. Long, says her case is an example of hospitals "making decisions based on dollars, not on patient safety." He calls the da Vinci robot a "fantastic tool," but says it can be dangerous in untrained hands. "If you give someone a few hours of training on a flight simulator for a 747, you don't expect them to go out and fly a plane full of people."

The suit is still in the discovery phase, says Mr. Mathieu. The Daily Democrat reports that Ms. Long's attorneys must first take their case before a state screening panel that reviews medical injury claims to ensure they're not frivolous.

Irene Tsikitas

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