Witness: Mistake cured patient

LITTLE ROCK — A Houston pediatric neurologist testified on Wednesday that the Little Rock man subjected to botched brain surgery as a teenager at Arkansas Children’s Hospital was likely cured of the seizure disorder the operation was intended to alleviate.

Dr. Angus Wilfong, the medical director of Texas Children’s Hospital’s comprehensive epilepsy program, took the stand as an expert witness for the defense, the hospital’s insurance providers, as the trial over Cody Ryan Metheny’s 2004 brain operation heads to a conclusion today after 12 days of testimony at the Pulaski County Courthouse. Proceedings resume at 9 a.m. Closing arguments are expected Friday.

“It really appears the surgery impacted his old seizures,” Wilfong told jurors. “He has new [types of] seizures now but I’m not exactly sure what they are. I can’t imagine they’d be a direct effect of his surgery.”

But pressed by the man’s attorneys, Wilfong acknowledged the surgery performed on the wrong side of Metheny’s brain could account for mental problems and declining intelligence reportedly suffered afterwards by the now 22-year-old, if the operation did as much damage as Metheny and his family maintain - a crucial point both Wilfong and the hospital deny and an issue that will have to be decided by the jury.

Metheny’s surgeon, Dr. Badih Adada, who now practices in Lebanon, initially operated on the left side of Metheny’s brain before realizing his error and performing the surgery on the right side. He has admitted liability and put up a $1 million settlement through his insurance over the August 2004 procedure that was featured in a front-page story in the Arkansas Democrat-Gazette.

Metheny’s parents, who brought the lawsuit, say the error caused brain scarring that has worsened their son’s condition, even causing psychosis, and that he’ll have to be institutionalized for the rest of his life.

The jury will have to determine whether the hospital had any responsibility for Adada’s mistakes and whether Metheny was injured by the procedure.

Defense attorneys argue that Adada deceived hospital administrators over the extent of how he mistakenly cut into the then-15-year-old’s brain. They also challenge the claim that Metheny was seriously injured by the procedure, arguing the surgical error resulted in diseased brain tissue being removed from the left side, which has relieved Metheny’s lifelong learning disorders and behavioral problems.

“You have to keep in mind, the part of the brain we’re taking out is abnormal,” Wilfong said. “It is brain tissue that is causing seizures.”

Questioned by attorney Jason Hendren, representing insurance carriers Medical Insurance Co., also known as Proassurance Indemnity Co., Wilfong said he wouldn’t expect any “major adverse reaction” to the surgery, disputing that the procedure had any long-term debilitating effects.

“If someone is going to be injured by brain surgery, the worst day is the day they wake up ... then the brain starts healing,” he said.

Metheny attorney Grant Davis challenged Wilfong’s credibility, saying that the nation’s children’s hospitals have a pact to work together to defend each other in malpractice cases, a claim Wilfong said he’d never heard before.He further disputed Wilfong’s impartiality, saying that Wilfong is beholden to Proassurance through his ties to a company that manufactures a nerve-stimulating device used to treat epilepsy that was improperly implanted in more than six dozen children - a relationship Wilfong said he wasn’t aware of.

“You’re not here to help Cody Metheny,” Davis said. “You’re here to help the insurance company.”

Also testifying on behalf of Arkansas Children’s Hospital Wednesday was Dr. Crayton Fargason of Children’s Hospital of Alabama, who told jurors that the Arkansas hospital’s policies and procedures meet national standards of care but were subverted by Adada’s failure to notify officials about what he’d done.

Hospital administrators didn’t immediately realize the extent of Adada’s mistake, Fargason said, because they had no reason to doubt his story that he’d only opened the wrong side of Metheny’s skull but not removed brain matter. Fargason described Adada’s documentation of the operation, which could have alerted administrators to his error, as “inappropriate and unethical.”