Orange County Register (California)
April 7, 2002, Sunday
By William Heisel and Mayrav Saar
Twenty women and families have taken Anaheim obstetrician-gynecologist Dr. Andrew Rutland to court, alleging everything from fraud to wrongful death. Rutland has won five of the cases and settled or lost three others. Four of the patients gave up before their cases could be brought to trial, and at least eight cases are pending. Lawsuits against doctors - especially obstetricians - are common. But the American College of Obstetrics and Gynecology says obstetricians can expect an average of 2.5 suits during their careers. The Register reviewed thousands of pages of legal filings and supporting documents in the cases against Rutland but was unable to view complete files in some older cases because records had been destroyed by the court. Rutland declined numerous requests to be interviewed and did not respond to more than three dozen written questions. The following is a glimpse of allegations by patients who say they were harmed while under Rutland's care.
Synthia Gunzel, a former attorney and aerobics instructor from Riverside, says she has given up work and sports because the pain from three surgeries, including a hysterectomy, keeps her at home.
She gained 30 pounds, a side effect of the hysterectomy Gunzel was told would save her life. Other doctors have told her she probably didn't need the surgery.
Stomach pain took her to Rutland's office in December 1996. According to the Medical Board of California, he told her that a sonogram revealed she had adenomyosis, a growth in her uterus, and needed surgery quickly or she'd die. Gunzel said a different doctor had diagnosed her with fibroids, but she took Rutland's word because he had helped her through a difficult pregnancy.
The pain still didn't go away, so Rutland operated on her again, saying her ovaries showed signs of endometriosis and would need to be removed. In court records, Rutland said he made no false statements to Gunzel and that she knew the risks of surgery before agreeing to the hysterectomy. Another doctor told her that adenomyosis not only can't be diagnosed with a sonogram but isn't life- threatening, she said.
She has complained to the Medical Board.
Tina Henson squeezed her mother's hand hard and screamed as Rutland inserted the amniocentesis needle into her belly three times. Henson said she had just seen her baby's image on an ultrasound machine. The fetal monitors all looked normal. Her husband was at home, waiting by the phone with Tina's packed bags and a video camera. They all knew that if Bailey's lungs looked mature enough, he'd be delivered that day.
But then came the amnio. After the third try, Rutland managed to squeeze the amniotic fluid from the needle into a vial, according to Medical Board records. When Henson looked over, she noticed blood in the vial. She said the nurse was no longer able to find Bailey's heartbeat. At that point, Rutland sent Henson to the hospital, telling her that Jan. 1, 1997, would indeed be Bailey's birthday.
''On the outside, he was a picture-perfect baby. On the inside, his kidneys weren't working,'' said Henson, of Murrieta.
She said Rutland told her that her diabetes caused her placenta to break away, ruining her baby's internal organs. And in court records, Rutland said the death was ''proximately caused and contributed to by the negligence'' of the Hensons. But hospital reports show no sign that her placenta broke away, according to the Medical Board, which is investigating Bailey's death.
Irene Verdugo said Rutland told her that she had a tumor on her uterus that required a hysterectomy. She said a doctor she went to for a second opinion argued vehemently against the operation. But she said Rutland told her that other surgeons are not interested in what's best for patients. So on Aug. 22, 1997, she had a hysterectomy and bladder operation.
For three months, she lived ''from pain pill to pain pill,'' growing increasingly bloated while unable to keep food down, she said in an interview and in a lawsuit. A urologist she saw found that Verdugo's ureter had been clamped shut. Urine had backed up and expanded her bladder, pushing her kidneys up against her rib cage. In court records, Rutland said scar tissue obstructed her ureter. She tried to sue at that time but couldn't find an expert witness to testify against Rutland. Verdugo, of La Habra, is now suing Rutland and the makers of the stapling device he used in her operation.
Luz Milla of Corona sought Rutland's help for fertility problems. She said he told her she had endometriosis and a uterine mass that might lead to cancer. On Oct. 3, 1997, she had diagnostic surgery. Milla said she's been in pain and on and off disability ever since. She said she became suspicious that her surgery had gone awry and asked for the pathology reports but was told that they were lost. In court papers, Rutland said he was not responsible for Milla's pain. She complained to the board.
Diana Maize-Gould of Mission Viejo received a hysterectomy Oct. 18, 1997, during which Rutland allegedly clamped shut her ureter. She has since lost a kidney and says the pain from her surgery was so bad she had to crawl to the bathroom. She's able to move about more freely now but says she still lives in pain. She has complained to the board.
Judy Michel of Buena Park went to Rutland on April 12, 1999, complaining of bleeding between her periods. She said he told her she had a tumor that had gone undetected by her other doctors and needed urgent surgery. Five days later, he performed a hysterectomy. In his deposition, Rutland said he offered her many options and did not tell her that her condition was dire.
Her lawsuit says Rutland stapled her bowels to her pelvic wall, leaving her in unyielding pain. Michel complained to the Medical Board.
Vivian Gray of Los Angeles was a classmate of Rutland's at the University of West Los Angeles law school in the early 1980s. So when she needed a bladder operation, she drove from her home in Los Angeles in June 2000 to be treated by him in Anaheim. She said she was supposed to be in the hospital for a couple of days, but pain and high fever kept her there for three weeks. She had to have two more surgeries to correct a cut to her bowels that caused a widespread infection, according to a pending lawsuit.
Beth Pimental of Costa Mesa went to Rutland as a 20-year-old with painful periods. He recommended surgery, but she worried that she'd be left unable to have kids. So he placed her on Vicodin, she said, encouraging her to take as many of the potentially addictive painkillers as she needed. Eventually, she said, she agreed to surgery to cut a nerve, which he said would relieve the pain. It didn't. She's been in nearly constant pain ever since and has had subsequent surgeries to repair a bowel tear that a surgeon told her could have been caused by the surgery Rutland per formed, according to Medical Board records. In a court response, Rutland denied harming Pimental.
Cases Rutland won
Sophie D. Melkonian of Los Angeles was repeatedly told that her pain was from pelvic inflammatory disease. Rutland confirmed the diagnosis with exploratory surgery. According to a lawsuit, another doctor questioned Rutland's diagnosis because her white cell count was high. But Rutland discharged her from the hospital Sept. 18, 1987, and told her to visit his office the next day. The lawsuit alleged that pain drove Melkonian to the emergency room two days later. Her breathing became difficult, the pain unbearable. On Oct. 10, 1987, she died. Her appendicitis had gone undiagnosed for too long, her family alleged in the lawsuit filed in 1988. A jury found that Rutland was negligent in Melkonian's care but not responsible for her death.
Mitzi Ouderkirken was diagnosed with genital warts Sept. 30, 1991, two months after Rutland took over the Anaheim practice of Dr. Stephen Walker. She told Rutland that she and her husband had been virgins before they were married and faithful since. In court records, she said he told her she could have contracted the warts from a hot tub or public bathroom. In a court deposition, Rutland said pathology reports vindicated his diagnosis, and at the trial Rutland supplied tissue that he contended showed Ouderkirken had the warts. During the trial, a DNA expert testified that the tissue belonged to someone else, according to Dr. Janis Fee, a medical witness in a lawsuit Ouderkirken filed along with two other women. The women who sued, all Fullerton residents and members of the Evangelical Free Church in Fullerton, learned that they had received the same diagnosis around the same time. After a lengthy court process, a jury found in favor of Rutland.
Sally Koehn , another plaintiff in the suit, was confused by Rutland's Nov. 6, 1991, diagnosis of genital warts. She said she was a virgin before marriage. Like Ouderkirken's husband, Koehn's husband tested negative for the disease. But she trusted her doctor and agreed to cryosurgery, a technique of freezing the cervix that would treat the problem. Instead, on March 16, 1992, without obtaining consent, Rutland put Koehn in stirrups and applied undiluted trichloracetic acid over her entire vaginal area, according to nurses who were present for the procedure. Koehn passed out from the pain , said the nurses who revived her. Several layers of tissue had been burned off. Rutland said in a sworn deposition that he used the milder acetic acid to remove the warts. Koehn complained to the Medical Board, but it didn't investigate.
Amy Robertson was a member of the same church and also a patient of Rutland's. She was told she had genital warts. After laser surgery Dec. 6, 1991, she sought a second opinion and found that she never had the disease, according to her lawsuit. In his deposition, Rutland said he believed there was an ''epidemic'' of undiagnosed condyloma, or genital warts, in the community.
Shelley J. Burns said she was still black-and-blue and vomiting during recovery from an exploratory procedure on her uterus when Rutland told her she had endometriosis, gonorrhea and chlamydia. He told her that if she didn't have a hysterectomy, she could have a tubal pregnancy and die, she said. In a court deposition, Rutland said the surgery was elective, and a jury agreed that she was not pressured into the surgery.
Three weeks later, her husband took her to Placentia Linda Hospital, where urologist Dr. Charles Streit discovered that her ureter had been cut and her abdomen was filled with a gallon of urine. Streit found fungus in her blood and told her that had she waited much longer, she would have died.
Burns alleged in her lawsuit that she didn't need the hysterectomy. The pathology reports showed that her uterus was normal. A defense witness for Rutland, Dr. Philip DiSaia, testified in a deposition that the hysterectomy was warranted but that he ''never saw any evidence that this woman had venereal disease.''
Burns, who now lives in Colorado, complained to the Medical Board, but it didn't investigate. The hospital, the former Martin Luther Hospital in Anaheim, settled with her out of court.
Case Rutland lost
Earlene Bone-Matthews of Lawndale hadn't received ultrasounds during the last six weeks of her pregnancy, so she didn't know that her first child, William, wasn't growing. William was born Jan. 17, 1986, with severe birth defects that could have been prevented had doctors induced labor two weeks earlier, according to Matthews' attorney, John Maloney. A jury awarded her $53.5 million in a verdict against Prairie Medical Group, of which Rutland was a partner. Maloney said Rutland was responsible for her prenatal care.
Isabel Conde of Panorama City went into labor Sept. 20, 1989. Fetal monitor readings showed that her baby was in distress, but delivery took almost two hours. Medical records show that the child might have had a condition that causes feces from the intestines to move into the airway. The umbilical cord also seemed to be wrapped too tightly around the baby's neck. By the time Rutland delivered baby Cynthia, lack of oxygen to her brain had caused irreparable damage, medical records show. She didn't gasp for her first breath until she was 8 minutes old. Severe birth defects keep her on feeding tubes and in special care to this day.
Centinela Hospital and Prairie Medical Group settled with the family for $200,000 and $580,000, respectively. As part of the settlement, the Conde family agreed to drop Rutland from the case.
Kathy Broussard of San Juan Capistrano went into labor July 22, 1999. Scott Broussard, an emergency medical technician, and Kathy, a neonatal intensive- care nurse, knew something was wrong early on. They say they asked Rutland to perform a Caesarean section but that he refused. Using forceps, Rutland pulled repeatedly to free Jillian Teresa Broussard from the womb. When he finally did, Jillian's spinal cord had been torn, making it impossible for her to move or breathe on her own. The baby only lived a week, dying from head and spinal-cord injuries, according to an Orange County coroner's autopsy report. That report also noted the scabs on the baby's head from where the forceps had grabbed her. Rutland settled with the family for an undisclosed amount. The family complained to the Medical Board, which filed charges against Rutland two years later. That case is under investigation.
Cases dismissed or dropped
Sharon London-Burton bought color-coordinated maternity outfits and got her hair done twice a week -- to let the world know she was a proud mother-to-be. She says Rutland told her to come in for regular ultrasounds, sometimes weekly, and she happily complied. But she says she never saw the results.
Her lawsuit alleged that when she started to feel ill, she called Rutland's group of doctors and was told to ''hang on.'' When she called to report vaginal bleeding and a yellow discharge, she said, she was told the same thing. When she became concerned that the baby had stopped moving, she went to Centinela Hospital. The hospital called her doctors, and she was sent home with the baby still in her womb. She returned in an ambulance the next day and was told that her baby had been dead for two to three days. Doctors delivered her stillborn child a month before her due date in October 1982.
London-Burton, of Inglewood, never complained to the Medical Board. After more than eight years, her case was dismissed in Los Angeles County Superior Court.
Iris Jones was having problems with her pregnancy in October 1984. In a lawsuit she filed the following year against Rutland and Prairie Medical Group, she said Rutland ignored her complaints and failed to diagnose a prenatal condition that eventually required her to have a complete hysterectomy. She dropped a lawsuit against the doctor in 1991, six years after filing it.
Denise Siska's bowels allegedly were punctured during abdominal surgery Oct. 31, 1997. In a declaration to the Medical Board, nurse Gloria Bandoni said she saw Rutland nick Siska's bowels. During a subsequent surgery, the nurse said, she saw ''a lot of chunky gray/yellow material'' being removed from Siska's abdomen. Siska, of Anaheim, developed sepsis and sued Rutland in 1999. She asked the court to dismiss the case Dec. 20 that year.
Ellan Lezcano was told she had endometriosis and cancerous cysts. In January 1995, Rutland performed a laser-assisted vaginal hysterectomy. The operation left her in so much pain she was hysterical, she said. Rutland stopped returning her calls, she said. Five months later, another doctor detected high blood pressure and decided to look at her kidneys. She said the X-ray showed that one of her kidneys had swollen to seven times its normal size, and a line of staples went through her ureter from her bladder to her kidneys. Lezcano, of Anaheim, sued but dropped the case because her urologist wouldn't testify.
CORRECTION: Because of errors in legal documents, an article titled ''Doctors Without Discipline'' in the April 7 edition of the Register incorrectly reported the number of surgeries Dr. Andrew Rutland performed on Synthia Gunzel. He performed two surgeries on her.