Roxine Lachney v. James L. Gates, M.D.

STATE OF LOUISIANA
COURT OF APPEAL, THIRD CIRCUIT

24-195

ROXINE LACHNEY

VERSUS

JAMES L. GATES, M.D., ET AL

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APPEAL FROM THE
NINTH JUDICIAL DISTRICT COURT
PARISH OF RAPIDES, 259,930, DIVISION “B”
HONORABLE LOWELL C. HAZEL, DISTRICT JUDGE

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LEDRICKA J. THIERRY
JUDGE

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Court composed of Gary J. Ortego, Ledricka J. Thierry, and Wilbur L. Stiles, Judges.

AFFIRMED.

Brian M. Caubarreaux
Eugene A. Ledet, Jr.
Jacob R. Caubarreaux
Charles A. Woessner
Brian Caubarreaux & Associates
2000 Kaliste Saloom Road, Suite 102
Lafayette, LA 70508
(337) 202-0900
COUNSEL FOR PLAINTIFF/APPELLANT
Roxine Lachney

Randall M. Seeser
Daniel T. Marler
Gold, Weems, Bruser, Sues & Rundell
P.O. Box 6118
Alexandria, LA 71307
(318) 445-6471
COUNSEL FOR DEFENDANT/APPELLEE
James L. Gates, M.D.

THIERRY, Judge.

This action stems from a medical malpractice lawsuit that was dismissed after

a bench trial on the merits. Plaintiff, who underwent three surgeries performed by

Defendant, resulting in the removal of her uterus, right ovary, and left ovary, appeals

the trial court’s judgment. For the reasons that follow, we affirm the judgment of the

trial court.

FACTS AND PROCEDURAL HISTORY

Prior to the events leading to this malpractice lawsuit, Plaintiff, Roxine

Lachney (“Ms. Lachney”), suffered from various women’s health issues for years.

From 2009 through 2012, Ms. Lachney treated with various doctors for symptoms

and diagnoses ranging from lower abdominal pain, interstitial cystitis, frequent

urination, excessive bleeding, and chronic pelvic pain. In November of 2012, after

trying Depo-Provera and oral contraception, Ms. Lachney presented with excessive

bleeding to Dr. K. Rabie at the Rabie Clinic for Women, who concluded she had

dysfunctional uterine bleeding.

On January 23, 2013, Ms. Lachney began treating with Defendant, Dr. James

Gates, at the Alexandria Women’s Center. She presented with complaints of

menometrorrhagia (excessive uterine bleeding) and explained her history of

bleeding and of taking birth control. Dr. Gates noted her history of interstitial cystitis

and abnormal uterine bleeding. He assessed her and noted that her uterus was

“boggy, tender retroflexed uterus consistent with adenomyosis.”

The medical records state that Ms. Lachney, who had one child, did not want

any more children and wanted “definitive” treatment, which according to Dr. Gates,

was a hysterectomy. Dr. Gates claimed he counseled Ms. Lachney on alternative

treatments, but says she rejected the alternative treatment options. However, Ms.

Lachney denied such discussion and testified Dr. Gates encouraged her to undergo

the hysterectomy.

On February 4, 2013, Dr. Gates performed a vaginal hysterectomy on Ms.

Lachney, who was twenty-nine years old at the time. Her uterus was removed and

sent to pathology, the results of which indicated that Ms. Lachney did not have

adenomyosis.

The hysterectomy did not resolve all of Ms. Lachney’s symptoms. A few

months later, Ms. Lachney returned to Dr. Gates complaining of abdominal and

pelvic pain. She was treated with medication in the months following, until

November 25, 2013, when Dr. Gates performed a diagnostic laparoscopic surgery

and removed adhesions and her right ovary (in a procedure known as a right salpingo

oophorectomy). Similar to the hysterectomy, Dr. Gates and Ms. Lachney’s version

of events leading to the right oophorectomy differ.

Ms. Lachney continued to have symptoms in the months following the right

oophorectomy. In May of 2014, Ms. Lachney returned to Dr. Gates, complaining of

chronic pain and requesting definitive treatment. Dr. Gates performed a left

oophorectomy (removal of the left ovary) on June 6, 2014. The pathology report

revealed that the left ovary had a benign follicular cyst.

Unfortunately, Ms. Lachney suffered serious complications following the left

oophorectomy. She became feverish after surgery and feces leaked from her vagina.

On June 9, 2014, Dr. Gates and a general surgeon performed surgery on her again

and found a pelvic abscess with a fistula. She continued having health complications

from the left oophorectomy and began treating with a different doctor, who

performed another surgery on her in January of 2015 to repair the fistula.

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On April 29, 2015, Ms. Lachney filed a medical malpractice claim against

Defendant, Dr. Gates, asserting that he breached the standard of care in performing

three surgeries on her: the hysterectomy, the right oophorectomy and the left

oophorectomy. The medical review panel issued its opinion on July 21, 2017, and

said, in part, that “in light of the sworn affidavit testimony submitted by the claimant,

Roxine Lachney, there is a material issue of fact, not requiring expert opinion, which

the panel cannot resolve without making a credibility determination, bearing on

liability for consideration by the court.” Following the medical review panel

proceeding, Ms. Lachney filed a petition for damages.

After a two-day trial on the merits and post-trial briefing, the trial court found

that Dr. Gates did not breach the standard of care in performing the three surgeries

at issue on Ms. Lachney. Ms. Lachney now appeals.

ASSIGNMENTS OF ERROR

Ms. Lachney alleges the following assignment of error on appeal:

1. The trial court committed legal error by applying the locality standard
in determining whether JAMES L. GATES, M.D. deviated from the
standard of care as a specialist practicing in the field of obstetrician and
gynecologist.

Ms. Lachney then lists several issues presented for review:

1. Considering Dr. Gates’ suspicion of adenomyosis as the cause for his
patient’s abnormal uterine bleeding, was it a deviation from the
standard of care in failing to order diagnostic imaging, or any minimal
testing, before proceeding with a sterilizing total hysterectomy?

2. Did Dr. Gates deviate from the standard of care by failing to determine
the cause of abnormal bleeding before resorting to an unnecessary and
irreversible hysterectomy?

3. Did Dr. Gates deviate from the standard of care by failing to allow Ms.
Lachney to wean off Depo-Provera to determine if the progestin was
the cause of the abnormal uterine bleeding, prior to the irreversible
hysterectomy?

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4. Did Dr. Gates obtain valid informed consent from his patient before
going forward with the right salpingo-oophorectomy on November 25,
2013?

5. Did Dr. Gates deviate from the standard of care by failing to perform a
thorough workup and evaluation of other non-gynecological causes of
pelvic pain before performing the right salpingo-oophorectomy on
November 25, 2013?

6. Did Dr. Gates deviate from the standard of care by performing a left
salpingo-oophorectomy on June 6, 2014 on a benign ovary?

Although incorrectly labeled as “issues presented for review” rather than

“assignments of error,” these issues were adjudicated in the trial court, thoroughly

briefed by Appellant, and alleged to be errors on the part of the trial court. Therefore,

we will address them. See Uniform Rules—Courts of Appeal, Rule 1-3 (“The Courts

of Appeal shall review issues that were submitted to the trial court and that are

contained in specifications or assignments of error, unless the interest of justice

requires otherwise.”); see also La.Code Civ.P. art. 2129 (“An assignment of errors

is not necessary in any appeal.”)

ANALYSIS

I. Standard of Review

The first assignment of error, regarding whether the trial court applied a

locality standard of care or a national standard of care, determines the standard of

review for the remaining issues before the court. If the trial court committed legal

error, then this court reviews the factual findings under de novo review and makes

its own independent review of the record. Latour v. Steamboats, LLC, 23-27 (La.

10/20/23), 371 So.3d 1026. If the trial court did not commit legal error, then the

factual findings must be reviewed under “the manifest error—clearly wrong

standard, which precludes the setting aside of a district court’s finding of fact unless

that finding is clearly wrong in light of the record reviewed in its entirety.” Hall v.

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Folger Coffee Co., 03-1734, p. 9 (La. 4/14/04), 874 So.2d 90, 98. Under the manifest

error standard of review, an appellate court is not permitted to weigh the evidence

or substitute its own factual findings, even though it may have decided the case

differently. Stobart v. State through Dep't. of Transp. & Dev., 617 So.2d 880

(La.1993).

Louisiana Revised Statutes 9:2794(A)(1) sets forth the standard of care a

plaintiff must prove in a medical malpractice claim:

The degree of knowledge or skill possessed or the degree of care
ordinarily exercised by physicians, dentists, optometrists, or
chiropractic physicians licensed to practice in the state of Louisiana and
actively practicing in a similar community or locale and under similar
circumstances [known as the “locality rule”]; and where the defendant
practices in a particular specialty and where the alleged acts of medical
negligence raise issues peculiar to the particular medical specialty
involved, then the plaintiff has the burden of proving the degree of care
ordinarily practiced by physicians, dentists, optometrists, or
chiropractic physicians within the involved medical specialty.

No party disputes that the locality rule is inapplicable here, as Dr. Gates was

a specialist in the field of obstetrics and gynecology. Rather, they dispute whether

the trial court applied a locality standard of care or a national standard of care. Ms.

Lachney claims that the trial court applied a locality standard, which was legal error

and would require de novo review. Conversely, Dr. Gates asserts that the trial court

did not apply a locality standard, but rather “merely addressed” such a standard,

which would require the manifest error standard of review (emphasis in original).

While Dr. Gates admits that the trial court cited the locality rule in its written reasons,

he points out that the court also cited the controlling standard for specialists.

Specifically, the trial judge stated in his written reasons: “In addressing the

standard of care, medical specialists are held to a uniform standard of care based on

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national standards existing with the specialty. Gros v. LAMMICO, 316 So.3d 61 (La.

App. 1st Cir. 2020).” Yet, he also cited to the locality standard of care:

The standard of care in a medical malpractice claim is based on
a locality standard. In a malpractice action based on the negligence of
a physician licensed in Louisiana, where the defendant practices in a
specialty and the alleged acts of medical negligence raise issues
peculiar to that specialty, the plaintiff has the burden of proving the
degree of care ordinarily practiced by physicians within the same
medical specialty.

The trial judge further noted that Defendant’s experts, Dr. George Morris and

Dr. Kerry Tynes, are admitted to practice in Louisiana, while Plaintiff’s expert, Dr.

Glenn Schattman, practiced in other areas of the country outside of Louisiana. After

providing a review of all the expert evidence, the trial judge concluded:

After careful consideration of the evidence and testimony
presented at trial from Ms. Roxine Lachney, Dr. James Gates, Dr. Kerry
Tynes, Dr. George Morris, and Dr. Glenn Schattman, the Court is
satisfied that Dr. James Gates met this standard of care and Ms. Roxine
Lachney gave well-informed consent to the procedures to which Dr.
James Gates performed.

Although the trial judge’s written reasons admittedly contain inconsistencies

in reference to the standard of care, we find that, after considering the totality of his

written reasons, he correctly applied a national standard of care. Furthermore, the

evidence presented at trial is devoid of any suggestion or testimony that the locality

rule applies. In fact, on cross examination, Dr. Gates agreed with Ms. Lachney’s

counsel that the standard of care in this case is a national standard of care. Simply

put, the controlling standard of care was not in dispute at trial. In the trial judge’s

conclusion, he specifically mentioned that he carefully considered all the testimonial

evidence at trial and did not state that he gave less weight to Dr. Glenn Schattman’s

opinion because of his location. Therefore, finding no legal error on behalf of the

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trial court, we will review the factual issues before us under the manifest error

standard of review.

II. Applicable Law

The Louisiana Supreme Court explained a plaintiff’s burden of proof in a

medical malpractice claim in Fusilier v. Dauterive, 00-0151, p. 7 (La. 7/14/00), 764

So.2d 74, 79:

A physician is required to exercise that degree of skill ordinarily
employed under similar circumstances by others in the profession and
also to use reasonable care, diligence, and judgment. Hastings v. Baton
Rouge General Hospital, 498 So.2d 713 (La.1986). A physician is not
required to exercise the highest degree of care possible; rather, his duty
is to exercise the degree of skill ordinarily employed by his professional
peers under similar circumstances. Gordon v. Louisiana State
University Board of Sup'rs, 27,966 (La.App. 2 Cir. 3/1/96), 669 So.2d
736; writ denied, 96–1038 (La.5/31/96), 674 So.2d 263. In a medical
malpractice action, the plaintiff has the burden of proving, by a
preponderance of the evidence, (1) that the doctor’s treatment fell
below the standard of care expected of a physician in his medical
specialty; and (2) the existence of a causal relationship between the
alleged negligent treatment and the injury sustained. Id. (citing White
v. McCool, 395 So.2d 774 (La.1981)).

“Informed consent is a claim that can be separate from a medical malpractice

claim.” Patterson v. Peterson, 19-1604, p. 7 (La.App. 1 Cir. 8/3/20), 310 So.3d 185,

190, writ denied, 20-1076 (La. 11/10/20), 303 So.3d 1041. Louisiana Revised

Statutes 40:1157.1 sets forth the law on informed consent:

A. Notwithstanding any other law to the contrary, written
consent to medical treatment means the voluntary permission of a
patient, through signature, marking, or affirmative action through
electronic means pursuant to R.S. 40:1163.1, to any medical or surgical
procedure or course of procedures which sets forth in general terms the
nature and purpose of the procedure or procedures, together with the
known risks, if any, of death, brain damage, quadriplegia, paraplegia,
the loss or loss of function of any organ or limb, of disfiguring scars
associated with such procedure or procedures; acknowledges that such
disclosure of information has been made and that all questions asked
about the procedure or procedures have been answered in a satisfactory
manner; and is evidenced by a signature, marking, or affirmative action

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through electronic means, by the patient for whom the procedure is to
be performed, or if the patient for any reason lacks legal capacity to
consent, by a person who has legal authority to consent on behalf of
such patient in such circumstances. Such consent shall be presumed to
be valid and effective, in the absence of proof that execution of the
consent was induced by misrepresentation of material facts.

....

D. In a suit against a physician or other health care provider
involving a health care liability or medical malpractice claim which is
based on the failure of the physician or other health care provider to
disclose or adequately to disclose the risks and hazards involved in the
medical care or surgical procedure rendered by the physician or other
health care provider, the only theory on which recovery may be
obtained is that of negligence in failing to disclose the risks or hazards
that could have influenced a reasonable person in making a decision to
give or withhold consent.

“A physician is required to provide his patient with sufficient information to

allow the patient to make an informed and intelligent decision on whether to submit

to the proposed course of treatment.” Deykin v. Ochsner Clinic Found., 16-488, p.

11 (La.App. 5 Cir. 4/26/17), 219 So.3d 1234, 1242 (internal citations omitted). When

lack of informed consent is raised, the burden of proof is as follows:

As in a case alleging breach of the medical standard of care, the
plaintiff in an informed consent case bears the burden of proof. He must
show: (1) the existence of a material risk which the physician must
disclose; (2) the failure of the physician to inform the patient of a
material risk; (3) the realization of the material risk; and (4) a causal
connection between the failure to inform the patient of the risk and
realization of the risk.

Maybrier v. La. Med. Mut. Ins. Co., 08–1508, p. 4 (La.App. 3 Cir. 6/10/09), 12 So.3d

1115, 1119, writ denied, 09–1558 (La. 10/9/09), 18 So.3d 1287; see also Labit v.

Cobb, 10-463 (La.App. 3 Cir. 11/3/10), 50 So.3d 267.

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III. Hysterectomy

Ms. Lachney’s first three issues for review relate to the hysterectomy. Ms.

Lachney alleges that Dr. Gates’ failure to order diagnostic imaging or less invasive

testing after suspecting adenomyosis, before proceeding with a “sterilizing total

hysterectomy,” was a deviation in the standard of care. Similarly, she alleges Dr.

Gates breached the standard of care by failing to determine the cause of Ms.

Lachney’s abnormal bleeding prior to removing her uterus. There is no dispute that

the pathology report revealed a normal uterus. Finally, she claims that Dr. Gates

deviated from the standard of care by not allowing Ms. Lachney to wean off Depo-

Provera prior to the hysterectomy.

Ms. Lachney first presented to Dr. Gates on January 23, 2013. His medical

records state that she had a “boggy, tender retroflexed uterus consistent with

adenomyosis.” He wrote, “The patient is tired of the persistent bleeding. She wants

no more children. She declines a Mirena IUD or NovaSure endometrial ablation. She

wants definitive treatment which would be a vaginal hysterectomy with conservation

of her ovaries.” After signing the consent form, Ms. Lachney underwent the

hysterectomy on February 4, 2013, with the pathology report showing a normal

uterus with weakly proliferative endometrium and chronic cervicitis.

Defendant and Plaintiff put forth conflicting testimony at trial. Ms. Lachney

denied that she told Dr. Gates she did not want any more children. She also testified

that he did not discuss alternative types of treatment with her, and that if he had done

so, she would have strongly considered those options. She testified that Dr. Gates

told her that she needed a hysterectomy “because my uterus was flipped back and

mushy” and because she could have difficulty with future childbirth.

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In regard to the consent form, Ms. Lachney testified that it was presented to

her by Dr. Gates’s nurse and she was simply told to sign without anyone reviewing

it with her. When defense counsel showed her the signed consent form at trial, she

testified: “I don’t understand what it says nor do I know what it means by looking at

this, I just – I don’t – I mean, if you tell me what this means – I don’t know, I can’t

– I mean, understand what it even says.”

Conversely, Dr. Gates testified at trial that he gave Ms. Lachney three options

of treatment for her symptoms: an IUD, an endometrial ablation, and a hysterectomy.

He explained, “If she wanted more children I would not have offered a vaginal

hysterectomy . . . .” However, he said she rejected the more conservative options.

He testified that he immediately dictates his notes after seeing patients and that he

would not have notated things that did not occur.

Dr. Gates admitted that there were other diagnostic tests he could have done

prior to surgery, but he believed further testing would not have changed anything

because he performed the surgery due to her pain and bleeding.

Both Plaintiff and Defendants put forth experts. Plaintiff’s expert, Dr. Glenn

Schattman, found that Dr. Gates failed to sufficiently examine other alternative

causes of Ms. Lachney’s symptoms and believes an MRI should have been

performed prior to the hysterectomy. He testified that Dr. Gates deviated from the

standard of care by failing to perform alternative treatments or therapies to try and

correct the abnormal bleeding before operating. Dr. Schattman further testified that

Dr. Gates removed a completely normal uterus, and that had Dr. Gates not removed

Ms. Lachney’s uterus, she would not have had adhesions with the right and left ovary

resulting in those future surgeries.

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Both defense experts, Dr. Morris and Dr. Tynes, testified that Ms. Lachney

consented to the hysterectomy and that her history did not warrant any additional

testing, such as a biopsy, MRI, or saline sonogram, prior to the hysterectomy.

Therefore, they did not find that Dr. Gates breached the standard of care in

performing the hysterectomy on Ms. Lachney.

The evidence presented at trial on whether the standard of care was breached

when Dr. Gates performed the hysterectomy on Ms. Lachney is conflicting. Under

the manifest error of review, we are not entitled to weigh the evidence. Our review

of the record shows ample evidence to support the trial court’s findings that Dr.

Gates properly obtained Ms. Lachney’s consent prior to the hysterectomy and was

not required to perform additional testing prior to the hysterectomy. The medical

records, coupled with the testimony from Dr. Gates, Dr. Morris, and Dr. Tynes,

support the trial court’s findings. Therefore, it was not manifestly erroneous for the

trial court to find that Dr. Gates did not breach the standard of care by performing

the hysterectomy on Ms. Lachney.

IV. Right Oophorectomy

Ms. Lachney next alleges that Dr. Gates breached the standard of care in

performing a right salpingo-oophorectomy on Ms. Lachney. Specifically, she alleges

that Dr. Gates did not obtain valid informed consent prior to performing the surgery,

nor did he perform a thorough workup and evaluation of alternative non-

gynecological causes of pelvic pain.

The surgery at issue was performed on November 25, 2013. The consent

forms indicated that Ms. Lachney would be undergoing a laparoscopy not for

sterilization and a cystoscopy, not a right oophorectomy. The consent form for the

laparoscopy stated: “A laparoscopy not for sterilization may be done only for the

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purpose of diagnosis, which means that it is not being done for treatment of any

disease or condition, but only to help the doctor find out if any disease or abnormality

is present.” It did not indicate that removal of the right ovary was a risk or known

complication. Similarly, the cystoscopy consent form did not state the possibility of

an ovary removal. When asked at trial why the consent forms did not mention the

risk of removal of an ovary, Dr. Gates replied:

Because at that stage, we didn’t have at the office anymore the consent
that I used on the vaginal hysterectomy, the one that we like that lists
everything. Hindsight being 20/20 I wish we had that but this is a form
that the Louisiana Medical Society had approved by it’s – it’s – this is
a[n] incomplete form but once again, go back to my H and P [history
and physical] and you’ll see everything.

In a medical record dated three days before the surgery, Dr. Gates noted that

Ms. Lachney “understands the possible risks of bleeding, infection, injury to bladder,

bowels, or blood vessels, or anesthetic complications. Despite this, she is willing to

undergo the procedure.” Similarly, another medical record stated the possibility of

an ovary being removed and that such was discussed with Ms. Lachney.

At trial, Ms. Lachney testified that she did not know that Dr. Gates was going

to remove her right ovary. She thought she was having scar tissue removal and a

scope put in to look at her pelvic organs. She only found out about the ovary removal

after surgery when Dr. Gates allegedly told her that it was “smothered with scar

tissue and it was shriveled.” Just as with the hysterectomy consent form, she testified

that Dr. Gates did not go over the consent form with her for this surgery and that a

nurse presented the form to her to sign.

Dr. Gates admitted that he was not planning on taking the ovary out, and only

did so after opening her up and finding the ovary covered in scar tissue. Dr. Gates

further admitted that the consent form was “suboptimal” and that he wished he had

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written “lysis of adhesions, cystectomy – ovarian cystectomy oophorectomy” on the

form.

Dr. Schattman testified that the consent form was legally flawed and thus the

surgery and subsequent removal of her right ovary was a deviation in the standard

of care. He also testified that “removing an ovary that’s polycystic would not be

within the standard of care for this procedure.” Finally, he testified that there was

nothing in the pathology report that justified removing Ms. Lachney’s right ovary.

Conversely, Dr. Morris testified that Ms. Lachney’s pain prior to the surgery

was “new pain” that did not respond to treatment, which justified surgery including

the possibility of an oophorectomy. Although the consent form did not explicitly

state the procedure would be an oophorectomy, he pointed out that the form did state

that it included “other indicated procedures,” which could include an oophorectomy.

Furthermore, Dr. Gates’s history of present illness medical record indicated that he

discussed with Ms. Lachney the possibility of an oophorectomy. Dr. Morris found

that Dr. Gates did not breach the standard of care by removing Ms. Lachney’s right

ovary. Similarly, Dr. Tynes testified that Dr. Gates did not breach the standard of

care by removing Ms. Lachney’s right ovary.

Although the consent form did not specifically mention the right

oophorectomy, it did list the scope of consent as including “other indicated

procedures.” That medical record, coupled with the medical record indicating that

Dr. Gates verbally discussed the possibility of removing an ovary with Ms. Lachney,

supports the trial court’s conclusion that Ms. Lachney did give informed consent to

Dr. Gates for the surgery, including the removal of her right ovary. Under the

manifest error of review, we find that the trial court was not clearly wrong in finding

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that Dr. Gates did not breach the standard of care in removing Ms. Lachney’s right

ovary.

V. Left Oophorectomy

Lastly, Ms. Lachney argues that Dr. Gates deviated from the standard of care

by performing a left-salpingo oophorectomy, in which pathology revealed a benign

follicular cyst of the ovary with no significant pathology alteration.

Dr. Gates performed the left oophorectomy on Ms. Lachney on June 6, 2014.

Prior to surgery, Dr. Gates noted that Ms. Lachney’s left ovary was polycystic and

seven centimeters, which is abnormally large for an ovary. During the surgery, Dr.

Gates perforated her bowel which caused a vesicovaginal fistula and severe

complications. Because of the complications, Ms. Lachney had to undergo two

additional surgeries and wear a colostomy bag for several months.

As with the other surgeries at issue in this appeal, the evidence presented at

trial is in conflict regarding both the scope of consent and the medical reason for

surgery. Ms. Lachney testified that Dr. Gates told her she had a cyst on her left ovary

the size of a lemon, and that if she did not remove it, it could rupture and cause her

to die. She testified that Dr. Gates did not discuss any alternative treatments other

than surgery, nor did he discuss the implications of removal of the left ovary, which

would be premature menopause. However, she does admit to signing the consent

form, though she said the nurse presented it to her and told her where to sign. She

testified that Dr. Gates did not tell her that her problem may be associated with

something other than a gynecological problem.

Dr. Gates explained his reasoning in removing her left ovary:

After I had an informed consent with the patient telling her in so doing,
she would have to go on hormone replacement therapy. She knew good
and well going into the surgery we were going to remove the ovary

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because that’s where the problems – that’s where all her pain was
coming from.

Plaintiff’s expert, Dr. Schattman, testified that the seven centimeter large cyst

had resolved by the time of surgery, as those cysts “come and go all the time,” and

thus Dr. Gates deviated in the standard of care by removing a normal ovary.

Defense experts, Dr. Tynes and Dr. Morris, found that because the cystic

ovary was growing and Ms. Lachney was tired of chronic pain, the removal of the

ovary was proper and not a deviation from the standard of care. Dr. Morris testified

that Ms. Lachney signed the consent form for this procedure, and that the risks of

fistula and leakage of urine or bowel contents from the vagina were contained in the

record. He did not find that the procedure was done incorrectly or below the standard

of care. The fact that she developed complications after the surgery did not indicate

that Dr. Gates breached the standard of care. Dr. Morris and Dr. Tynes also testified

that the standard of care did not require Dr. Gates to have a colorectal surgeon

present during the left oophorectomy.

Although we sympathize with Ms. Lachney for the serious complications and

health issues she endured following the left oophorectomy, we do not find that the

trial court manifestly erred in finding no breach in the standard of the care. The

undisputed evidence shows that Ms. Lachney consented to removal of the left ovary,

and the fistula complication, though unfortunate, was a known risk and not an

indication of a breach.

DECREE

For the foregoing reasons, the judgment of the trial court is affirmed. Costs of

this appeal are assessed against Appellant, Roxine Lachney.

AFFIRMED.

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