DB STATE OF MICHIGAN IN THE CIRCUIT COURT FOR THE COUNTY OF WAYNE PATRICIA KNECHTEL, as Personal Representative of the Estate of Dean A KNECHTEL, Deceased, Plaintiff, v. Case No. 17- NH 17-004225-N Hon- FILED IN MY OFFICE HENRY FORD HOSPITAL, an assumed WAYNE COUNTY CLERK Name for HENRY FORD HEALTH. SYSTEM 3/10/2017 4:24:27 PM and JEFFREY MORGAN, MD. CATHY M. GARRETT - Jointly and Severally, Defendants. GEOFFREY N. IEGER (P3 0441) HARRY J. SHERBROOK (P128169) JAMES S. CRAIG (P52691) KITCHZ DRUTCHAS WAGNER, IE GER LA VALIT TTI SHERBROOK Attorneys for Plaintiff Attorneys for Defendants 19390 Ten Mile Rd One Woodward Avenue, Ste. 2400 South?eld, MI 48075 Detroit, MI 48226 248/355-5555 . (313) 9625-7530 COMPLAINT AND JURY DEMAND There is no other pending or resolved civil action arising out of the same transaction or occurrence as alleged in the complaint. BY: A /s/James S. Craig JAMES s. CRAIG (P52691) NOW COMES Plaintiff, PATRICIA KNECHTEL, as Personal Representative of the Estate of Dean A KNECHTEL, Deceased, and by and through her Attorneys, FIEGER LAW, now complains against the Defendants as follows: 1 GENERAL ALLEGATIONS 1. That PATRICIA KNECHTEL was appointed Personal Representative of the Estate of DEAN A. KNECHTEL, Deceased by the Probate Court for the County of Wayne. 2. - At all times material, Defendant, JEFFREY MORGAN, M.D., was a physician, licensed by the State of Michigan, specializing in General Cardiac/Thoracic Surgery and practicing medicine on a continuous and systematic basis in the City of Detroit, Wayne County, Michigan. 3. That at all times material, Defendant HENRY FORD HOSPITAL, an assumed name for HENRY FORD HEALTH SYSTEM was/is a Michigan Domestic Nonpro?t Corporation authorized to do business in the State of Michigan, with principal of?ces in the City of Detroit and regularly conducting business in the County of Wayne. 4. That the medical malpractice alleged herein occurred at HENRY FORD HOSPITAL located at 2799 W. Grand Boulevard, Detroit, Ml 48202 in the County of Wayne and venue is properly laid pursuant to MCL 600.1629(a) 5. The amount in controversy, exclusive of costs, interest and attorney fees, is in excess of $25,000 and the Court otherwise has personal jurisdiction over the parties and is otherwise within the jurisdiction of this Court. FACTUAL ALLEGATIONS 6. Plaintiff incorporates by reference all of the above paragraphs. 7. Dean Knechtel, age 58, was admitted to Henry Ford Hospital on December 17, 2014 following a scheduled outpatient right heart catheterization showed hemodynamics consistent with cardiogenic shock. 8. Following admission, Dean suffered a cardiac arrest preceded by respiratory distress from which he was successfully resuscitated with full recovery of neurologic function. 9. However, due to progressive hemodynamic decompensation requiring escalating 2 inotropic support with dopamine and then milrinone, Dr. Jeffrey Morgan, M.D., the Henry Ford Cardiothoracic surgeon of record, determined that Dean was in need of temporary mechanical circulatory support. 10. On December 19, 2014 Dean was then taken to the operating room where, after placing Dean in a supine position, Dr. Jeffrey Morgan proceeded to implant bilateral CentriMag ventricular assist devices (LVAD) and (RVAD). According to the records the procedure began at 3:02 pm. and was completed at 5:31 pm. Following the procedure Dean was taken to the Cardiovascular Intensive Care Unit (CVICU) for recovery. 11. While in the CVICU, hourly checks from 6:00-10:00 pm. indicated that all VAD connections were secure. 12. At approximately 10:00 pm. Dean was evaluated and it was noted that his right pupil was irregular, larger than the left and non-reactive. (right 4 mm sluggish/left 2 mm sluggish). Anna Marrocco, Nurse Practitioner, Cardiothoracic Surgery was then noti?ed. At this time RVAD and LVAD ?ows were 3.23 and 3.53. 13. Dean?s pupils were not reassessed until the following morning at 1:15 am. At this time both pupils were dilated and non reactive to light. Nurse Practitioner Marrocco was again noti?ed and indicated that she is going to consult neurology. At 1:23 am. a head CT scan was ordered by Anna Marrocco, CNP and authorized by Jeffrey Morgan, MD. for ?blown pupilsscan was then performed revealing linear areas of air throughout the subcutaneous tissues and throughout the brain compatible with a massive arterial air embolus. In addition, there were air-?uid levels identi?ed within the visualized bilateral vertebral and internal carotid arteries. Neurology was then consulted. 15. Dean was then seen by Neurology resident, Dr. _Nour Abdul-Baki, MD, who performed a limited neurological exam due to altered mental status. At this time both pupils were 3 dilated to 7 mm and brainstem re?exes were absent. 16. Shortly thereafter Neurologist Dr. Elizabeth J. Angus, M.D. reviewed Dr. Abdul? Baki?s documentation and determined that no intervention could be done due to the diffuse injury to his brain. 17. From that point forward, Mr. Knechtel deteriorated rapidly and in the absence of neurologic function, he was pronounced dead at 07:32 am. on December 20, 2014. The diagnosis was fatal massive air embolism. 18. Postmortem examination of the brain con?rmed that the death was caused by a massive arterial air embolization to the brain. The manner of death was characterized as accident. The death certi?cate con?rmed the above diagnosis. COUNT I - NEGLIGENCE JEFFREY MORGAN, MD. 19. Plaintiff incorporates by reference all of the above paragraphs. 20. At all times relevant,-Defendant, JEFFREY MORGAN, MD. owed a duty to Dean Knechtel to provide proper and skill?il care and treatment within the standard of care. 21. Notwithstanding said duty, Defendant, JEFFREY MORGAN, M.D., as a licensed physician specializing in Cardiothoracic Surgery, when presented with a patient such as Dean Knechtel, breached the standard of practice and was professionally negligent in at least one of the following ways: a. Failing to utilize careful de-airing techniques during the placement or initiation of the bilateral CentriMag ventricular assist devices to exclude the presence of air within the circuit; b. Failing to properly position the patient in a head down, deep Trendelenburg position to reduce any air in the arterial system from entering the delicate cerebral circulation; c. Failing to use adequate de-airing techniques and refrain from suctioning air into the system; d. Failing to properly check the heart and aorta for air with 4 SD Failing to avoid the introduction of air into the circuit during connection of the tubing to the cannula; Failing to avoid incorrect placement of the tubing into the pump; Failing to avoid suctioning of air from the LV in?ow cannula during implantation; Failing to monitor the patient for signs of air within the circuit; Additional violations as may become known during discovery. r-p? quiz-h 22. As a direct and proximate result of the above deviations from the accepted standard of care, Mr. Knechtel suffered a massive cerebral air embolism which caused his subsequent death on December 20, 2014 at 7:32 am. 23. That Mr. Knechtel?s injury is of a kind of which does not ordinarily occur without someone's negligence. As such, there is an inference of negligence of a breach of the standard of care pursuant to the doctrine of res ipsa loquitur. 24. As a further direct and proximate result of one or more of the above mentioned acts and/or omissions by the Defendant, Plaintiff claims all damages recoverable under Michigan?s Wrongful Death Act, including but not limited to: a. Medical, hOSpital, funeral and burial expenses incurred; b. Conscious pain and suffering by Dean Knechtel; c. Losses suffered by decedent?s next of kin as a result of his death, including loss of financial support, loss of service, loss of gifts or other valuable gratuities, loss of society and companionship. WHEREFORE, Plaintiff requests that this Honorable Court enter Judgment in favor of Plaintiff and against Defendants, jointly and severally, in an amount in excess of Twenty-Five Thousand Dollars exclusive of costs, interest and attorney fees. COUNT II - VICARIOUS LIABILITY HENRY FORD HEALTH SYSTEM 25. Plaintiff incorporates by reference all of the above paragraphs. 26. At all times relevant, Defendant, HENRY FORD HEALTH SYSTEM, doing 5 business as HENRY FORD HOSPITAL, owed a duty to Dean Knechtel to provide proper and skillful care and treatment within the standard of care. 27. Upon his presentation to Henry Ford Hospital. on December 17, 2014, Dean had no prior physician-patient relationship with any health care providers, including Defendant, JEFFREY MORGAN, MD. 28. That Defendant HENRY FORD HEALTH SYSTEM, doing business as HENRY FORD HOSPITAL, provided Dr. Jeffrey Morgan and members of the Cardiology and Intensive Care unit to Dean Knechtel, who at all times were agents, servants and employees of Defendant HENRY FORD HEALTH SYSTEM. I 29. That Defendant, HENRY FORD HEALTH SYSTEM, by and through their duly authorized agents, servants and/or employees, including JEFFREY MORGAN, M.D., was negligent and breached the standard of practice in at least one of the following ways: a. Failing to utilize careful de?airing techniques during the placement or initiation of the bilateral CentriMag ventricular assist devices to exclude the presence of air within the circuit; b. Failing to properly position the patient in a head down, deep Trendelenburg position to reduce any air in the arterial system from entering the delicate cerebral circulation; c. Failing to use adequate de-airing techniques and refrain from suctioning air into the system; (1. Failing to properly Check the heart and aorta for air with Failing to avoid the introduction of air into the circuit during connection of the tubing to the cannula; Failing to avoid incorrect placement of the tubing into the pump; Failing to avoid suctioning of air from the LV in?ow cannula during implantation; Failing to monitor the patient for signs of air within the circuit; Additional violations as may become known during discovery. (pat-b 30. As a direct and proximate result of one or more of the above deviations from the accepted standard of care, Mr. Knechtel suffered a massive cerebral air embolism causing his subsequent death on December 20, 2014 at 7:32 am. . 6 31. That Mr. Knechtel?s injury is of a kind which does not ordinarily occur without someone's negligence. As such, there is an inference of negligence of a breach of the standard of care pursuant to the doctrine of res ipsa loquitur. 32. As a further direct and proximate result of the above mentioned acts and/or omissions by the Defendants, Plaintiff claims all damages recoverable under Michigan's Wrongful Death Act, including but not limited to: a. Medical, hospital, funeral and burial expenses incurred; b. Conscious pain and suffering by Dean Knechtel; c. Losses suffered by decedent?s next of kin as a result of his death, including loss of financial support, loss of service, loss of gifts or other valuable gratuities, loss of society and companionship. WHEREFORE, Plaintiff requests that this Honorable Court enter Judgment in favor of Plaintiff and against Defendants, jointly and severally, in an amount in excess of Twenty-Five Thousand Dollars exclusive of costs, interest and attorney fees. FIEGER, FIE GER, HARRINGTON, P. C. James S. Craig GEOFFREY N. FIEGER (P30441) JAMES S. CRAIG (P52691) Attorneys for Plaintiff 19390 Ten Mile Rd South?eld MI 48075 248/355?5555 I Dated: March 10, 2017 7 STATE OF MICHIGAN IN THE CIRCUIT COURT FOR THE COUNTY OF WAYNE PATRICIA KNECHTEL, as Personal Representative of the Estate of Dean A KNECHTEL, Deceased, Plaintiff, V. Case No. 17- NH Hon. HENRY FORD HOSPITAL, an assumed Name for HENRY FORD HEALTH SYSTEM and JEFFREY MORGAN, M.D. Jointly and Severally, Defendants. GEOFFREY N. FIEGER (P3 044 1) JAMES S. CRAIG (P52691) FIEGER LA Attorneys for Plaintiff 193 90 Ten Mile Rd South?eld, MI 48075 248/355?5555 DEMAND FOR JURY TRIAL NOW COMES Plaintiff, PATRICIA KNECHTEL, as Personal Representative of the Estate of Dean A KNECHTEL, Deceased, by and through Attorneys, FIEGER LA W, hereby demands a trial by jury on all issues so triable. FIE GER, FIE GER, HARRINGTON, P. C. ?James S. Craig GEOFFREY N. FIEGER (P30441) JAMES S. CRAIG (P5269l) Attorneys for Plaintiff 19390 Ten Mile Rd South?eld MI 48075 Dated: March 10, 2017 248/355-5555 8 AFFIDAVIT OF MERIT OF ARIE BLITZ, M.D. ARIE BLITZ, M.D., being ?rst duly sworn, states the following: 1. I am a Board Certi?ed thoracic and cardiac surgeon. 2. I am familiar with the standard of care applicable to Jeffrey A Morgan, M.D., a Board Certi?ed thoracic and cardiac surgeon. 3. I have reviewed Plaintiffs Notice of Intent to File Claim, and all medical records pertaining to Dean Knechtel?s admission to Henry Ford Hospital from December 17, 2014 through December 20, 2014. 1 have also reviewed the autopsy and Death Certi?cate. 4. According to the medical records, Dean Knechtel, age 58, was admitted to Henry Ford Hospital on December 17, 2014 with progressive SOB/respiratory distress requiring intubation. 5. He su??ered a cardiac arrest with pulseless VT necessitating 2? of from which he was success?rlly resuscitated. Several nursing notes con?rmed recovery of neurologic 6. Due to progressive hemodynamic decompensation, he was subsequently taken to the operating room on December'19, 2014 at 3:43 pm. for temporary mechanical circulatory support. 7. - Dr. Jeffrey Morgan, MD, the Cardiothoracic surgeon of record, determined that he was too unstable for more durable MCS and proceeded to implant bilateral CentriMag ventricular assist devices (LVAD) and (RVAD) on December 19, 2014. 8. . Just a few hours after the procedure, on December 19, 2014 at 10:00 pm. Dean?s right pupil was found to be noticeably dilated compared with the left and was non- reactive to light. {00263432.nocx} 9. A Nurse practitioner was contacted and a STAT neurology consult was requested followed by a STAT head CT scan performed at 2:12 am. on 12/20/14. The CT revealed extensive extra- and intra-cranial air emboli in the cerebral vessels c/w diffuse and severe hypoxic ischemic injury/encephalopathy. 10. From that point forward, Mr. Knechtel deteriorated rapidly and in the absence of neurologic ?mction, he was pronounced dead at 07:32 on December 20, 2014. The diagnosis was fatal massive air embolism. 11. Postmortem examination of the brain con?rmed that the death was Icausedhby a massive arterial air embolization and pneumocephalus. The death certi?cate con?rmed the above diagnosis. I 12. Based upon my review of the medical records, it is my professional opinion that the standard of care was breached by Jeffrey A Morgan, MD. and Henry Ford Hospital, together with their agents, servants and employees in at least one of the following particulars: I a. - Failing to utilize careful de-airing techniques of the aorta and bilateral CentriMag ventricular assist devices to exclude the . presence of air within the circuit; b. Failing to properly position the patient in a head down, deep Trendelenburg position to reduce any air in the arterial system from entering the delicate cerebral circulation; c. Failing to use adequate de-airing techniques and refrain from suctioning air into the system; d. Failing to properly check the heart and aorta for air with e. Failing to avoid the introduction of air into the circuit during connection of the tubing to the cannula; f. Failing to avoid incorrect placement of the tubing into the pump; g. Failing to avoid suctioning of air from the LV in?ow cannula during implantation; . . h. Failing to monitor the patient for signs of air within the circuit; i. Additional violations as may become known during discovery. 13. These violations of the standard of care detailed in this af?davit of merit were to I within a reasonable degree of medical certainty, more probable than not with a greater than 50% probability the direct and proximate cause of Mr. Knechtel?s massive Cerebral air embolism and subsequent death on December 20, 2014 at 7:32 am. 14. Given the degree of massive arterial air embolism there is no question that air was introduced into the arterial system during the device implantation or exchange. Had Defendant utilized careful de-airing techniques of the aorta and device to exclude the presence of air within the circuit and properly monitored the device for signs of air within the circuit,Dean Knechtel would not have suffered the massive Cerebral air embolism which caused his death. 15. Furthermore, Mr. Kneohtel?s injury is of a kind of which does not ordinarily occur without someone's negligence. As- such, there is an inference of negligence of a breach of the stande of care in this matter on behalf of each of the Defendant describe above pursuant to the doctrine of res ipsa loquitur. 16. That I reserve the right to amend, modify or change my opinions upon the receipt of additional information. ARIE BLITZ, M.D. Subscribed and swom to before me on MWWA ,2016 In. Notary Public, County of State of My Commission?xpires: /20- ?a 5? {00263432 STATE OF MICHIGAN . IN THE CIRCUIT COURT FOR THE COUNTY OF WAYNE PATRICIA KNECHTEL, as Personal Representative of the Estate of Dean A KNECHTEL, Deceased, Plaintiff, v. Case No. 2017- 004225 NH Hon. Lita Masini Popke HENRY FORD HOSPITAL, an assumed Name for HENRY FORD HEALTH SYSTEM FILED IN My OFFICE and JEFFREY MORGAN, M.D. WAYNE COUNTY CLERK Jointly and Severallya 4/13/2017 10:23:51 AM CATHY M. GARRETT Defendants. GEOFFREY N. FIEGER (P30441) HARRY J. SHERBROOK (P28169) JAMES S. CRAIG (P52691) . KITCH, DRUTCHAS, WAGNER, FIE GER LA VALI TU TT 1 SHERBR 00K Attorneys for Plaintiff . Attorneys for Defendants 19390 Ten Mile Rd One Woodward Avenue, Ste. 2400 South?eld, MI 48075 Detroit, MI 48226 248/355-5555 (313) 965-7530 i . h.sherbrook@kitch.com MOTION TO APPROVE SETTLEMENT and DISTRIBUTION of PROCEEDS NOW COMES Petitioner, PATRICIA KNECHTEL, Personal Representative of the. Estate of Dean A KNECHTEL, Deceased, by and through her attorneys, FIEGER LAW, and now seeks approval of the Wrongful Death Settlement and Distribution, stating as follows: 1. That PATRICIA KNECHTEL, was appointed Personal Representative of the Estate of DEAN A. KNECHTEL, Deceased. 2. This is/was a medical malpractice case whicharose out of a surgical prpcedure {0034-443 . Warp?n. 3. That this case has been resolved as to all parties, subject to Court approval. 4. That due to a con?dentiality agreement, the terms of the resolution of this matter will be contained in a separate cover, Exhibit A, to be given to the Court at the time of hearing. 5. That PATRICIA KNECHTEL, Personal Representative of the Estate of Dean A KNECHTEL, Deceased, seeks approval of the settlement and distribution in accordance with the Michigan Wrongful Death Statute as it is in the best interest of the Estate. 6. At this time Plaintiff also requests the Court to approve payment of litigation costs which have been incurred by the law ?rm of Fieger, Fieger, Kenney, Harrington, P.C. as stated in Exhibit A to be presented at the hearing. 7. In addition, there is an attorney fee which is to be paid to Plaintiff?s counsel pursuant to a contingency fee agreement of a one-third percentage. Plaintiff counsel asks the Court to approve the attorney fee set forth in Exhibit A to be presented at the hearing. 8. Plaintiff also requests that the Court approve Probate fees set forth in Exhibit A payable to Howard Linden, Esq, for services in opening and maintaining the Estate. 9. Plaintiff states that burial and funeral eXpenses have been paid. 10. That Plaintiff further requests that the Court approve proceeds of $5,000.00 to be held in escrOw for 30 days to pay costs not yet billed the balance of which will be refunded pursuant to the contingent fee agreement. I 11. Finally, Plaintiff further requests that the Court approve the distribution of proceeds-as set forth in Exhibit A to be presented at the hearing. 12. That the decedent was survived by his spouse Patricia, his father, three (3) adult children and several siblings. Written notice of the terms of the settlement and distribution, notice of hearing and a copy of the proposed Order of Distribution has been served on all persons 2 who may be entitled to damages pursuant to MCL 700.3924 and section 2922 of the revised judicature act of 1961. WHEREFORE, Plaintiff respectfully requests that the Court approve the settlement and authorize payment of litigation costs and attorney fees as well as the distribution set forth in Exhibit A to be presented at the hearing. Respectfully submitted, FIE GER, FIE GER, KEMVE Y, HARRINGTON, RC. James S. Crater GEOFFREY N. FIEGER (P3 0441) JAMES S. CRAIG (P52691) Attorneys for Personal Representative 19390 Ten Mile Rd South?eld MI 48075 . 248/355-5555 Dated: April 13, 2016 CERTIFICATE OF SERVICE I hereby certify that on April 13, 2016, I electronically ?led the foregoing document with the Clerk of the Court using the ECF system which will send notification of such ?ling to counsel of record, as addressed above. Respectfully submitted, FIEGER. LA James S. Craig JAMES S. CRAIG (P52691) Attorneys for Plaintiff 19390 W. Ten Mile Road 48075-2463 (248) 355?5555 3 STATE OF MICHIGAN IN THE CIRCUIT COURT FOR THE COUNTY OF WAYNE PATRICIA KNECHTEL, as Personal Representative of the Estate of Dean A KNECHTEL, Deceased, Plaintiff, V. Case No. 2017- 004225 NH 7? 422 - Hon. Lita Masini Peak; 00 5 NH HENRY FORD HOSPITAL, an assumed IN MY Name for HENRY FORD HEALTH SYSTEM WAYNE COUNTY CLERK and JEFFREY MORGAN, MD. 511/201 7 2:58:33 PM Jointly and Severally, CATHY M. GARRETT Isl Marcuana Lawrence Defendants. GEOFFREY N. FIEGER (P30441) HARRY J. SHERBROOK (P28169) JAMES S. CRAIG (P52691) KITCH, DRUT CHAS, WAGNER. FIE GER LA VALITUT I SHERBROOK Attorneys for Plaintiff Attorneys for Defendants 19390 Ten Mile Rd One Woodward Avenue, Ste. 2400 Scuth?eld, MI 48075 Detroit, MI 48226 248855-5555 (313) 965-7530 'h.sherbrook@kitch.com ORDER APPROVING SETTLEMENT and DISTRIBUTION of PROCEEDS This matter having come before the Court upon the Plaintiff?s Motion to Approve Settlement and Distribution (Con?dential), thereby requesting the entry of an Order approving the terms of the Settlement and Distribution, and the Motion having been served upon all parties pursuant to MCL 600.2922, MCL 700.3924 and this Court being otherwise fully advised; NOW, THEREFORE, IT IS HEREBY ORDERED THAT the settlement as indicated in Exhibit A is found to be in the in the best interest of the Estate and is approved. IT IS FURTHER ORDERED that PATRICIA KNECHTEL, as Personal Representative of the Estate Of Dean A KNECHTEL, Deceased, is authorized to execute Releases pursuant to the settlement agreement. IT IS FURTHER ORDERED that the Court approves the litigation costs and a one-third attorney fee pursuant to agreement. IT IS FURTHER ORDERED that the remaining settlement proceeds shall be allocated as allocated on Exhibit A, which was presented to the Court at the hearing on April 28, 2017. IT IS FURTHER ORDERED that zero damages are awarded for conscious pain and suffering. ls! Lita M. Popke Hon: Lita Masini Popke CIRCUIT COURT JUDGE 2