June 11, 2013 in City

Trial begins in wrongful death suit

Cloninger died after kidney stone procedure
By The Spokesman-Review
 

One of the last designs Spokane architect Glen A. Cloninger completed was the entrance to the Memorial Gardens.

Now his body lies under the cemetery structure after a 2010 kidney stone surgery went wrong.

His family’s medical malpractice lawsuit blames anesthesiologist Dr. Kim Chen and Deaconess Hospital for Cloninger’s death. Trial began Monday and could take weeks.

Cloninger’s death in December 2010 occurred after his surgery when Chen removed his breathing tube and his airway collapsed, depriving him of oxygen. When he was revived more than 90 minutes later, Cloninger had suffered brain damage so severe that his family took him off life support four days later.

Chen’s attorney, Dan Keefe, told jurors that Cloninger’s death was “unpredictable and unpreventable.” He said “all the right steps were done” after Cloninger’s breathing tube was removed.

“Aggressive ventilation” was used, including a breathing mask that, until they could get a tube back down his throat, was “just as good as intubation.”

Stephen Haskell, representing Cloninger’s widow, Pamela Cloninger, said Chen had a hard time getting the tube down his patient’s airway – an indicator he would have problems getting the tube out and should have taken extra precautions.

Cloninger, 66, who had three children, was well-known for designing homes and retail buildings, and investing in downtown landmarks. His designs included North Central High School, the Colville Tribe headquarters and the downtown Spokane Club addition, said Haskell.

He was set to have laser surgery for a kidney stone on Dec. 1, 2010 under full anesthesia. Haskell told the jury it took Chen three attempts to intubate Cloninger. That’s considered a “difficult airway,” Haskell said, and as a result, there should have been ample warning that Cloninger’s airway would collapse after the tube was removed. When the airway did collapse and Chen had to put the tube back in, he should have had a scope tool to ease the process readily available, Haskell said. Instead, another doctor had to put in the tube, and Cloninger was deprived of oxygen.

Haskell showed the jury a video of a simulated intubation using the scope. From start to finish, the intubation takes 16 seconds.

“This case is about airway management,” Haskell said.

He also argued that data was fabricated in the hours and days after Cloninger’s surgery. A machine that tracks a patient’s vitals didn’t store any of the data, Haskell said, and Chen made several amendments to his reports.

Keefe contended that Chen’s priority was to take care of his patient, not to chart his movements. Of course there would be some going back and filling in holes, he said. Before that day, Chen had performed more than 8,000 intubation and extubation procedures with no major complications, Keefe said.

Deaconess attorney Brian Rekofke said the heart data machine can collect up to two hours of data but has to be pre-programmed to do so. He said the death was declared a “sentinel event,” which initiates an investigation but does not immediately imply someone was at fault.

Haskell said Cloninger was healthy, with only “minor cardiac problems.” Chen’s defense argued that Cloninger had a severe heart disease that was only discovered on autopsy, and that it contributed to his death.

Haskell said airway obstruction is a fairly common occurrence.

But if problems occur going in, he said, “you should expect problems going out.”

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