Former patients challenge oral surgeon’s testimony

Three women treated by Dr. Patrick Collins for jaw problems testified that the Spokane oral surgeon promised to be their “hero” or “savior” – and then turned on them when they reported post-operative pain.

Their testimony Wednesday in the malpractice trial brought by former patient Kimberly Kallestad undercut Collins’ earlier testimony that he likely never claimed to be a “hero” to Kallestad and didn’t say her severe pain was “all in her head.”

But Spokane County Superior Court Judge Michael P. Price strictly limited the new testimony in the trial’s rebuttal stage, and the jury was not allowed to hear the medical specifics of what brought the women to Collins in the first place or how he treated them. Price also allowed only three of eight potential witnesses to testify.

Ella Mae Porter, of Spokane, told the jury Collins began to operate on her in November 2000. Mary Schultz, Kallestad’s attorney, asked her what Collins had said to her that fall before her surgeries.

“He told me he was going to be my hero … (and) I’d think of him as my savior,” the 35-year-old Porter said.

After she reported severe, burning, post-operative pain, “he told me this was highly unusual; he’d not had this experience with any other patient,” she said.

Collins then accused her of “drug-seeking” and said the pain “was all in my head,” Porter said.

Beth Breckner, a 34-year-old Spokane resident, said Collins treated her from 1994 to 2004.

“When you reported pain, what did Dr. Collins say?” Schultz asked.

“Dr. Collins told me a variety of things. He’d appear to be frustrated and agitated when I reported pain. He told me all my surgeries were successful and the pain was ‘in my head.’… He said I was the only one who was unsuccessful,” she said.

Her husband, Chase Breckner, was not allowed to testify that Collins told him there was nothing wrong with his wife.

Jurors in Washington are allowed to submit written questions to witnesses in civil trials. One juror asked why Breckner stayed with Collins for 10 years if she had continuing pain and he appeared frustrated.

“Most doctors wouldn’t touch me after I’d been treated by Dr. Collins,” Breckner said.

Alberta Olson, 53, reported ongoing pain after Collins operated on her jaw.

“What was Dr. Collins’ response?” Schultz asked.

“He said I was a baby. He said that at least three times – I was not just a baby but a big baby,” Olson replied. Responding to a juror’s question, Olson said she didn’t stay long with Collins because of his demeaning attitude.

When asked Monday in cross-examination whether he’d ever called a patient a baby, Collins replied “I’d never say that.”

John Versnel III, Collins’ lawyer, posed no questions to the three women.

Schultz also recalled Kallestad’s mother, Charlene Kallestad, who contradicted Collins’ earlier assertion that he’d ordered vigorous home physical therapy for Kimberly Kallestad after a series of 2001 surgeries. Collins testified that Kallestad didn’t work hard enough on the jaw-stretching exercises and that was a major factor in why her jaw eventually fused shut.

“Did Dr. Collins tell you she needed to work harder on home exercises?” Schultz asked.

“No, never,” Kallestad’s mother replied.

Kallestad’s physicial therapist, John Risse, gave her exercises and “she was determined to be the best patient,” Charlene Kallestad said.

Another defense expert, Dallas oral surgeon Dr. Robert Walker, testified that Collins’ post-operation physical therapy regimen wasn’t aggressive enough. Collins said he didn’t agree with Walker’s personal efforts to get patients to open their jaws immediately after surgery because it was too painful.

Kallestad’s mother also said Collins never told the family the results of an August 2001 CT scan that appeared to show the discs in Kallestad’s jaw joint had dissolved – despite a note in Collins’ office records that the scan had been “discussed” with the patient.

“We didn’t ever find out,” Charlene Kallestad said.

Collins told the family on Sept. 6, 2001, “he’d be putting a metal jaw in Kim’s face and we needed to get going right away,” Charlene Kallestad said. Kimberly Kallestad declined to have the operation and first learned about her dissolved discs after she sought a second opinion with a Colorado specialist, her mother said.

There was also one last attempt this week to rebut Collins’ testimony that Kallestad had been adequately informed about a series of steroid injections starting in 2000. Collins has testified he gave Kallestad four injections in her left jaw and three and a half doses in her right jaw. He said his informed consent was adequate, but has admitted under cross-examination he didn’t inform Kallestad about steroid injections he performed during two operations in 2001.

“What gave you the right to do that?” Schultz asked.

“You just don’t ask (for consent) for everything you do in a procedure,” Collins replied.

Kallestad’s father, insurance agent Dan Kallestad, was recalled Wednesday after he’d spent Tuesday night poring over his daughter’s medical bills and insurance statements from Collins’ surgeries.

The only medical statements that show billings for steroid injections are in September and October 2000, Dan Kallestad said.

“That was the last time the word ‘steroid’ appeared,” he said.

Kimberly began to experience “devastating” changes to her body at the end of 2001 that included growth of hair on the center line of her body and the “disappearance” of her breasts, her mother testified.

Oral surgeon Dr. Daniel Laskin, one of Kallestad’s experts, also testified by phone from Richmond, Va., reiterating his previous testimony that Collins did not meet the standard of care by performing a series of aggressive surgeries on Kallestad. Collins has insisted he’s met the standard of care in the 284 joint surgeries he’s performed in his career.

Laskin, however, said less aggressive procedures should have been attempted first in Kallestad’s case.

“The first rule in surgery is do no harm. … You don’t start out with the most complicated procedure first,” Laskin said.

Closing arguments in the trial are scheduled for today.