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Amanda Cicatello, then 15, was undergoing an appendectomy on March 15, 2008, when the surgeon punctured her aorta, causing her to bleed into her stomach cavity. Surgery to fix the aorta left a scar from her breastbone to below her navel. She remains self-conscious about her body and suffers bouts of depression.
Sunday, Sept. 19, 2010 | 2 a.m.
Do No Harm: Amanda Cicatello
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When Amanda Cicatello was 15, a surgeon accidentally punctured her aorta with a surgical instrument during an operation to remove her appendix. She nearly bled out and died on the operating table.
Do No Harm: Hospital Care in Las Vegas, Part 3
- Patients at risk under the knife
- Routine surgery, harrowing result
- A cry for help
- Doctors avoid discipline
- Colorado transparency unique
- Last drumroll
- How the Sun identified surgical injuries
Share your stories
Amanda Cicatello appears in some ways to be a typical teenager. Her bedroom is whimsically decorated with a zebra-striped bedspread and a stuffed panda. She works at a trendy clothing store and loves to hang out with friends.
Yet when Amanda, 18, describes the nearly three-year ordeal since her aorta was punctured during surgery, she sounds like a woman aged beyond her years.
"It stays with you," she says of the incident that nearly claimed her life. "I'm physically healing, but it takes even longer to emotionally heal."
Amanda and her parents are suing the surgeon, Dr. Charles Walton.
The injury occurred March 15, 2008, when Amanda underwent a laparoscopic appendectomy at St. Rose Dominican Hospitals — San Martin Campus.
Dr. Kenneth Deck, a California physician working as an expert witness for the plaintiffs, said Walton did not properly position an internal camera when he inserted a trocar — a sharp surgical device used to penetrate the abdomen. Deck said that resulted in the injury to the aorta — the body's largest artery, descending from the left ventricle of the heart to the abdomen.
Blood jetted from the wound with every heartbeat.
"I started to bleed out in my stomach cavity," Amanda says.
Walton immediately opened Amanda, then 15, from her breastbone to below her navel and, with the assistance of another surgeon, repaired the wound. Amanda was given multiple blood transfusions.
Walton, who did not comment for this story, said in a deposition that he did not violate acceptable standards of care.
The injury occurred in part because his preferred trocar wasn't on hand, he said in the deposition. He said he requested it, but rather than "waste time waiting" he went ahead with the procedure. Using an unfamiliar trocar, the surgeon pushed too hard, plunging it through one side of Amanda's aorta and out the other.
Walton said he knew Amanda and her family were devastated. The operating-room staff was upset, and he was too, Walton said.
"Not very often do I damage someone," he said, adding that he had apologized for the injury.
Despite suffering the effects of the incident, Amanda describes it with detachment, as if it wasn't her on the operating table.
That detachment quickly dissolves when she discusses the worry her parents felt in the waiting room as what should have been a 45-minute procedure stretched to almost three hours.
Sensing something was wrong, Tom Cicatello, Amanda's father, hunted down a nurse and pressed for details. She acknowledged there had been a complication, but said everything was "fine." Amanda's mother, Nancy, raced to the restroom, where she threw up and collapsed, weeping.
Walton was apologetic, Cicatello says. "I could tell he was distraught and upset. I believe he's probably a decent man and a decent surgeon. But he was obviously negligent."
When they finally saw Amanda, she was in critical condition and breathing with the assistance of a ventilator. A one- to two-day hospital stay was instead 10 days, followed by six weeks of bed rest.
"It was just a nightmare," Cicatello says.
St. Rose officials said they could not speak specifically about the lawsuit, but said the hospital investigates potential adverse events and takes action to ensure the safety of patients. Physician performance is reviewed, and doctors are disciplined if necessary, the hospital said in a statement.
Amanda suffers migraines and anxiety related to the emotional trauma. She gets sick often and is afraid to visit a doctor or go near a hospital.
There are other lingering effects. Like many teenage girls, Amanda is self-conscious about her body. The long scar that spans her abdomen has only made that worse. The few people who have seen it made rude comments, she says. "Did you get a C-section?" one said.
She used to take belly-dancing classes before the surgery but has since quit. She would like to wear a two-piece bathing suit. Her dad even bought her an expensive bikini that "looked cute and still covered my scar," but she says she is too self-conscious to wear it. She avoids the pool.
The family says they understand how important it is for the public to know about the training and track records of physicians who treat them. But they realize there is little public information.
"I completely understand and am sympathetic that people make mistakes and things happen," Amanda says. But "if you're not going to follow procedure and almost kill me and affect my life, then that's when it's not OK. It should be OK for people to see that information."
when will the legislature finally dismantle the medical board???
http://www.medboard.nv.gov/New_MemStaff....
when will the legislature finally dismantle the medical board???
http://www.medboard.nv.gov/New_MemStaff....
I guess one of the drawbacks of the explosion in growth in Las Vegas over the past 2 decades is the rapid increase in the need for services to support it. This increase also has had a down side.
Comment removed by moderator. Comment referred to an earlier comment that has since been removed.
Comment removed by moderator. Comment referred to an earlier comment that has since been removed.
I give someone a compliment and I'm chastised??
@Wdog007:
Well said. Much better than my effort.
Comment removed by moderator. Comment referred to an earlier comment that has since been removed.
@United_727:
I seriously doubt whether Ms. Cicatello considers your post to be a compliment. Cheap bar talk is all it is.
BTW--good story.
Indeed, a young girls self esteem and self image are very delicate. Especially in Vegas. I can't tell you how many girls I know who are otherwise very attractive who want implants or some other work done to their body. Did no one watch Mr. Rogers as a kid?
"You make each day a special day. You know how, by just your being you. There's only one person in this whole world like you. And people can like you exactly as you are."
Good lord its a scar...
How will she feel about herself if lord forbid, she has to have breast removed? She needs to work on her self esteem (her insides not her outsides).
And the c-section comment came from a moron, who doesn't realize the scar is the wrong direction......
From a pure statistical standpoint, some small percentage of medical procedures will go wrong.
Doctors aren't perfect nor are the tools they use. While I agree that there should be liability in the case of gross negligence, we are a society that loves to sue people at the drop of a hat. This is one reason we have such crazy medical costs due to all the insurance required.
This case may have been gross negligence. I certainly can't judge that. But in general, people are looking to sue doctors way too often.
Comment removed by moderator. Personal attack.
Heil Hannity and the gang of sound bite belchers of talk radio and Fox fame cry "tort reform" as a way of fixing the health care system. Of course, they really don't believe it is "broken" because they, along with the inherited wealth crowd that backs these creepo teapot coven groups (Club for Greif, Americans for Prosperity of inherited wealth rich guys, Teabarf Express, Freedumb Works and "Values Voters" [Newt was there at their convention, did GOVO Gibbons the parking Garage Casanova Make it?])get the best health care their money can buy.
(Why did Sherm go to AZ for his medical treatment? They don't do bypasses or prostate surgery in Nevada?)
Defenders of butchers to the rescue, blame the victim time...The scar is what you can see, any internal damage? The fatality rate for appendectomy is low. Did the Good doctor have a golf game, so he didn't want to wait for the right instrument? Selecting the proper tool is important, maybe Lizzie Borden want to do a tonsillectomy with an AX?
I am not defending this doctor. Surgery has risks, puncturing the aorta may be a risk during a laproscopic appendectomy.
Before we "cast stones" we must understand risk. This physician will be judged by others that understand risk and hold him to what should have been reasonable and prudent for that particular situation.
Puncturing the aorta was not an outcome that ANYBODY wanted. Should that act be considered beyond the reasonable risk of the surgery, the attorneys and State Medical Board should be encouraged to take APPROPRIATE action.
I am thankful that the situation was reversed, the outcome could have been much worse.
Comment removed by moderator. Mistating the facts of the story.
To those saying "oh, it's just a scar", you obviously don't remember your "awkward" teenage years. Also, she's 18 now and can dress however she wants. Yes, I am sure she probably realizes she is lucky to be alive. I don't think the point of her telling her story is her scar or lack of self esteem right now, but rather that the doctor didn't want to wait and accidentally or not, she almost died. Maybe her parents could've instilled more self esteem in her, but who are we to say what "enough" is. My mom was extremely supportive and taught us early to be happy as you are, but my sister and I are at 2 very different ends of the "self esteem" spectrum. Also, what some of you missed is that she now suffers anxiety and migraines. As someone who suffers from at least 3 bad migraines a month (and several less severe ones): they are HORRIBLE. I wouldn't wish them on an enemy. You feel like your own body is attacking you and there is no escape. Someone else brought it up: what about any other long term, internal issues she may have going forward?
Amanda: if you are reading this, ignore the negative comments. Focus on feeling better about yourself, not the hate that so many people would rather spew. Know that you are still beautiful and one day, when you feel more comfortable, you'll be able to tell a kick a** story of how you almost died, but lived. Try to embrace your scar as a reminder how fragile life can be.
To cmcconnell: The doctor should be thanked? You mean the doctor that almost killed her should be thanked for then saving her life? If he had waited for his tool, maybe this wouldn't have happened.
I am not bashing the doctor. Even good doctors can make mistakes. But when they make their mistakes, it can change lives. I would like to know why he couldn't wait for his preferred trocar. Was it life or death that he couldn't "waste time waiting"?
is this truly the most evil town in america? chastising a teenager for being self conscious about her body? really? pls just stop commenting if your heart is so cold. pls stop sharing your evil, if you have no empathy, no apathy, pls keep your misery to yourself.
the article is trying to inform, share, and educate. I am truly at a loss for words. Nevada really is at the bottom of education...
*only apathy
Time heals all wounds Amanda. Thank God you survived a nightmare. YOU WILL BE HAPPY AGAIN! I promise. Yodi
I have had surgery four times in Vegas myself, and there has never been a complication.
Actually I think that the quality of medical care here is pretty good.
I hope that the staff of the SUN can still get their medical needs taken care of after this series of articles.
It sounds like the doctor made an honest mistake. The Sun realizes that a mistake does not equal malpractice, right? I've seen malpractice, many times. If this story is accurate as written, it doesn't sound like malpractice.
I've seen cases where a patient was accidentally loaded up with formaldehyde, killed on the spot! Malparactice. Another case where a man gained 30 pounds in a couple of weeks and wasn't spotted as having congestive heart failure even though he saw a doctor and his weight was noted in his chart. He died while driving a bus a week later. He was released by the doctor to go back to work. That's malpractice.
Unless this guy has a history, it was a technical error that he corrected, and feels bad about.If you work in medicine long enough, you will make some mistakes. Hopefully, you don't kill anyone.
I'm sorry this young lady feels self-conscious about her body. She looks quite beautiful to me, and scars are for story-tellin'. She should make up some stuff about Ninja assasins. : )
That said, she and her family deserve some sort of repayment for expenses, trauma, etc. That's what insurance is there for.
When a person rates the quality of care in this state as "pretty good" I don't want anything to do with it!
She looks fine. She'll have no problems in life.
Sun, you're a little happy with the removals. Why don't you explain why you won't let the conversation take the turns it will? That will clear up why this looks like such censorship.
looks like she had a heart surgery on her right hip.
Native, she's 18 and yes, self esteem is very important at that age, especially with the tummy baring shirts the youngsters arre wearing now. As she gets older, she will realize that. For now, she can see if Bio-Oil or Mederma will cause the scar to disappear. I'm sure that if she starts now, by next summer the scar will be significantly reduced.
WOW!!! Two back to back stories about St.Rose hospital and their staff of Doctors and obviously serious or deadly mistakes in the Operating room.
Sevenhills the scar she received from the surgery is not very visible in the picture but I will say I have twos scars on my stomach on from back surgery and on from abdominal surgery and trust me they are extremely visible and it does create a since on insecurity with the way you you look.When I go swimming I wear a shirt to hide the scars and I can only imagine what this girl is going through as we all know women especially young women have a tendency to care more about there looks and how others may look at them.I am still having to wear a brace from my surgery and people stare at me when I am out.Oh well to them but it does happen.I feel sure the doctor did not mean for this to happen but it still did and he should have taken his time and waited for the equipment he had requested.The doctor made it sound as though he is blamming the equipment and this may be the case but if he is not used to using something and he has a life in his hands he should have used better judgement in this case.I feel sorry for the girl and her family go in for a simple procedure as they say and end up messed up.If you notice this is the second article about the same procedure and also same hospital sounds there is an issue with this hospital that needs to be addressed by the hospital administration and even maybe the state.
AdamSun,
You wrote that we seem a bit "happy" with the removals.
Comments are removed when they violate the comments policy that readers agree to when they register.
In a nutshell, the comments should not attack anyone (including the subjects of a story), should be civil, stay on focus, and elevate the discussion.
Pretty simple expectations.
Yes, I agree that no one is perfect and that we all make mistakes. How ever this patients story is only a part in the importance of having "quality" healthcare. If we make a mistake it could cost the patient their life. This patient was lucky to come out with hers.
Healthcare in Nevada is in a downward spiral and I see no end in sight. So many errors are being committed on a daily bases in these hospitals that are never reported. The general public really has no idea what really goes on inside of these hospitals. There needs to be accountabilty on the part of the hospitals for their grossly inadeguate actions on resolving the issues. How many patients need to suffer or die due to budget cuts or the unrealistic views of the management. "First do not harm." I want to thank Marshall allen for bringing these very important issues to the attention of the people. Maybe this will help and be part of the solution on how to save lives that will be lost unnecessarily.
Keep up the good work.
i
The St. Rose Hospitals require a "Time Out" before every procedure. Before the patient is touched, everyone in the room must agree that they are preparing to operate on the right patient, the right site and all necessary equipment is available. That is supposed to prevent a situation like this one in which an operation is already underway before the doctor realizes he doesn't have an essential instrument. In his deposition, Dr. Walton says the sharp trocar he prefers wasn't on the table, so he accepted a blunt trocar that was more difficult to use with this particular patient. It required more pressure to pass the linea alba, which caused it to pop through and pierce the aorta.
This is a good reminder to all busy physicians not to resist procedures designed to enhance patient safety and reduce their own liability.
Where to Nevadan's go for first rate hospital care and surgery,the airport. We were sold a load of crap with Tort Reform and Malpractice limits. Our board of Medical Examiners is controlled by politically connected MD's. Since Tort Reform over the last decade our rate of increase in health care costs leads the nation