Robotic Surgery Failures, Complications Result in Med. Bd. Complaint

A doctor faces charges from the Colorado state medical board following a number of robotic surgery failures and complications experienced following use of the da Vinci Surgical System. 

Dr. Warren Kortz faces 14 counts of unprofessional conduct from the Colorado Medical Board, indicating that he misrepresented the success ratio of robotic surgery procedures, did not offer patients other surgical options and failed to follow the generally accepted standards of medical practice.

In 2010, Porter Adventist Hospital in Denver placed Dr. Kortz on suspension after at least 11 patients experienced problems following robotic kidney surgery. The hospital indicated at that time that Dr. Kortz was suspended from surgical procedures involving the da Vinci robot while he obtained additional training and proctoring.

The da Vinci Surgical System is a complex robot that has been heavily marketed and increasingly used in recent years for a number of surgical procedures to provide a less invasive surgery, which reduces recovery time. The device is controlled by a surgeon looking at a virtual reality representation of the patient’s internal organs and manipulating its four metal arms with hand and foot controls.

The Colorado Medical Board complaint comes amid increased scrutiny and concerns over the da Vinci surgical robot nationwide in recent months. There have been concerns that many surgeons are not adequately trained on use of the da Vinci robot or overuse the device, potentially increasing the risk of serious and life-threatening injuries from a failed robotic surgery procedure.

Robotic Surgical Treatment Problems

According to the complaint filed against Dr. Kortz in the State of Colorado Office of Administrative Courts on April 2, the Colorado Medical Board has requested that an administrative law judge discipline Dr. Kortz’s license to practice medicine in the state.

The complaint outlines cases of treatment between 2008 and 2010 where patients suffered various injuries, including at least one patient who died after suffering a torn aorta and others who had surgical sponges or other instruments left inside of them after the procedure. In some cases, the medical board claims Dr. Kortz failed to document the complications in the patients’ medical records.

According to a report by the Denver Post, Shanti Lechuga is one of the patients outlined in the complaint, and she is now pursuing a medical malpractice lawsuit against Dr. Kortz.

Lachuga suffered injuries while undergoing a procedure to donate a kidney to her brother. According to the medical board’s complaint, Dr. Kortz told her that the da Vinci was the “gold standard” for kidney transplant surgery, even though it was not the standard medical practice for the procedure at the time. The board indicates that Dr. Kortz did not tell her she had other surgical options.

During surgery, Lechuga suffered an injury to her aorta from the da Vinci surgical robot, Dr. Kortz allegedly left a surgical sponge in her body, and had to abort the procedure and use traditional surgery to stop the bleeding.

Lachuga suffered post-operative respiratory distress and also suffered nerve damage, which the board says was due to Kortz failing to correctly pad the operating table. As a result of the failed surgery, her brother had to wait six more months for a kidney from a different donor while undergoing dialysis.

Concerns Over da Vinci Surgery Robot

Since it was introduced in 2000, use of the da Vinci robot-assisted surgical system has increased dramatically throughout the United States amid aggressive marketing and promotions by the manufacturer, Intuitive Surgical.

The da Vinci robot costs between $1 million and $2.25 million for a hospital to purchase, depending on the model. It then costs another $140,000 a year in maintenance and between $1,500 and $2,000 for replacement parts after every surgery.

Many doctors and hospitals have reported feeling pressured to have the device to stay competitive with other facilities that offer it, but they also were then in a position where they were pressured to start using it as often as possible to make up for the costs.

One particular area of concern is that of training. Many health care experts have expressed concern that doctors are not being properly trained in the use of the da Vinci before they begin operating on patients.

Last month, the Massachusetts Board of Registration in Medicine issued an advisory calling for better patient selection criteria and improved training for surgeons conducting robotic surgery.

Earlier this year, the FDA sent a survey to doctors, asking them to detail their experiences and any problems following da Vinci robotic surgery, to outline their training in the use of the device and for information on which surgeries the robot seems most and least suited to perform.

Intuitive Surgical currently faces a number of da Vinci robotic surgery lawsuits filed by patients who allege that problems with the actual machine caused them to suffer internal burns, tears and other injuries. The lawsuits allege that the manufacturer aggressively promoted the da Vinci robot, failed to ensure that doctors were adequately trained and failed to warn about the potential risk of complications.